TRA RN and Allied specialties Travel and Local Contracts
Psychiatric registered nurse job at Tenet Healthcare
This is a general application which is applicable across all TRA locations and, all RN and Allied Travel and Local contracts. When you receive your offer letter, it will be customized for the specific position you are hired into.
With TRA, you will receive greater contract security than with outside agencies while accessing exciting travel and local contracts across the nation.
Why Choose TRA?
Guaranteed Hours for Travel Contracts
Preferred Booking Agreement for Local Contracts
Company Matching funds for the 401K
Holiday Pay
TRA is preferred for all contract assignments within Tenet while receiving the same tenure as Tenet staff.
Location: This is a general application link and, you can be hired into any specific position that fits with what location you are looking to be hired into. As mentioned above, your offer letter will be customized and specific for the position you and your Recruiter speak about.
Auto-ApplyRN CRC Coding Auditor - Remote
Psychiatric registered nurse 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.
**********
Registered Nurse (RN), Behavioral Health
Columbus, OH jobs
Registered Nurse Job Type: Full Time Shift: Days/Nights 36 hour weeks (12 hour shift 7 - 7:30) $10,000.00 sign-on bonus Columbus Springs East is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Registered Nurse joining our team, you're embracing a vital mission dedicated to making communities healthier . Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.
How you'll contribute:
You'll make an impact by utilizing your specialized plan-of-care intervention and serving as a patient-care innovator. You will shape exceptional patient journeys every day and leverage your skills and our cutting-edge technology to directly impact patient wellbeing.
* Accurately performs patient assessments and identifies patient needs
* Identifies and initiates appropriate nursing interventions
* Provides care appropriate to condition and age of the patient
* Performs timely and appropriate documentation relating to medical necessity in the medical record
* Responsible for completion and revision of the Interdisciplinary Care Plan for each patient
* Performs timely and accurate QI assessments
Why Join Us:
* Health (Medical, Dental, Vision) and 401K Benefits
* Flexible spending and health savings accounts
* Competitive Paid Time Off
* Employee Assistance Program - mental, physical, and financial wellness assistance
* Free Parking
* Tuition Reimbursement/Assistance for qualified applicants
* Membership discounts with local gyms and community businesses
* Working with a highly engaged staff
* Healthy staffing levels
* Flexible scheduling
* Career growth
What we are looking for:
Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.
* Associate's degree in nursing required.
* Current Registered Nurse license as required by state regulations in which the facility operates.
* 1-year experience in a psychiatric health care facility preferred.
* CPR certification is required within 30 days of employment and prior to any patient contact.
* De-escalation certification required within 30 days of employment and prior to any patient contact.
Connect with a Recruiter: Not ready to complete an application, or have questions? Please contact Cyndi by email: *****************************
More about Columbus Springs East:
Columbus Springs East is a 72-bed behavioral health hospital located in Columbus, OH. We provide high-quality compassionate care for those facing mental health and addiction challenges. Programs include 24/7 crisis care and assessment, inpatient mental health and addiction treatment, Patrial Hospitalization Programs (PHP) and Intensive Outpatient Programs (IOP) for adults age 18+.
EEOC Statement:
Columbus Springs East is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans' status or any other basis protected by applicable federal, state or local law.
Apply today!
Join us in delivering high-quality care.
Easy ApplyRegistered Nurse (RN), Behavioral Health
Dublin, OH jobs
Registered Nurse Job Type: Full Time/Parttime Shift: Days/Nights 36 hour weeks (12 hour shift 7 - 7:30) Dublin Springs is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Registered Nurse joining our team, you're embracing a vital mission dedicated to making communities healthier . Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.
How you'll contribute:
You'll make an impact by utilizing your specialized plan-of-care intervention and serving as a patient-care innovator. You will shape exceptional patient journeys every day and leverage your skills and our cutting-edge technology to directly impact patient wellbeing.
* Accurately performs patient assessments and identifies patient needs
* Identifies and initiates appropriate nursing interventions
* Provides care appropriate to condition and age of the patient
* Performs timely and appropriate documentation relating to medical necessity in the medical record
* Responsible for completion and revision of the Interdisciplinary Care Plan for each patient
* Performs timely and accurate QI assessments
Why Join Us:
* Health (Medical, Dental, Vision) and 401K Benefits
* Flexible spending and health savings accounts
* Competitive Paid Time Off
* Employee Assistance Program - mental, physical, and financial wellness assistance
* Free Parking
* Tuition Reimbursement/Assistance for qualified applicants
* Membership discounts with local gyms and community businesses
* Working with a highly engaged staff
* Healthy staffing levels
* Flexible scheduling
* Career growth
What we are looking for:
Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.
* Associate's degree in nursing required.
* Current Registered Nurse license as required by state regulations in which the facility operates.
* 1-year experience in a psychiatric health care facility preferred.
* CPR certification is required within 30 days of employment and prior to any patient contact.
* De-escalation certification required within 30 days of employment and prior to any patient contact.
Connect with a Recruiter: Not ready to complete an application, or have questions? Please contact Cyndi by email: *****************************
More about Dublin Springs:
Dublin Springs is a 72-bed behavioral health hospital located in Dublin, OH. We provide high-quality compassionate care for those facing mental health and addiction challenges. Programs include 24/7 crisis care and assessment, inpatient mental health and addiction treatment, Patrial Hospitalization Programs (PHP) and Intensive Outpatient Programs (IOP) for adults age 18+.
EEOC Statement:
Dublin Springs is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans' status or any other basis protected by applicable federal, state or local law.
Apply today!
Join us in delivering high-quality care.
Easy ApplyRN Assessment Specialist, Behavioral Health
Dublin, OH jobs
Full-time, day shift (7am-7pm) Mondays, Tuesdays, Fridays, and Sundays available Your experience matters Columbus Springs Dublin is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As an Assessment Specialist joining our team, you're embracing a vital mission dedicated to making communities healthier . Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.
How you'll contribute
An Assessment Specialist who excels in this role:
* Facilitates response to a request for services, including the initial response, the assessment, and referral process, the designation of the appropriate level of care, admission into services, and appropriate follow up activity.
* Conducts initial evaluation, initiates the assessment, documents patient symptomology, functioning, and needs and provides information to MD for LOC determination.
* Demonstrates excellent customer service skills in assisting patients, physicians, visitors, and coworkers in a prompt and courteous manner.
* Possess clear knowledge of Emergency Detention paperwork and processes and EMTALA.
* Other duties as assigned.
Why join us
We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers:
* Comprehensive Benefits: Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
* Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.
* Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
* Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
* Professional Development: Ongoing learning and career advancement opportunities.
What we're looking for
Applicants should have an associate's degree in nursing and an RN license in the state of OH. Additional requirements include:
* Prior experience in a psychiatric healthcare facility working with adult and geriatric patients preferred.
* Must have strong clinical assessment skills.
* CPR and CPI certified within 30 days.
More about Columbus Springs Dublin
Columbus Springs Dublin is a 72-bed behavioral health hospital that has been offering exceptional care to the Columbus community for over 7 years. We are proud to be Accredited by The Joint Commission.
EEOC Statement
"Columbus Springs Dublin is an Equal Opportunity Employer. Columbus Springs Dublin is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment."
Registered Nurse (RN), Behavioral Health
Olde West Chester, OH jobs
Registered Nurse Job Type: Fulltime/part time Beckett Springs is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Registered Nurse joining our team, you're embracing a vital mission dedicated to making communities healthier . Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.
How you'll contribute:
You'll make an impact by utilizing your specialized plan-of-care intervention and serving as a patient-care innovator. You will shape exceptional patient journeys every day and leverage your skills and our cutting-edge technology to directly impact patient wellbeing.
* Accurately performs patient assessments and identifies patient needs
* Identifies and initiates appropriate nursing interventions
* Provides care appropriate to condition and age of the patient
* Performs timely and appropriate documentation relating to medical necessity in the medical record
* Responsible for completion and revision of the Interdisciplinary Care Plan for each patient
* Performs timely and accurate QI assessments
Why Join Us:
* Health (Medical, Dental, Vision) and 401K Benefits
* Flexible spending and health savings accounts
* Competitive Paid Time Off
* Employee Assistance Program - mental, physical, and financial wellness assistance
* Free Parking
* Tuition Reimbursement/Assistance for qualified applicants
* Membership discounts with local gyms and community businesses
* Working with highly engaged staff
* Healthy staffing levels
* Flexible scheduling
* Career growth
What we are looking for:
Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.
* Associate's degree in nursing required.
* Current Registered Nurse license as required by state regulations in which the facility operates.
* 1-year experience in a psychiatric health care facility preferred.
* CPR certification is required within 30 days of employment and prior to any patient contact.
* De-escalation certification required within 30 days of employment and prior to any patient contact.
Connect with a Recruiter: Not ready to complete an application, or have questions? Please contact Cyndi by email: *****************************
More about Columbus Springs Dublin:
Beckett Springs is a 96-bed behavioral health hospital located in the Dayton, OH area. We provide high-quality compassionate care for those facing mental health and addiction challenges. Programs include 24/7 crisis care and assessment, inpatient mental health and addiction treatment, Patrial Hospitalization Programs (PHP) and Intensive Outpatient Programs (IOP) for adults age 18+.
EEOC Statement:
Beckett Springs is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans' status or any other basis protected by applicable federal, state or local law.
Apply today!
Join us in delivering high-quality care.
Easy ApplyLicensed Vocational Nurse/LVN - Heart & Vascular Specialists Clinic - Full-Time, Days
Remote
Licensed Vocational Nurse/LVN - Heart & Vascular Specialists Clinic - Full-Time, Days - (25011364) Description Licensed Vocational Nurse/LVN - Heart & Vascular Specialists Clinic - Full-Time, DaysBring your passion to Texas Health so we are Better + Together Work location: Alliance - 10840 Texas Health Trail, Alliance/Keller, TX 76244Work hours: Full-time, 40 hours weekly, Monday thru Friday, 8:00am - 5:00pmTravel: 25% to surrounding clinics as needed (mileage reimbursement provided) Heart & Vascular Specialists Clinic Highlights:Strong teamwork and collaboration Fast-paced, high volume inbound/outbound calls Compassion and empathy to our patients and the TeamJoin an innovative team working towards making healthcare more accessible, integrated, and reliable Qualifications Here's What You NeedLVN - Licensed Vocational Nurse Upon Hire (required) Accredited School of Practical Nursing Program (required)6 months LVN experience (strongly preferred)1 year LVN experience (preferred) Proficient IV insertion and ECG rhythms experience (strongly preferred) ACLS or BCLS (required upon hire) Knowledge of basic nursing processes and understanding of healthcare technology, equipment, and supplies Knowledge of state law on nursing care, nurse practice guidelines, and clinic policies and procedures Ability to effectively communicate to staff and patients Demonstrate sound judgment and composure Ability to take appropriate action in questionable or emergency situations Maintain a positive, caring attitude towards staff and patients Possess a strong work ethic and a high level of professionalism Efficient time management skills What You Will DoDelivers care to patients utilizing the LVN ProcessPerforms basic nursing care for patients by following established standards and procedures.
May perform specific nursing care as it relates to specialty of the practice.
Collects patient data such as vital signs, notes how the patient looks and acts or responds to stimuli and reports this information accordingly.
Prepares and administers injections, performs routine tests, treats wounds and changes bandages.
10%Prepares patient records and files using established medical record forms/automated systems and documentation practices.
Administers certain prescribed medications and monitors and documents treatment progress and patient response.
Participates in the implementation and evaluation of patient care based on practice guidelines, standards of care, and federal/state laws and regulations.
Monitors and documents treatment progress and patient response.
Conveys information to patients and families about health status, health maintenance, and management of acute and chronic conditions.
Participates in teams to improve patient care processes and outcomes.
Performs other duties as assigned.
Additional perks of being a Texas Health employee Benefits include 401k, PTO, medical, dental, Paid Parental Leave, flex spending, tuition reimbursement, Student Loan Repayment Program as well as several other benefits.
Delivery of high quality of patient care through nursing education, nursing research and innovations in nursing practice.
Strong Unit Based Council (UBC).
A supportive, team environment with outstanding opportunities for growth.
Learn more about our culture, benefits, and recent awards.
Entity Highlights:Texas Health Physicians Group includes more than 1,000 physicians, nurse practitioners and physician assistants dedicated to providing quality, patient-safe care at more than 240 offices located throughout the DFW Metroplex.
THPG members are active in group governance and serve on multiple committees and councils.
Ongoing Texas Health initiatives, like the Diversity Action Council and Living the Promise, have helped to create an inclusive, supportive, people-first, excellence-driven culture and workplace, making THPG a great place to work.
If you're ready to join us in our mission to improve the health of our community, then let's show the world how we're even better together! Do you still have questions or concerns? Feel free to email your questions to recruitment@texashealth.
org.
#LI-CT1 Primary Location: AllianceOther Locations: Pecan Acres, Decatur, Dish, Northlake, Highland Village, Krum, Newark, Argyle, Haslet, Saginaw, Copper Canyon, Blue Mound, Rhome, Denton, Corral City, Flower Mound, Justin, Trophy Club, Roanoke, Westlake, Watauga, KellerJob: LVNOrganization: Texas Health Physicians Group 9250 Amberton Parkway TX 75243Travel: Yes, 25 % of the TimeJob Posting: Nov 3, 2025, 5:43:32 AMShift: Day JobEmployee Status: RegularJob Type: StandardSchedule: Full-time
Auto-ApplyRegistered Nurse (RN), Behavioral Health
Highland Hills, OH jobs
Registered Nurse Job Type: Full Time Shift: Days 36 hour weeks (12 hour shift 11 am - 11 pm) We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Registered Nurse (RN) joining our team, you're embracing our promise to provide superior patient care that exceeds industry standards as well as patient expectations. Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve
What you will do in this role:
You'll make an impact by utilizing your specialized plan-of-care intervention and serving as a patient-care innovator. You will shape exceptional patient journeys every day and leverage your skills and our cutting-edge technology to directly impact patient wellbeing.
* Accurately performs patient assessments and identifies patient needs
* Identifies and initiates appropriate nursing interventions
* Provides care appropriate to condition and age of the patient
* Performs timely and appropriate documentation relating to medical necessity in the medical record
* Responsible for completion and revision of the Interdisciplinary Care Plan for each patient
* Performs timely and accurate QI assessments
Why Choose Us:
* Health (Medical, Dental, Vision) and 401K Benefits
* Flexible spending and health savings accounts
* Competitive Paid Time Off
* Employee Assistance Program - mental, physical, and financial wellness assistance
* Free Parking
* Tuition Reimbursement/Assistance for qualified applicants
* Membership discounts with local gyms and community businesses
* Working with highly engaged staff
* Healthy staffing levels
* Flexible scheduling
* Career growth
Qualifications:
Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.
* Associate's degree in nursing required.
* Current Registered Nurse license as required by state regulations in which the facility operates.
* 1-year experience in a psychiatric health care facility preferred.
* CPR certification is required within 30 days of employment and prior to any patient contact.
* De-escalation certification required within 30 days of employment and prior to any patient contact.
Connect with a Recruiter:
Not ready to complete an application, or have questions? Please contact Cyndi Hayes by emailing: *****************************
EEOC Statement:
Highland Springs is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans' status or any other basis protected by applicable federal, state or local law.
Easy ApplyRegistered Nurse (RN), Behavioral Health
Highland Hills, OH jobs
Registered Nurse Job Type: Full Time Shift: Days 40 hours no weekends (3 pm - 11:30 pm) Highland Springs is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Registered Nurse joining our team, you're embracing a vital mission dedicated to making communities healthier . Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.
How you'll contribute:
You'll make an impact by utilizing your specialized plan-of-care intervention and serving as a patient-care innovator. You will shape exceptional patient journeys every day and leverage your skills and our cutting-edge technology to directly impact patient wellbeing.
* Accurately performs patient assessments and identifies patient needs
* Identifies and initiates appropriate nursing interventions
* Provides care appropriate to condition and age of the patient
* Performs timely and appropriate documentation relating to medical necessity in the medical record
* Responsible for completion and revision of the Interdisciplinary Care Plan for each patient
* Performs timely and accurate QI assessments
Why Join Us:
* Health (Medical, Dental, Vision) and 401K Benefits
* Flexible spending and health savings accounts
* Competitive Paid Time Off
* Employee Assistance Program - mental, physical, and financial wellness assistance
* Free Parking
* Tuition Reimbursement/Assistance for qualified applicants
* Membership discounts with local gyms and community businesses
* Working with a highly engaged staff
* Healthy staffing levels
* Flexible scheduling
* Career growth
What we are looking for:
Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.
* Associate's degree in nursing required.
* Current Registered Nurse license as required by state regulations in which the facility operates.
* 1-year experience in a psychiatric health care facility preferred.
* CPR certification is required within 30 days of employment and prior to any patient contact.
* De-escalation certification required within 30 days of employment and prior to any patient contact.
Connect with a Recruiter: Not ready to complete an application, or have questions? Please contact Cyndi by email: *****************************
More about Highland Springs:
Highland Springs is a 72-bed behavioral health hospital located in Highland Hills, OH, part of the greater Cleveland area. We provide high-quality compassionate care for those facing mental health and addiction challenges. Programs include 24/7 crisis care and assessment, inpatient mental health and addiction treatment, Patrial Hospitalization Programs (PHP) and Intensive Outpatient Programs (IOP) for adults age 18+.
EEOC Statement:
Highland Springs is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans' status or any other basis protected by applicable federal, state or local law.
Apply today!
Join us in delivering high-quality care.
Easy ApplyRN Behavioral Health
Remote
Behavioral Health Registered Nurse
Position Type: Full Time Days
Benefits:
Health Insurance (Medical, Dental, Vision)
401(k) with matching
Student Loan Repayment: Up to $20,000
Educational Assistance
Paid Time Off
Competitive salary and comprehensive benefits package
Job Summary
The Registered Nurse (RN) provides patient-centered care through the nursing process of assessment, diagnosis, planning, implementation, and evaluation. This role is responsible for coordinating and delivering high-quality care based on established clinical protocols and physician/provider orders. The RN collaborates with physicians, nurses, and other healthcare professionals to ensure effective patient care and desired outcomes, while maintaining a supportive and compassionate environment for patients and their families.
Essential Functions
Coordinates and delivers high-quality, patient-centered care in accordance with organizational policies, protocols, and the nursing process.
Conducts thorough patient assessments and documents findings accurately, reporting changes in condition to the appropriate care team members.
Utilizes knowledge of human growth and development to provide age-appropriate care and education.
Administers prescribed medications, monitors for side effects, and documents administration in accordance with standards of practice.
Assists physicians during procedures within the scope of documented competency and skill level.
Collaborates with the healthcare team to develop, implement, and evaluate individualized care plans based on patient assessments and needs.
Responds to medical emergencies and participates in life-saving interventions, such as CPR and code team activities, as appropriate.
Advocates for the rights and needs of patients, ensuring their voices are heard and respected in care planning and delivery.
Provides patient and family education on medical conditions, treatment plans, and post-discharge care, ensuring understanding and adherence to instructions.
Implements and adheres to infection control protocols to prevent the spread of healthcare-associated infections.
Monitors and operates medical equipment (e.g., IV pumps, monitors, ventilators) as needed for patient care and safety.
Promotes patient safety by adhering to National Patient Safety Goals and maintaining a clean, safe environment for patients and staff.
Participates in audits, chart reviews, and compliance checks to ensure adherence to standards of practice and regulatory requirements.
Demonstrates responsible decision-making in planning, delegating, and providing care based on patient needs and organizational policies.
Documents patient care and education thoroughly and promptly in the medical record.
Engages in professional development to maintain clinical competency and understanding of current nursing standards and regulations.
Participates in performance improvement initiatives, including data collection and process development, to enhance patient outcomes and care delivery.
Performs other duties as assigned.
Maintains regular and reliable attendance.
Complies with all policies and standards.
Qualifications
0-2 years of experience in a clinical nursing role or student clinical rotations in an acute care setting required
Knowledge, Skills and Abilities
Strong knowledge of the nursing process and clinical nursing practices.
Ability to perform thorough patient assessments and communicate findings effectively.
Proficient in administering medications and monitoring for side effects.
Effective communication and interpersonal skills to collaborate with interdisciplinary teams.
Strong organizational skills and attention to detail in documenting patient care.
Knowledge of safety standards, infection control, and quality improvement initiatives.
Licenses and Certifications
RN - Registered Nurse - State Licensure and/or Compact State Licensure required
BCLS - Basic Life Support required
ACLS - Advanced Cardiac Life Support preferred
PALS - Pediatric Advanced Life Support preferred
NRP - Neonatal Resuscitation preferred
Refer to facility or unit-specific guidelines for additional requirements.
INDBH
Auto-ApplySeasonal Registered Nurse RN PRN Nights
Lima, OH jobs
Seasonal Registered Nurse RN PRN Nights (Job Number: 540389) 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
Provides planning and delivery of direct and indirect patient care through the nursing process of Assessment, Planning, Intervention, and Evaluation. Develops nursing care plans in coordination with patient, family and interdisciplinary staff as necessary. Communicates changes in patient's clinical condition with Physicians, Nursing Supervisor/Manager, and co-workers as appropriate. Participates in discharge planning process.
Essential Functions
Maintains the standard of nursing care and implements policies and procedures of the hospital and nursing department.
Directs, supervises, provides and evaluates nursing care provided to patients.
Assigns or delegates tasks based on the needs and condition of the patient, potential for harm, complexity of the task, and within scope of practice of the staff to whom the task is delegated.
Assigns nursing care team members in accordance with patient needs, team member's capabilities and qualifications.
Documents patient admission assessment and reassessments, patient care plans and other pertinent information, completely in the patient's medical record according to nursing standards and policies.
Performs assessment on all patients on admission and reassessments as per policy. Makes referrals to other disciplines based on assessment.
Develops nursing care plan of assigned patient on admission, updates plan of care as needed and ensures plan of care is coordinated with patient, family, and other members of the team.
Assesses and reassesses pain. Utilizes appropriate pain management techniques. Educates the patient and family regarding pain management.
Revises the plan of care as indicated by the patient's response to treatment and evaluates overall plan daily for effectiveness.
Performs patient care responsibilities considering needs specific to the standard of care for patient's age.
Receives physician's orders, ensures transcription is accurate and documents completion.
Administers medication utilizing the five rights of medication administration reducing the potential for medication errors.
Formulates a teaching plan based upon identified learning needs and evaluates effectiveness of learning; family is included in teaching as appropriate.
Assists physicians with examinations, treatments and special procedures and performs services requiring technical and manual skills within scope of practice.
Performs treatments and provides services to level of licensure.
Treats patients and their families with respect and dignity. Identifies and addresses psychosocial, cultural, ethnic, and religious/spiritual needs of patients and their families. Functions as liaison between administration, patients, physicians, and other healthcare providers.
Interacts professionally with patient/family and involves patient/family in the formation of the plan of care.
Interprets data about the patient's status to identify each patient's age specific needs and provide care needed by the patient group.
Performs all aspects of patient care in an environment that optimizes patient safety and reduces the likelihood of medical/health care errors.
Initiates or assists with emergency measures for sudden adverse developments in patients' condition.
Answers telephone, paging system, patients' call lights, anticipates patients' needs, and makes rounds of assigned patients and responds as appropriate.
Consults other departments as appropriate to provide for an interdisciplinary approach to the patient's needs.
Provides end of shift report to oncoming nurse, narcotics are counted, documentation is complete, and physician orders signed off.
Communicates appropriately and clearly to management, co-workers, and physicians.
Identifies and addresses psychosocial needs of patients and family; communicates with Social Service/Discharge Planner regarding both in hospital and post discharge needs.
Participates in orientation, instruction/training of new personnel.
Manages and operates equipment safely and correctly.
Knowledge/Skills/Abilities/Expectations
Knowledge of medications and their correct administration based on age of the patient and their clinical condition.
Basic computer knowledge.
Able to organize tasks, develop action plans, set priorities and function under stressful situations.
Ability to maintain a good working relationship both within the department and with other departments.
Approximate percent of time required to travel: 0%
Must read, write and speak fluent English.
Must have good and regular attendance.
Performs other related duties as assigned.
Qualifications Education
Graduation from an accredited Bachelor of Science in Nursing,
Associate Degree in Nursing or Nursing Diploma program.
Licenses/Certification
Current state licensure as Registered Nurse.
BCLS certification required.
ACLS certifications preferred.
Experience
Minimum six months' Medical/Surgical experience in an acute care setting preferred.
Job: RNPrimary Location: OH-Lima-Kindred Hospital-LimaOrganization: 4851 - Kindred Hospital-LimaShift: Night
Auto-ApplyRegistered Nurse RN Weekend Night Option Program
Lima, OH jobs
Registered Nurse RN Weekend Night Option Program (Job Number: 540377) Description $20,000 Sign-on-Bonus!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 Provides planning and delivery of direct and indirect patient care through the nursing process of Assessment, Planning, Intervention, and EvaluationDevelops nursing care plans in coordination with patient, family and interdisciplinary staff as necessary Communicates changes in patient's clinical condition with Physicians, Nursing Supervisor/Manager, and co-workers as appropriate Participates in discharge planning process Essential Functions Maintains the standard of nursing care and implements policies and procedures of the hospital and nursing department Directs, supervises, provides and evaluates nursing care provided to patients Assigns or delegates tasks based on the needs and condition of the patient, potential for harm, complexity of the task, and within scope of practice of the staff to whom the task is delegated Assigns nursing care team members in accordance with patient needs, team member's capabilities and qualifications Documents patient admission assessment and reassessments, patient care plans and other pertinent information, completely in the patient's medical record according to nursing standards and policies Performs assessment on all patients on admission and reassessments as per policy. Makes referrals to other disciplines based on assessment Develops nursing care plan of assigned patient on admission, updates plan of care as needed and ensures plan of care is coordinated with patient, family, and other members of the team Assesses and reassesses pain. Utilizes appropriate pain management techniques. Educates the patient and family regarding pain management Revises the plan of care as indicated by the patient's response to treatment and evaluates overall plan daily for effectiveness Performs patient care responsibilities considering needs specific to the standard of care for patient's age Receives physician's orders, ensures transcription is accurate and documents completion Administers medication utilizing the five rights of medication administration reducing the potential for medication errors Formulates a teaching plan based upon identified learning needs and evaluates effectiveness of learning; family is included in teaching as appropriate Assists physicians with examinations, treatments and special procedures and performs services requiring technical and manual skills within scope of practice Performs treatments and provides services to level of licensure Treats patients and their families with respect and dignity. Identifies and addresses psychosocial, cultural, ethnic, and religious/spiritual needs of patients and their families Functions as liaison between administration, patients, physicians, and other healthcare providers Interacts professionally with patient/family and involves patient/family in the formation of the plan of care Interprets data about the patient's status to identify each patient's age specific needs and provide care needed by the patient group Performs all aspects of patient care in an environment that optimizes patient safety and reduces the likelihood of medical/health care errors Initiates or assists with emergency measures for sudden adverse developments in patients' condition Answers telephone, paging system, patients' call lights, anticipates patients' needs, and makes rounds of assigned patients and responds as appropriate Consults other departments as appropriate to provide for an interdisciplinary approach to the patient's needs Provides end of shift report to oncoming nurse, narcotics are counted, documentation is complete, and physician orders signed off Communicates appropriately and clearly to management, co-workers, and physicians Identifies and addresses psychosocial needs of patients and family; communicates with Social Service/Discharge Planner regarding both in hospital and post discharge needs Participates in orientation, instruction/training of new personnel Manages and operates equipment safely and correctly Knowledge/Skills/Abilities/ExpectationsKnowledge of medications and their correct administration based on age of the patient and their clinical condition Basic computer knowledge Able to organize tasks, develop action plans, set priorities and function under stressful situations Ability to maintain a good working relationship both within the department and with other departments Approximate percent of time required to travel: 0%Must read, write and speak fluent EnglishMust have good and regular attendance Performs other related duties as assigned Qualifications Education
Graduation from an accredited Bachelor of Science in Nursing
Associate Degree in Nursing or Nursing Diploma program
Licenses/Certification
Current state licensure as Registered Nurse
BCLS certification required
ACLS certifications preferred
Experience
Minimum six months' Medical/Surgical experience in an acute care setting preferred
Job: RNPrimary Location: OH-Lima-Kindred Hospital-LimaOrganization: 4851 - Kindred Hospital-LimaShift: Night
Auto-ApplyRegistered Nurse/FT/Days
Lima, OH jobs
Registered Nurse/FT/Days (Job Number: 548658) Description $20,000 SIGN ON BONUS THROUGH JANUARY 2026. 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 Provides planning and delivery of direct and indirect patient care through the nursing process of Assessment, Planning, Intervention, and Evaluation.
Develops nursing care plans in coordination with patient, family and interdisciplinary staff as necessary.
Communicates changes in patient's clinical condition with Physicians, Nursing Supervisor/Manager, and co-workers as appropriate.
Participates in discharge planning process.
Essential Functions Maintains the standard of nursing care and implements policies and procedures of the hospital and nursing department Directs, supervises, provides and evaluates nursing care provided to patients Assigns or delegates tasks based on the needs and condition of the patient, potential for harm, complexity of the task, and within scope of practice of the staff to whom the task is delegated Assigns nursing care team members in accordance with patient needs, team member's capabilities and qualifications Documents patient admission assessment and reassessments, patient care plans and other pertinent information, completely in the patient's medical record according to nursing standards and policies Performs assessment on all patients on admission and reassessments as per policy Makes referrals to other disciplines based on assessment Develops nursing care plan of assigned patient on admission, updates plan of care as needed and ensures plan of care is coordinated with patient, family, and other members of the team Assesses and reassesses pain Utilizes appropriate pain management techniques Educates the patient and family regarding pain management Revises the plan of care as indicated by the patient's response to treatment and evaluates overall plan daily for effectiveness Performs patient care responsibilities considering needs specific to the standard of care for patient's age Receives physician's orders, ensures transcription is accurate and documents completion Administers medication utilizing the five rights of medication administration reducing the potential for medication errors Formulates a teaching plan based upon identified learning needs and evaluates effectiveness of learning; family is included in teaching as appropriate Assists physicians with examinations, treatments and special procedures and performs services requiring technical and manual skills within scope of practice Performs treatments and provides services to level of licensure Treats patients and their families with respect and dignity Identifies and addresses psychosocial, cultural, ethnic, and religious/spiritual needs of patients and their families Functions as liaison between administration, patients, physicians, and other healthcare providers Interacts professionally with patient/family and involves patient/family in the formation of the plan of care Interprets data about the patient's status to identify each patient's age specific needs and provide care needed by the patient group Performs all aspects of patient care in an environment that optimizes patient safety and reduces the likelihood of medical/health care errors Initiates or assists with emergency measures for sudden adverse developments in patients' condition Answers telephone, paging system, patients' call lights, anticipates patients' needs, and makes rounds of assigned patients and responds as appropriate Consults other departments as appropriate to provide for an interdisciplinary approach to the patient's needs Provides end of shift report to oncoming nurse, narcotics are counted, documentation is complete, and physician orders signed off Communicates appropriately and clearly to management, co-workers, and physicians Identifies and addresses psychosocial needs of patients and family; communicates with Social Service/Discharge Planner regarding both in hospital and post discharge needs Participates in orientation, instruction/training of new personnel Manages and operates equipment safely and correctly Knowledge/Skills/Abilities/ExpectationsKnowledge of medications and their correct administration based on age of the patient and their clinical condition Basic computer knowledge Able to organize tasks, develop action plans, set priorities and function under stressful situations Ability to maintain a good working relationship both within the department and with other departments Approximate percent of time required to travel: 0%Must read, write and speak fluent EnglishMust have good and regular attendance Performs other related duties as assigned Qualifications EducationGraduation from an accredited Bachelor of Science in NursingAssociate Degree in Nursing or Nursing Diploma program Licenses/CertificationCurrent state licensure as Registered NurseBCLS certification required ACLS certifications preferred ExperienceMinimum six months' Medical/Surgical experience in an acute care setting preferred Job: RNPrimary Location: OH-Lima-Kindred Hospital-LimaOrganization: 4851 - Kindred Hospital-LimaShift: Day
Auto-ApplyClinical Appeals RN - Remote - M-F Working Alternating Saturdays
Cypress, CA jobs
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
The Clinical Appeals RN is responsible for providing expertise in clinical appeals and grievances (analyzing, reviewing, and evaluating appeals and grievances), and acting as a Clinical Interface Liaison (clinical problem solver with facilities, providers, carriers, resolution of issues concerning members, benefits, program definition and clarification).
You'll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:
* Review medical records and verify if the requested service meets criteria
* Review pre-service appeals for clinical eligibility for coverage as prescribed by the Plan benefits
* Review and interpret Plan language
* Coordinate reviews with the Medical Director
* Utilize clinical guidelines and criteria
* Accurately documenting determinations
* Adherence to all confidentiality regulations and agreements
* Hours M-F 8a-5p with alternating Saturdays
* Comfortable working mandatory overtime
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
* Active, unrestricted RN license in state of residence
* 2+ years of clinical experience as an RN, including in an acute, inpatient hospital setting
* Proficiency in Microsoft Office, Word, Outlook, and Internet applications
* Available M-F, 8:00- 4:30 in their time zone and alternating Saturdays (2 per month with a weekday off when working a Saturday)
Preferred Qualifications:
* Bachelor of Science in Nursing
* 1+ years of experience using MCG and/or Medicare criteria
* 1+ years of Utilization Management, pre-authorization, concurrent review or appeals experience
* Appeals experience
* Proven excellent communication, interpersonal, problem-solving, and analytical skills
* All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits re subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Clinical Appeals RN - Remote in EST or CST Time Zone
Cypress, CA jobs
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
If you are located within Eastern Standard time zone, you will have the flexibility to work remotely* as you take on some tough challenges. The work schedule is generally Monday-Friday, 8-5 EST or 8-5 CST.
Primary Responsibilities:
* Perform initial assessment review of appeals, medical records, and CMS/State Policies to determine if care/services provided meets coverage and billable criteria to be paid
* Identify if additional information is required to process an appeal
* Ability to adapt to changes that require cross training on appeal types as they are identified
* Ability to work independently
* Utilize Clinical nursing judgment assessment and critical thinking skills, guided by regulatory policy, to make decision on administrative nurse level cases
* Ability to navigate multiple computer programs, moving from one system to another, while managing multiple tasks and priorities
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
* Current, valid, and unrestricted RN licensure in your state of residence
* 2+ years of clinical experience in an acute care or an outpatient setting
* 1+ years of direct experience within one (or more) of the following areas:
* Utilization Review
* Medicaid and/or Medicare appeals experience
* LOC assessment planning and Discharge SNF Planning including understanding of Denial Notice and NOMNC
* Proven experience/understanding of billable services and claims in a managed care environment
* Solid Microsoft Office (Word, Excel & Outlook) Basic computer skills
* Access to high-speed internet
* Ability to work 8-5 within EST (Eastern standard time zone)
Preferred Qualifications:
* 5+ years of Medical Appeal experience working with Medicare and Medicaid
* Solid coding experience or Certified Coder (CPC)
* All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Clinical Appeals RN (M&R) - Remote (M-F 8-5)
Cypress, CA jobs
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.
As a Clinical Appeals RN for UHC Clinical Services, you will work on post-service appeals for Medicare-based claims.
Primary Responsibilities:
* Review provider post-service appeals for Medicare and Retirement
* Gather clinical information including medical records and coverage criteria as it pertains to Medicare guidelines
* Discuss cases with medical directors when applicable
* Ability to communicate and collaborate with other teams in order to gather medical information to process cases
* Communicate effectively in both verbal and written documentation
* Must meet quality and productivity metrics
* Ability to work independently and prioritize
* Attend mandatory trainings and scheduled staff meetings
* Engage in respectful and courteous team dialog via email, IM and in staff meeting
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:
* Undergraduate degree or equivalent experience
* Unrestricted, active RN license
* 2+ years of RN experience in acute setting
* Proven working knowledge of Clinical Criteria and CMS Guidelines/InterQual
* Proven proficiency in basic computer skills
* Demonstrated ability to have high speed internet installed in home for Secure Job use only
* Proven designated HIPPA compliant home workspace
Preferred Qualifications:
* Undergraduate degree (BSN)
* Proven utilization management, prior authorization, case management or prior appeals experience
* Proven claims and coding experience
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
Clinical Appeals RN (M&R) - Remote (M-F 8-5)
Cypress, CA jobs
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start **Caring. Connecting. Growing together.**
As a Clinical Appeals RN for UHC Clinical Services, you will work on post-service appeals for Medicare-based claims.
**Primary Responsibilities:**
+ Review provider post-service appeals for Medicare and Retirement
+ Gather clinical information including medical records and coverage criteria as it pertains to Medicare guidelines
+ Discuss cases with medical directors when applicable
+ Ability to communicate and collaborate with other teams in order to gather medical information to process cases
+ Communicate effectively in both verbal and written documentation
+ Must meet quality and productivity metrics
+ Ability to work independently and prioritize
+ Attend mandatory trainings and scheduled staff meetings
+ Engage in respectful and courteous team dialog via email, IM and in staff meeting
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ Undergraduate degree or equivalent experience
+ Unrestricted, active RN license
+ 2+ years of RN experience in acute setting
+ Proven working knowledge of Clinical Criteria and CMS Guidelines/InterQual
+ Proven proficiency in basic computer skills
+ Demonstrated ability to have high speed internet installed in home for Secure Job use only
+ Proven designated HIPPA compliant home workspace
**Preferred Qualifications:**
+ Undergraduate degree (BSN)
+ Proven utilization management, prior authorization, case management or prior appeals experience
+ Proven claims and coding experience
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
Clinical Appeals RN - Remote - M-F Working Alternating Saturdays
Cypress, CA jobs
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start **Caring. Connecting. Growing together.**
The Clinical Appeals RN is responsible for providing expertise in clinical appeals and grievances (analyzing, reviewing, and evaluating appeals and grievances), and acting as a Clinical Interface Liaison (clinical problem solver with facilities, providers, carriers, resolution of issues concerning members, benefits, program definition and clarification).
You'll enjoy the flexibility to work remotely* from anywhere within the U.S. as you take on some tough challenges.
**Primary Responsibilities:**
+ Review medical records and verify if the requested service meets criteria
+ Review pre-service appeals for clinical eligibility for coverage as prescribed by the Plan benefits
+ Review and interpret Plan language
+ Coordinate reviews with the Medical Director
+ Utilize clinical guidelines and criteria
+ Accurately documenting determinations
+ Adherence to all confidentiality regulations and agreements
+ Hours M-F 8a-5p with alternating Saturdays
+ Comfortable working mandatory overtime
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ Active, unrestricted RN license in state of residence
+ 2+ years of clinical experience as an RN, including in an acute, inpatient hospital setting
+ Proficiency in Microsoft Office, Word, Outlook, and Internet applications
+ **Available M-F, 8:00- 4:30 in their time zone and alternating Saturdays (2 per month with a weekday off when working a Saturday)**
**Preferred Qualifications:**
+ Bachelor of Science in Nursing
+ 1+ years of experience using MCG and/or Medicare criteria
+ 1+ years of Utilization Management, pre-authorization, concurrent review or appeals experience
+ Appeals experience
+ Proven excellent communication, interpersonal, problem-solving, and analytical skills
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits re subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
Clinical Appeals RN - Remote in EST or CST Time Zone
Cypress, CA jobs
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start **Caring. Connecting. Growing together.**
If you are located within Eastern Standard time zone, you will have the flexibility to work remotely* as you take on some tough challenges. The work schedule is generally Monday-Friday, 8-5 EST or 8-5 CST.
**Primary Responsibilities:**
+ Perform initial assessment review of appeals, medical records, and CMS/State Policies to determine if care/services provided meets coverage and billable criteria to be paid
+ Identify if additional information is required to process an appeal
+ Ability to adapt to changes that require cross training on appeal types as they are identified
+ Ability to work independently
+ Utilize Clinical nursing judgment assessment and critical thinking skills, guided by regulatory policy, to make decision on administrative nurse level cases
+ Ability to navigate multiple computer programs, moving from one system to another, while managing multiple tasks and priorities
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ Current, valid, and unrestricted RN licensure in your state of residence
+ 2+ years of clinical experience in an acute care or an outpatient setting
+ 1+ years of direct experience within one (or more) of the following areas:
+ Utilization Review
+ Medicaid and/or Medicare appeals experience
+ LOC assessment planning and Discharge SNF Planning including understanding of Denial Notice and NOMNC
+ Proven experience/understanding of billable services and claims in a managed care environment
+ Solid Microsoft Office (Word, Excel & Outlook) Basic computer skills
+ Access to high-speed internet
+ Ability to work 8-5 within EST (Eastern standard time zone)
**Preferred Qualifications:**
+ 5+ years of Medical Appeal experience working with Medicare and Medicaid
+ Solid coding experience or Certified Coder (CPC)
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
Licensed Practical/Vocational Nurse (LPN/LVN) - Part-Time, Night Shift
Dayton, OH jobs
Licensed Practical/Vocational Nurse (LPN/LVN) - Part-Time, Night Shift (Job Number: 526663) Description ScionHealth is committed to a culture of service excellence as demonstrated by our employees' adherence to the service excellence principles of Pride, Teamwork, Compassion, Integrity, Respect, Fun, Professionalism, and Responsibility.
As our most acute level of care, our specialty hospitals offer the same critical care patients receive in a traditional hospital or intensive care unit, but for an extended recovery period.
Our clinicians play a vital role in the recovery process for chronic, critically ill and medically complex patients.
SummaryPart-time, 36 hours a week, 12 hour shifts.
Night shift.
Under direct supervision of Registered Nurse, the Licensed Practical Vocational Nurse/LPN/LVN job provides nursing care within the scope of licensure for assigned patients according to established nursing standards and hospital policies and procedures.
Essential FunctionsUnder direct supervision of a Registered Nurse, the Licensed Practical Vocational Nurse/LPN/LVN administers medication, performs treatments and patient care responsibilities as prescribed.
The Licensed Practical Vocational Nurse / LPN / LVN consults with and keeps Registered Nurse informed of activities, symptoms, reactions, and changes in the patient's condition with regard to assigned patients.
The Licensed Practical Vocational Nurse / LPN / LVN provides appropriate pain management techniques and educates the patient and family regarding pain management.
The Licensed Practical Vocational Nurse / LPN / LVN administers medication following the five rights of medication administration within scope of practice.
The Licensed Practical Vocational Nurse / LPN / LVN assists with the rehabilitation and treatment of patients in accordance with the medical plan of care, updates, and revises plan of care under the supervision of Registered Nurse.
The Licensed Practical Vocational Nurse / LPN / LVN assists physicians with examinations, treatments and special procedures and performs services requiring technical and manual skills as directed by the Registered Nurse.
The Licensed Practical Vocational Nurse / LPN / LVN treats patients and their families with respect and dignity.
Identifies and addresses psychosocial, cultural, ethnic and religious/spiritual needs of patients and their families.
The Licensed Practical Vocational Nurse / LPN / LVN interacts professionally with patient/family and involves patient/family in the formation of the plan of care.
The Licensed Practical Vocational Nurse / LPN / LVN assists with admitting, discharging and transferring of patients.
The Licensed Practical Vocational Nurse / LPN / LVN identifies and addresses psychosocial needs of patients and family; communicates with Social Services/Discharge Planner regarding both in-hospital and post discharge needs.
Qualifications Education:Graduate of an accredited program for Licensed Vocational/Practical Nurses.
Licenses/Certification:Licensed Practical/Vocational Nurse License.
BCLS Certification.
Intravenous Blood Certification preferred.
Experience:Minimum six months prior experience in an acute care setting preferred.
Job: LPN/LVNPrimary Location: OH-Dayton-Kindred Hospital - DaytonOrganization: 4500 - Kindred Hospital - DaytonShift: Night
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