Nurse Manager jobs at Tenet Healthcare - 125 jobs

RN DRG Coding Auditor - Remote
Tenet Healthcare Corporation 4.5
Nurse manager job at Tenet Healthcare
The CRC Auditor, conducts coding and documentation quality reviews and generates responses for cases that have been denied by commercial and government payors to ensure hospital inpatient, outpatient, and pro-fee claims, were coded and billed in accordance with nationally recognized coding guidelines, standards, regulations and regulatory requirements, as well as payor and billing guidelines. The responses generated by the Auditor may include system documentation of findings and / or a formal appeal letter. The Auditor will escalate trends to CRC leadership, Conifer Quality & Performance leadership and Conifer Compliance as warranted. The Auditor will perform analysis on clinical documentation, evidenced based criteria application outcome, physician documentation, physician advisor input and complete review of the medical record related to clinical denials. Assures appropriate action is taken within appeal time frames. Communicates identified denial trends and patterns to the CRC leadership. Provides expert application of evidence based medical necessity review criteria tool. Works collaboratively to review, evaluate and improve the denial appeal process. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. * Formulates and submits letters of appeal. Creates an effective appeal utilizing relevant and effective clinical documentation from the medical record; supported by current industry clinical guidelines and coding guidelines, evidence-based medicine, community and national medical management and coding standards and protocols. * Performs reviews of accounts denied for DRG validation and DRG downgrades. * Documents in appropriate denial tracking tool (ACE). Maintains and distributes reports as needed to leadership. * Identifies payment methodology of accounts including Managed Care contract rates, Medicare and State Funded rates, Per-Diems, DRG's, Outlier Payments, and Stop Loss calculations. * Collaborates with Physician Advisors and CRC leadership when documentation-specific areas of concern are identified. * Maintains expertise in clinical areas and current trends in healthcare, inpatient coding and reimbursement methodologies and utilization management specialty areas. KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Effectively organizes work priorities * Demonstrates compliance with departmental safety and security policies and practices * Demonstrates critical thinking, analytical skills, and ability to resolve problems * Demonstrates ability to handle multiple assignments and carry out work independently with minimal supervision * Demonstrates quality proficiency by maintaining accuracy at unit standard key performance indicator goals * Possesses excellent written and verbal communication skills * Detail oriented and ability to work independently and in a team setting * Moderate skills in MS Excel and PowerPoint, MS Office * Ability to research difficult coding and documentation issues and follow through to resolution * Ability to work in a virtual setting under minimal supervision * Ability to conduct research regarding state/federal guidelines and applicable regulatory guidelines related to government audit processes Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings. EDUCATION / EXPERIENCE Includes minimum education, technical training, and/or experience required to perform the job. Education * Minimum Required: * Completion of BSN Degree Program or three years of experience and completion of BSN within five years of employment * RN License in the State of Practice * Current working knowledge of clinical documentation and inpatient coding, discharge planning, utilization management, case management, performance improvement and managed care reimbursement. * Preferred/Desired: * Completion of BSN Degree Program * CCDS certification or inpatient coding certification Experience * Minimum Required: * Three to Five years Clinical RN Experience * Three to Five years of Clinical Documentation Integrity experience * Must have expertise with Interqual and/or MCG Disease Management Ideologies * Strong communication (verbal/written) and interpersonal skills * Knowledge of CMS regulations * Knowledge of inpatient coding guidelines * 1-2 years of current experience with reimbursement methodologies * Preferred/Desired: * Experience preparing appeals for clinical denials related to DRG assignment. * Strong understanding of rules and guidelines, including AHA's Coding Clinics, American Association of Medical Audit Specialists (AAMAS), National Commission on Insurance Guidelines and Medicare Billing Guidelines (CMS), State Funded Billing Regulations (Arizona, California, Nevada) and grievance process; working knowledge of billing codes such as RBRVS, CPT, ICD-10, HCPCS CERTIFICATES, LICENSES, REGISTRATIONS * Required: * RN, * CCDS or other related clinical documentation specialist certification, and/or AHIMA or AAPC Coding Credential CCS, CCA, CIC, CPC or CPMA * Preferred: BSN PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Ability to lift 15-30lbs * Ability to travel approximately 10% of the time; either to client sites, National Insurance Center (NIC) sites, Headquarters, or other designated sites * Ability to sit and work at a computer for a prolonged period of time conducting medical record quality reviews WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Characteristic of typical office environment requiring use of desk, chair, and office equipment such as computer, telephone, printer, etc. OTHER * Interaction with facility HIM and / or physician advisors * Must meet the requirements of the Conifer Telecommuting Policy and Procedure As a part of the Tenet and Catholic Health Initiatives family, Conifer Health brings 30 years of healthcare industry expertise to clients in more than 135 local regions nationwide. We help our clients strengthen their financial and clinical performance, serve their communities and succeed at the business of healthcare. Conifer Health helps organizations transition from volume to value-based care, enhance the consumer and patient healthcare experience and improve quality, cost and access to healthcare. Are you ready to be part of our solutions? Welcome to the company that gives you the resources and incentives to redefine healthcare services, with a competitive benefits package and leadership to take your career to the next step! Compensation and Benefit Information Compensation * Pay: $56,784.00 - $85,176.00 annually. Compensation depends on location, qualifications, and experience. * Management level positions may be eligible for sign-on and relocation bonuses. Benefits Conifer offers the following benefits, subject to employment status: * Medical, dental, vision, disability, life, and business travel insurance * Paid time off (vacation & sick leave) - min of 12 days per year, accrued accrue at a rate of approximately 1.84 hours per 40 hours worked. * 401k with up to 6% employer match * 10 paid holidays per year * Health savings accounts, healthcare & dependent flexible spending accounts * Employee Assistance program, Employee discount program * Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. * For Colorado employees, Conifer offers paid leave in accordance with Colorado's Healthy Families and Workplaces Act. Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program. Follow the link below for additional information. E-Verify: ***************************** The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations. **********
$56.8k-85.2k yearly 60d+ ago

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RN
Brookdale Senior Living 4.2
Westlake, OH jobs
Recognized by Newsweek in 2024 and 2025 as one of America's Greatest Workplaces for Diversity 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. Role is also eligible for team based bonus opportunities. 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. Implement and coordinate the delivery of care in collaboration with physicians and resource health care personnel. Registered Nurses will direct resident care to include making rounds on a timely basis to ensure continuity of care as well as documenting all pertinent information regarding care and observation of residents' overall condition and behavior. RN's utilize the nursing process (assessment, planning, implementation and evaluation) in ensuring overall resident care. RN License is required Brookdale is an equal opportunity employer and a drug-free workplace.
$54k-65k yearly est. 3d ago
Care Manager, LTSS (RN)
Molina Healthcare Inc. 4.4
Columbus, OH jobs
Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Completes comprehensive member assessments within regulated timelines, including in-person home visits as required. * Facilitates comprehensive waiver enrollment and disenrollment processes. * Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals. * Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. * Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care. * Assesses for medical necessity and authorizes all appropriate waiver services. * Evaluates covered benefits and advises appropriately regarding funding sources. * Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration. * Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. * Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns. * Identifies critical incidents and develops prevention plans to assure member health and welfare. * May provide consultation, resources and recommendations to peers as needed. * Care manager RNs may be assigned complex member cases and medication regimens. * Care manager RNs may conduct medication reconciliation as needed. * 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications * At least 2 years experience in health care, including at least 1 year experience in care management, managed care, and/or experience in a medical or behavioral health setting, and at least 1 year of experience working with persons with disabilities, chronic conditions, substance abuse disorders, and long-term services and supports (LTSS), or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in state of practice. * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. * Ability to operate proactively and demonstrate detail-oriented work. * Demonstrated knowledge of community resources. * Ability to work within a variety of settings and adjust style as needed - working with diverse populations and various personalities and personal situations. * Ability to work independently, with minimal supervision and demonstrate self-motivation. * Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. * Ability to develop and maintain professional relationships. * Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. * Excellent problem-solving and critical-thinking skills. * Strong verbal and written communication skills. * Microsoft Office suite/applicable software program(s) proficiency. * In some states, must have at least one year of experience working directly with individuals with substance use disorders. Preferred Qualifications * Certified Case Manager (CCM). * Experience working with populations that receive waiver services. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
$26.4-51.5 hourly 2d ago
Care Manager, LTSS (Must Reside In Idaho)
Molina Healthcare 4.4
Akron, OH jobs
Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties - Completes comprehensive member assessments within regulated timelines, including in-person home visits as required. - Facilitates comprehensive waiver enrollment and disenrollment processes. - Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals. - Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. - Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care. - Assesses for medical necessity and authorizes all appropriate waiver services. - Evaluates covered benefits and advises appropriately regarding funding sources. - Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration. - Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. - Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns. - Identifies critical incidents and develops prevention plans to assure member health and welfare. - Collaborates with licensed care managers/leadership as needed or required. - 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications - At least 2 years health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. -Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. - In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). - Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. - Demonstrated knowledge of community resources. - Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. - Ability to operate proactively and demonstrate detail-oriented work. - Ability to work independently, with minimal supervision and self-motivation. - Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations. - Ability to develop and maintain professional relationships. - Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. - Excellent problem-solving, and critical-thinking skills. - Strong verbal and written communication skills. - Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. - In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). Preferred Qualifications - Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice. - Experience working with populations that receive waiver services. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $24 - $56.17 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
$24-56.2 hourly 34d ago
Care Manager, LTSS (Must Reside In Idaho)
Molina Healthcare Inc. 4.4
Cincinnati, OH jobs
Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Completes comprehensive member assessments within regulated timelines, including in-person home visits as required. * Facilitates comprehensive waiver enrollment and disenrollment processes. * Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals. * Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. * Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care. * Assesses for medical necessity and authorizes all appropriate waiver services. * Evaluates covered benefits and advises appropriately regarding funding sources. * Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration. * Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. * Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns. * Identifies critical incidents and develops prevention plans to assure member health and welfare. * Collaborates with licensed care managers/leadership as needed or required. * 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications * At least 2 years health care experience, including at least 1 year of experience working with persons with disabilities/chronic conditions long-term services and supports (LTSS), and 1 year of experience in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. •Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN). Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. * In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. * Demonstrated knowledge of community resources. * Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. * Ability to operate proactively and demonstrate detail-oriented work. * Ability to work independently, with minimal supervision and self-motivation. * Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations. * Ability to develop and maintain professional relationships. * Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. * Excellent problem-solving, and critical-thinking skills. * Strong verbal and written communication skills. * Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. * In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). Preferred Qualifications * Certified Case Manager (CCM), Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN). License must be active and unrestricted in state of practice. * Experience working with populations that receive waiver services. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $24 - $56.17 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
$24-56.2 hourly 14d ago
Care Manager RN (FIDE-SNP)
Molina Healthcare Inc. 4.4
Columbus, OH jobs
For this position we are seeking a (RN) Registered Nurse who must live and have a current active unrestricted RN license in the state of OH Case Manager RN will work in remote and field setting supporting Medicare and Medicaid l health population. This role will be supporting our FIDE-SNP population, completing face to face assessments, care plans, and providing education and support to our members. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important. Home office with internet connectivity of high speed required. Schedule: Monday thru Friday 8:00AM to 5:00PM Field Travel (Up to 50%) - Union, Delaware, Franklin, Madison, and Pickaway (Columbus OH). (Mileage is reimbursed) JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. * Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. * Conducts telephonic, face-to-face or home visits as required. * Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. * Maintains ongoing member caseload for regular outreach and management. * Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. * Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration. * Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. * Assesses for barriers to care, provides care coordination and assistance to member to address concerns. * May provide consultation, resources and recommendations to peers as needed. * Care manager RNs may be assigned complex member cases and medication regimens. * Care manager RNs may conduct medication reconciliation as needed. * 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications * At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in state of practice. * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. * Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA). * Demonstrated knowledge of community resources. * Ability to operate proactively and demonstrate detail-oriented work. * Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. * Ability to work independently, with minimal supervision and self-motivation. * Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. * Ability to develop and maintain professional relationships. * Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. * Excellent problem-solving, and critical-thinking skills. * Strong verbal and written communication skills. * Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications * Certified Case Manager (CCM). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
$26.4-51.5 hourly 46d ago
Care Manager RN (FIDE-SNP)
Molina Healthcare 4.4
Columbus, OH jobs
For this position we are seeking a (RN) Registered Nurse who must live and have a current active unrestricted RN license in the state of OH Case Manager RN will work in remote and field setting supporting Medicare and Medicaid l health population. This role will be supporting our FIDE-SNP population, completing face to face assessments, care plans, and providing education and support to our members. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important. Home office with internet connectivity of high speed required. Schedule: Monday thru Friday 8:00AM to 5:00PM Field Travel (Up to 50%) - Union, Delaware, Franklin, Madison, and Pickaway (Columbus OH). (Mileage is reimbursed) JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties - Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. - Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. - Conducts telephonic, face-to-face or home visits as required. - Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. - Maintains ongoing member caseload for regular outreach and management. - Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. - Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration. - Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. - Assesses for barriers to care, provides care coordination and assistance to member to address concerns. - May provide consultation, resources and recommendations to peers as needed. - Care manager RNs may be assigned complex member cases and medication regimens. - Care manager RNs may conduct medication reconciliation as needed. - 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications - At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. - Registered Nurse (RN). License must be active and unrestricted in state of practice. - Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. - Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA). - Demonstrated knowledge of community resources. - Ability to operate proactively and demonstrate detail-oriented work. - Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. - Ability to work independently, with minimal supervision and self-motivation. - Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. - Ability to develop and maintain professional relationships. - Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. - Excellent problem-solving, and critical-thinking skills. - Strong verbal and written communication skills. - Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications - Certified Case Manager (CCM). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
$26.4-51.5 hourly 60d+ ago
MGR - NURSING
Universal Health Services 4.4
Willoughby, OH jobs
Responsibilities Windsor Laurelwood Center for Behavioral Medicine is seeking a Nurse Manager! * - $10,000 Sign-on Bonus -- The Nursing Manager, under direction of the CNO: * Develops and manages a mental health or chemical dependency based program of nursing and other clinical services on unit. * Provides overall management and administrative guidance to specifically assigned programs. * Assesses educational and programmatic needs. * Develops policies and collaborates with other health care providers in the provision of services to target populations. It takes passion and dedication to meet the behavioral health needs of our community. For over 100 years, Windsor Laurelwood Center for Behavioral Medicine, located in Willoughby, Ohio, has provided high-quality behavioral health and substance abuse treatment services to adults, adolescents, and children. We provide both inpatient and outpatient programming to meet your healthcare needs. The team at Windsor Laurelwood is dedicated to helping you regain control of your life. Windsor Laurelwood Center for Behavioral Medicine is a part of one of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, our annual revenues were $11.4 billion in 2019. In 2020, UHS was again recognized as one of the World's Most Admired Companies by Fortune; in 2019, ranked #293 on the Fortune 500; and in 2017, listed #275 in Forbes inaugural ranking of America's Top 500 Public Companies. Headquartered in King of Prussia, PA, UHS has more than 90,000 employees and through its subsidiaries operates 26 acute care hospitals, 328 behavioral health facilities, 42 outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 37 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. Qualifications Education/Licensure: Active Ohio RN license, BSN preferred. Experience: Minimum (3) three years clinical experience and/or managerial, supervisory or leadership experience required or a combination of both. Additional Requirements: Trained in Non-violent crisis intervention training and CPR prior to accepting independent assignment or released from orientation. EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success. Notice At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: ************************* or **************.
$76k-94k yearly est. 9d ago
Nursing Manager (RN)
Universal Health Services 4.4
Willoughby, OH jobs
Responsibilities Windsor Laurelwood Center for Behavioral Medicine is seeking a Nurse Manager! * - $10,000 Sign-on Bonus -- The Nursing Manager, under direction of the CNO: * Develops and manages a mental health or chemical dependency based program of nursing and other clinical services on unit. * Provides overall management and administrative guidance to specifically assigned programs. * Assesses educational and programmatic needs. * Develops policies and collaborates with other health care providers in the provision of services to target populations. It takes passion and dedication to meet the behavioral health needs of our community. For over 100 years, Windsor Laurelwood Center for Behavioral Medicine, located in Willoughby, Ohio, has provided high-quality behavioral health and substance abuse treatment services to adults, adolescents, and children. We provide both inpatient and outpatient programming to meet your healthcare needs. The team at Windsor Laurelwood is dedicated to helping you regain control of your life. Windsor Laurelwood Center for Behavioral Medicine is a part of one of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, our annual revenues were $11.4 billion in 2019. In 2020, UHS was again recognized as one of the World's Most Admired Companies by Fortune; in 2019, ranked #293 on the Fortune 500; and in 2017, listed #275 in Forbes inaugural ranking of America's Top 500 Public Companies. Headquartered in King of Prussia, PA, UHS has more than 90,000 employees and through its subsidiaries operates 26 acute care hospitals, 328 behavioral health facilities, 42 outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 37 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. Qualifications Education/Licensure: Active Ohio RN license, BSN preferred. Experience: Minimum (3) three years clinical experience and/or managerial, supervisory or leadership experience required or a combination of both. Additional Requirements: Trained in Non-violent crisis intervention training and CPR prior to accepting independent assignment or released from orientation. EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success. Notice At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: ************************* or **************.
$76k-94k yearly est. 22d ago
Care Manager RN (FIDE-SNP)
Molina Healthcare 4.4
Delaware, OH jobs
For this position we are seeking a (RN) Registered Nurse who must live and have a current active unrestricted RN license in the state of OH Case Manager RN will work in remote and field setting supporting Medicare and Medicaid l health population. This role will be supporting our FIDE-SNP population, completing face to face assessments, care plans, and providing education and support to our members. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important. Home office with internet connectivity of high speed required. Schedule: Monday thru Friday 8:00AM to 5:00PM Field Travel (Up to 50%) - Union, Delaware, Franklin, Madison, and Pickaway (Columbus OH). (Mileage is reimbursed) JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties - Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. - Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. - Conducts telephonic, face-to-face or home visits as required. - Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. - Maintains ongoing member caseload for regular outreach and management. - Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. - Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration. - Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. - Assesses for barriers to care, provides care coordination and assistance to member to address concerns. - May provide consultation, resources and recommendations to peers as needed. - Care manager RNs may be assigned complex member cases and medication regimens. - Care manager RNs may conduct medication reconciliation as needed. - 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications - At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. - Registered Nurse (RN). License must be active and unrestricted in state of practice. - Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. - Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA). - Demonstrated knowledge of community resources. - Ability to operate proactively and demonstrate detail-oriented work. - Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. - Ability to work independently, with minimal supervision and self-motivation. - Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. - Ability to develop and maintain professional relationships. - Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. - Excellent problem-solving, and critical-thinking skills. - Strong verbal and written communication skills. - Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications - Certified Case Manager (CCM). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
$26.4-51.5 hourly 44d ago
Care Manager RN (FIDE-SNP)
Molina Healthcare Inc. 4.4
New Franklin, OH jobs
For this position we are seeking a (RN) Registered Nurse who must live and have a current active unrestricted RN license in the state of OH Case Manager RN will work in remote and field setting supporting Medicare and Medicaid l health population. This role will be supporting our FIDE-SNP population, completing face to face assessments, care plans, and providing education and support to our members. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important. Home office with internet connectivity of high speed required. Schedule: Monday thru Friday 8:00AM to 5:00PM Field Travel (Up to 50%) - Union, Delaware, Franklin, Madison, and Pickaway (Columbus OH). (Mileage is reimbursed) JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. * Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. * Conducts telephonic, face-to-face or home visits as required. * Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. * Maintains ongoing member caseload for regular outreach and management. * Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. * Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration. * Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. * Assesses for barriers to care, provides care coordination and assistance to member to address concerns. * May provide consultation, resources and recommendations to peers as needed. * Care manager RNs may be assigned complex member cases and medication regimens. * Care manager RNs may conduct medication reconciliation as needed. * 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications * At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in state of practice. * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. * Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA). * Demonstrated knowledge of community resources. * Ability to operate proactively and demonstrate detail-oriented work. * Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. * Ability to work independently, with minimal supervision and self-motivation. * Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. * Ability to develop and maintain professional relationships. * Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. * Excellent problem-solving, and critical-thinking skills. * Strong verbal and written communication skills. * Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications * Certified Case Manager (CCM). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
$26.4-51.5 hourly 46d ago
Care Manager RN (FIDE-SNP)
Molina Healthcare 4.4
Ohio jobs
For this position we are seeking a (RN) Registered Nurse who must live and have a current active unrestricted RN license in the state of OH Case Manager RN will work in remote and field setting supporting Medicare and Medicaid l health population. This role will be supporting our FIDE-SNP population, completing face to face assessments, care plans, and providing education and support to our members. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important. Home office with internet connectivity of high speed required. Schedule: Monday thru Friday 8:00AM to 5:00PM Field Travel (Up to 50%) - Union, Delaware, Franklin, Madison, and Pickaway (Columbus OH). (Mileage is reimbursed) JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties - Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. - Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. - Conducts telephonic, face-to-face or home visits as required. - Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. - Maintains ongoing member caseload for regular outreach and management. - Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. - Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration. - Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. - Assesses for barriers to care, provides care coordination and assistance to member to address concerns. - May provide consultation, resources and recommendations to peers as needed. - Care manager RNs may be assigned complex member cases and medication regimens. - Care manager RNs may conduct medication reconciliation as needed. - 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications - At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. - Registered Nurse (RN). License must be active and unrestricted in state of practice. - Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. - Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA). - Demonstrated knowledge of community resources. - Ability to operate proactively and demonstrate detail-oriented work. - Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. - Ability to work independently, with minimal supervision and self-motivation. - Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. - Ability to develop and maintain professional relationships. - Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. - Excellent problem-solving, and critical-thinking skills. - Strong verbal and written communication skills. - Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications - Certified Case Manager (CCM). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
$26.4-51.5 hourly 44d ago
Care Manager RN (FIDE-SNP)
Molina Healthcare Inc. 4.4
North Madison, OH jobs
For this position we are seeking a (RN) Registered Nurse who must live and have a current active unrestricted RN license in the state of OH Case Manager RN will work in remote and field setting supporting Medicare and Medicaid l health population. This role will be supporting our FIDE-SNP population, completing face to face assessments, care plans, and providing education and support to our members. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important. Home office with internet connectivity of high speed required. Schedule: Monday thru Friday 8:00AM to 5:00PM Field Travel (Up to 50%) - Union, Delaware, Franklin, Madison, and Pickaway (Columbus OH). (Mileage is reimbursed) JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. * Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. * Conducts telephonic, face-to-face or home visits as required. * Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. * Maintains ongoing member caseload for regular outreach and management. * Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. * Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration. * Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. * Assesses for barriers to care, provides care coordination and assistance to member to address concerns. * May provide consultation, resources and recommendations to peers as needed. * Care manager RNs may be assigned complex member cases and medication regimens. * Care manager RNs may conduct medication reconciliation as needed. * 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications * At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in state of practice. * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. * Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA). * Demonstrated knowledge of community resources. * Ability to operate proactively and demonstrate detail-oriented work. * Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. * Ability to work independently, with minimal supervision and self-motivation. * Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. * Ability to develop and maintain professional relationships. * Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. * Excellent problem-solving, and critical-thinking skills. * Strong verbal and written communication skills. * Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications * Certified Case Manager (CCM). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
$26.4-51.5 hourly 46d ago
Care Manager RN (FIDE-SNP)
Molina Healthcare 4.4
North Madison, OH jobs
For this position we are seeking a (RN) Registered Nurse who must live and have a current active unrestricted RN license in the state of OH Case Manager RN will work in remote and field setting supporting Medicare and Medicaid l health population. This role will be supporting our FIDE-SNP population, completing face to face assessments, care plans, and providing education and support to our members. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important. Home office with internet connectivity of high speed required. Schedule: Monday thru Friday 8:00AM to 5:00PM Field Travel (Up to 50%) - Union, Delaware, Franklin, Madison, and Pickaway (Columbus OH). (Mileage is reimbursed) JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties - Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. - Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. - Conducts telephonic, face-to-face or home visits as required. - Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. - Maintains ongoing member caseload for regular outreach and management. - Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. - Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration. - Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. - Assesses for barriers to care, provides care coordination and assistance to member to address concerns. - May provide consultation, resources and recommendations to peers as needed. - Care manager RNs may be assigned complex member cases and medication regimens. - Care manager RNs may conduct medication reconciliation as needed. - 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications - At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. - Registered Nurse (RN). License must be active and unrestricted in state of practice. - Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. - Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA). - Demonstrated knowledge of community resources. - Ability to operate proactively and demonstrate detail-oriented work. - Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. - Ability to work independently, with minimal supervision and self-motivation. - Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. - Ability to develop and maintain professional relationships. - Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. - Excellent problem-solving, and critical-thinking skills. - Strong verbal and written communication skills. - Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications - Certified Case Manager (CCM). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
$26.4-51.5 hourly 44d ago
Care Manager RN (FIDE-SNP)
Molina Healthcare Inc. 4.4
Union, OH jobs
For this position we are seeking a (RN) Registered Nurse who must live and have a current active unrestricted RN license in the state of OH Case Manager RN will work in remote and field setting supporting Medicare and Medicaid l health population. This role will be supporting our FIDE-SNP population, completing face to face assessments, care plans, and providing education and support to our members. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important. Home office with internet connectivity of high speed required. Schedule: Monday thru Friday 8:00AM to 5:00PM Field Travel (Up to 50%) - Union, Delaware, Franklin, Madison, and Pickaway (Columbus OH). (Mileage is reimbursed) JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. * Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. * Conducts telephonic, face-to-face or home visits as required. * Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. * Maintains ongoing member caseload for regular outreach and management. * Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. * Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration. * Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. * Assesses for barriers to care, provides care coordination and assistance to member to address concerns. * May provide consultation, resources and recommendations to peers as needed. * Care manager RNs may be assigned complex member cases and medication regimens. * Care manager RNs may conduct medication reconciliation as needed. * 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications * At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in state of practice. * Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. * Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA). * Demonstrated knowledge of community resources. * Ability to operate proactively and demonstrate detail-oriented work. * Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. * Ability to work independently, with minimal supervision and self-motivation. * Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. * Ability to develop and maintain professional relationships. * Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. * Excellent problem-solving, and critical-thinking skills. * Strong verbal and written communication skills. * Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications * Certified Case Manager (CCM). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 / HOURLY * Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. About Us Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
$26.4-51.5 hourly 46d ago
Care Manager RN (FIDE-SNP)
Molina Healthcare 4.4
Union, OH jobs
For this position we are seeking a (RN) Registered Nurse who must live and have a current active unrestricted RN license in the state of OH Case Manager RN will work in remote and field setting supporting Medicare and Medicaid l health population. This role will be supporting our FIDE-SNP population, completing face to face assessments, care plans, and providing education and support to our members. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important. Home office with internet connectivity of high speed required. Schedule: Monday thru Friday 8:00AM to 5:00PM Field Travel (Up to 50%) - Union, Delaware, Franklin, Madison, and Pickaway (Columbus OH). (Mileage is reimbursed) JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties - Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. - Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. - Conducts telephonic, face-to-face or home visits as required. - Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. - Maintains ongoing member caseload for regular outreach and management. - Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. - Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration. - Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. - Assesses for barriers to care, provides care coordination and assistance to member to address concerns. - May provide consultation, resources and recommendations to peers as needed. - Care manager RNs may be assigned complex member cases and medication regimens. - Care manager RNs may conduct medication reconciliation as needed. - 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications - At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. - Registered Nurse (RN). License must be active and unrestricted in state of practice. - Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. - Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA). - Demonstrated knowledge of community resources. - Ability to operate proactively and demonstrate detail-oriented work. - Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. - Ability to work independently, with minimal supervision and self-motivation. - Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. - Ability to develop and maintain professional relationships. - Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. - Excellent problem-solving, and critical-thinking skills. - Strong verbal and written communication skills. - Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications - Certified Case Manager (CCM). To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $26.41 - $51.49 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
$26.4-51.5 hourly 44d ago
Behavioral Health Nursing Supervisor - Nights
Kindred Healthcare 4.1
Dayton, OH jobs
Behavioral Health Nursing Supervisor - Nights (Job Number: 550147) Description At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates. Job Summary The Nursing Supervisor functions under the direction of the Chief Nursing Officer and assumes responsibility for the Nursing Department as assigned. The Nursing Supervisor is the leader in charge when administration is out of the building. The Nurse Supervisor is responsible for implementing nursing goals and objectives based on budget parameters. Supervises nursing staff, assesses patient's needs, and provides nursing care of patients. Plans and organizes training for unit staff members and participates in guidance and educations programs. Essential Functions Participates in hiring, training, supervision and evaluates designated nursing staff as assigned. Assigns duties and coordinates nursing services as assigned. Participates in developing nursing protocol and procedures. Provides continuing education and staff development opportunities for nursing staff. Assesses patient needs. Participates in providing nursing care, ensures services are carried out and documented appropriately. Maintains patient health care records. Maintain supply inventory records. Orders supplies and equipment, as necessary. Promotes adherence to the Corporate Compliance Agreement by monitoring employee performance and identifying and responding to compliance issues. ScionHealth has a comprehensive benefits package that includes Medical, Dental, Vision, 401(k), FSA/HSA, Life Insurance, Paid Time Off, and Wellness. Knowledge/Skills/Abilities/Expectations Supervisory skills and ability to evaluate job performance. Ability to make decisions and accept responsibility for work unit. Time management skills and ability to organize priorities. Ability to maintain confidentiality of all patients and/or employee information to assure patient and /or employee rights are protected. Approximate percent of time required to travel: None Must read, write and speak fluent English. Must have good and regular attendance. Performs other related duties as assigned Qualifications Education Degree from accredited school of nursing. BSN preferred. Licenses/Certification Valid state Registered Nurse license. Experience 3-5 years of nursing experience in a behavioral health hospital environment. 1-2 years supervisory / leadership experience. Job: Behavior/Mental HealthPrimary Location: OH-Dayton-Kindred Dayton BHUOrganization: 4020 - Kindred Dayton BHUShift: Night
$68k-82k yearly est. Auto-Apply 15d ago
Field Nurse Case Manager - Grove City, OH
Unitedhealth Group 4.6
Columbus, OH jobs
Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere. As a team member of our Optum At Home product, together with an interdisciplinary care team we help patients navigate the health care system, and connect them to key support services. This preventive care can help patients stay well at home. We're connecting care to create a seamless health journey for patients across care settings. Join us to start **Caring. Connecting. Growing together.** Registered Nurses in the Optum at Home program work with patients primarily in their home setting. They perform as part of a care team including a Nurse Practitioner, Behavioral Health Advocate, Care Navigator and other supporting team members. They deliver role appropriate patient care through in-home visits, telephonic outreach and consultations, and interdisciplinary team activities. The Field Case Manager RN may perform care and counsel of the ill, injured, or infirm, in the promotion and maintenance of health with individuals, groups, or both throughout the life span. They help to manage health problems and coordinate health care for the Optum at Home patients in accordance with State and Federal rules and regulations and the nursing standards of care. This includes (but is not limited to) assessment of health status, development and implementation of plan of care, and ongoing evaluation of patient status and response to the plan of care. Clinical management is conducted in collaboration with other care team members. **Primary Responsibilities:** + Reports to RN Manager + Assess the health status of members as within the scope of licensure and with the frequency established in the model of care + Establish goals to meet identified health care needs + Plan, implement and evaluate responses to the plan of care + Work collaboratively the multidisciplinary team to engage resources and strategies to address medical, functional, and social barriers to care + Works closely with mental health clinicians to help bridge the gap between mental and physical health + Consult with the patient's PCP, specialists, or other health care professionals as appropriate + Assess patient needs for community resources and make appropriate referrals for service + Facilitate the patient's transition within and between health care settings in collaboration with the primary care physician and other treating physicians + Completely and accurately document in patient's electronic medical record + Provide patients and family members with counseling and education regarding health maintenance, disease prevention, condition trajectory and need for follow up as appropriate during each patient visit + Verify and document patient and/or family understanding of condition, plan of care and follow up recommendations + Actively participate in organizational quality initiatives + Participate in collaborative multidisciplinary team meetings to optimize clinical integration, efficiency, and effectiveness of care delivery + Maintain credentials essential for practice, to include licensure, certification (if applicable) and CEUs + Demonstrate a commitment to the mission, core values and goals of UnitedHealthcare and its healthcare delivery including the ability to integrate values of compassion, integrity, performance, innovation and relationships in the care provided to our member 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. Years of post-high school education can be substituted/is equivalent to years of experience. **Required Qualifications:** + Current unrestricted licensure as RN in Ohio + 2+ years of relevant experience + Experience in assessing the medical needs of patients with complex behavioral, social and/or functional needs + Demonstrated ability to work with diverse care teams in a variety of settings including non-clinical settings (primarily patient homes) + Proven solid computer skills, including use of electronic medical records + Ability to travel 100% of the time for field-based work within 60 miles of residence + Valid driver's license + Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area **Preferred Qualification:** + Field based experience + Case management experience + Proven effective time management and communication skills 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 salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. _OptumCare 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._ _OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
$58.8k-105k yearly 22d ago
Field Nurse Case Manager - Grove City, OH
Unitedhealth Group 4.6
Grove City, OH jobs
Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere. As a team member of our Optum At Home product, together with an interdisciplinary care team we help patients navigate the health care system, and connect them to key support services. This preventive care can help patients stay well at home. We're connecting care to create a seamless health journey for patients across care settings. Join us to start **Caring. Connecting. Growing together.** Registered Nurses in the Optum at Home program work with patients primarily in their home setting. They perform as part of a care team including a Nurse Practitioner, Behavioral Health Advocate, Care Navigator and other supporting team members. They deliver role appropriate patient care through in-home visits, telephonic outreach and consultations, and interdisciplinary team activities. The Field Case Manager RN may perform care and counsel of the ill, injured, or infirm, in the promotion and maintenance of health with individuals, groups, or both throughout the life span. They help to manage health problems and coordinate health care for the Optum at Home patients in accordance with State and Federal rules and regulations and the nursing standards of care. This includes (but is not limited to) assessment of health status, development and implementation of plan of care, and ongoing evaluation of patient status and response to the plan of care. Clinical management is conducted in collaboration with other care team members. **Primary Responsibilities:** + Reports to RN Manager + Assess the health status of members as within the scope of licensure and with the frequency established in the model of care + Establish goals to meet identified health care needs + Plan, implement and evaluate responses to the plan of care + Work collaboratively the multidisciplinary team to engage resources and strategies to address medical, functional, and social barriers to care + Works closely with mental health clinicians to help bridge the gap between mental and physical health + Consult with the patient's PCP, specialists, or other health care professionals as appropriate + Assess patient needs for community resources and make appropriate referrals for service + Facilitate the patient's transition within and between health care settings in collaboration with the primary care physician and other treating physicians + Completely and accurately document in patient's electronic medical record + Provide patients and family members with counseling and education regarding health maintenance, disease prevention, condition trajectory and need for follow up as appropriate during each patient visit + Verify and document patient and/or family understanding of condition, plan of care and follow up recommendations + Actively participate in organizational quality initiatives + Participate in collaborative multidisciplinary team meetings to optimize clinical integration, efficiency, and effectiveness of care delivery + Maintain credentials essential for practice, to include licensure, certification (if applicable) and CEUs + Demonstrate a commitment to the mission, core values and goals of UnitedHealthcare and its healthcare delivery including the ability to integrate values of compassion, integrity, performance, innovation and relationships in the care provided to our member 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. Years of post-high school education can be substituted/is equivalent to years of experience. **Required Qualifications:** + Current unrestricted licensure as RN in Ohio + 2+ years of relevant experience + Experience in assessing the medical needs of patients with complex behavioral, social and/or functional needs + Demonstrated ability to work with diverse care teams in a variety of settings including non-clinical settings (primarily patient homes) + Proven solid computer skills, including use of electronic medical records + Ability to travel 100% of the time for field-based work within 60 miles of residence + Valid driver's license + Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area **Preferred Qualification:** + Field based experience + Case management experience + Proven effective time management and communication skills 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 salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. _OptumCare 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._ _OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
$58.8k-105k yearly 53d ago
Registered Nurse (RN)
Tenet Healthcare 4.5
Nurse manager job at Tenet Healthcare
Responsible for patient triage, patient education, and assisting physicians in the assessment of patient needs and treatment plan(s). Maintain chart documentation to ensure all information about patient is completed and documented correctly. Education: High School Diploma or equivalent and completion of an accredited nursing program. Experience: 2 years of clinical in a physician office. Certification: Current State RN license and CPR certification. #LI-RF1
$25k-76k yearly est. Auto-Apply 22d ago