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Traveling Nurse remote jobs - 440 jobs

  • RN Registered Nurse Full Time PAT Remote after Training

    St. Joseph's Health 4.8company rating

    Remote job

    *Employment Type:* Full time *Shift:* *Description:* Posting This RN position includes incorporating approved processes, systems, protocols and tools when screening incoming colleagues, providers, vendors and visitors entering Trinity Health facilities. These screening protocols follow CDC and other regulatory guidelines and internal procedures. This opportunity is located in our Preadmission Testing (PAT) department in the medical office building (MOB) on our main campus. Documents and maintains compiled screening information as necessary within the scope of the RN role. Reports to manager or identified escalation resources any issues or concerns and identifies person(s) who do not pass screening and/or compliance screening requirement guidelines per approved protocols. A Registered Nurse (RN) is a licensed health care provider who provides nursing care under the direction of a physician, or other authorized health care provider. There is no independent component to the RN role. The Nurse Practice Act defines the practice of a RN as "performing tasks and responsibilities within the framework of case finding, health teaching, health counseling, and provision of supportive and restorative care under the direction of a registered nurse or licensed physician, dentist, or other licensed health care provider legally authorized under this title and in accordance with the commissioner's regulations." *ESSENTIAL FUNCTIONS* Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions. As outlined in processes, practice guides and protocols and applying required systems and tools, performs specific health screening of persons entering Trinity Health facilities following established regulatory and Trinity Health guidelines and internal procedures. May check temperature (no touch) and screens for symptoms by asking colleagues, providers, vendors and visitors a series of questions or ensuring that inquiry systems or electronic applications are used and that persons are approved for entry. Provides masks as needed. Educates those desiring to enter facilities on the practices and protocols for entry and re-entry. Reports to manager or other identified escalation resources any person(s) who refuses and / or does not pass the screening and / or compliance screening requirement guidelines. Monitors, organizes and keeps work areas sanitized and clean. Screenings may be required to take place outside the doors to Trinity Health facilities in order to maintain appropriate protection inside the buildings. Ensures testing related supplies are properly maintained and available. Maintains good rapport and cooperative relationships with colleagues, providers, vendors and visitors. Approaches conflict in a professional, calm and constructive manner; escalates problem resolution to manager or other identified resources, as needed and according to protocols and processes. Creates a positive environment that promotes customer satisfaction. Completes required training and sign off on usage of infrared thermometer and instructions needed to be followed. Keeps abreast of updated internal instructions, processes, protocols and CDC and/or regulatory guidelines. Performs other duties as assigned by the manager. Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health's Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior. *RESPONSIBILITIES:* Ensures quality nursing care is rendered to all patients in accordance with the New York Nurse Practice Act, National Standards of Practice, and Nursing and Clinical Service standards of care and practice. Utilizing the Nursing Process is involved in the provision of direct care of patients and families. *PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS* Operates in a healthcare, office or outdoor environment. Understands and follows infection control standards and complies with the use of personal protection equipment to prevent exposure and transmission of communicable disease. Ability to stand or sit for long periods of time. Frequent walking, sitting, bending and stooping. Must be able to hear and speak to those desiring to enter Trinity Health facilities and to communicate via phone, email and other electronic methods. Must be able to adapt to frequently changing work priorities and be able to prioritize and balance the requirements of the job. Ability to concentrate and pay close attention to details for over 90% of time *Mission Statement:* We, St Joseph's Health and Trinity Health, serve together in the spirit of the Gospel as a compassionate and transforming healing presence within our communities. *Vision:* To be world-renowned for passionate patient care and outstanding clinical outcomes. *Core Values:* In the spirit of good Stewardship, we heal by practicing Justice in fostering right relationships to promote common good, Reverence in honoring the dignity of every person, Excellence in expecting the best of ourselves and others; Integrity in being faithful to who we say we are. *Education, Training, Experience, Certification and Licensure:* Graduation from an accredited school for Registered Nurse and current licensure, or eligibility for licensure, in the State of New York. Maintains current BLS/CPR. Participates in orientation and continuing education and updates and maintains knowledge and skills related to specific areas of expertise. *Work Contact Group:* All services, medical staff, patients, visitors, and various regulatory and professional agencies. *Supervised by:* Team Leader, Clinical Coordinator, Unit Manager, and Clinical Services/Nursing Administration. *Diversity and Inclusion* Trinity Health employs about 133,000 colleagues at dozens of hospitals and hundreds of health centers in 22 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions. Trinity Health's Commitment to Diversity and Inclusion Trinity Health's dedication to diversity includes a unified workforce (through training and education, recruitment, retention and development), commitment and accountability, communication, community partnerships, and supplier diversity. Pay Range: $33.00 - $43.58 Pay is based on experience, skills, and education. Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. *Our Commitment * Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
    $33-43.6 hourly 1d ago
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  • Remote Travel NP/PA Clinical Educator in Physiatry

    Iconic Care Support Services

    Remote job

    A healthcare provider group is seeking a Clinical Educator NP/PA & Travel Nurse to enhance patient outcomes through education and clinical coverage. This role requires a strong background in Physiatry, a passion for teaching, and the ability to travel nationwide. The competitive compensation includes a salary of $155,000-$185,000, full benefits, and comprehensive travel support. Located remotely with necessary metropolitan area constraints, candidates must be residing in specified locales. #J-18808-Ljbffr
    $155k-185k yearly 5d ago
  • Care Management Coordinator/RN | 100% remote

    Alpha Business Solutions

    Remote job

    is remote - candidate must reside in the tri-state area (PA, DE, NJ) Must have an active PA license or a Nurse Licensure Compact to include PA. The Care Management Coordinator primary responsibility is to evaluate a member's clinical condition through the review of medical records (including medical history and treatment records) to determine the medical necessity for patient's services based on advanced knowledge and independent analysis of those medical records and application of appropriate medical necessity criteria. If necessary, the Care Management Coordinator directly interact with providers to obtain additional clinical information. The Care Management Coordinator has the authority to commit the company financially by independently authorizing services determined to be medically necessary based on their personal review. For those cases that do not meet established criteria, the Care Management Coordinator provides relevant information regarding members medical condition to the Medical Director for their further review and evaluation. The Care Management Coordinator has the authority to approve but cannot deny the care for patients. The Care Management Coordinator is also responsible for maintaining regulatory compliance with federal, state and accreditation regulations. Additionally, the Care Management Coordinator acts a patient advocate and a resource for members when accessing and navigating the health care system. Key Responsibilities: Utilizes the medical criteria of InterQual and/or Medical Policy to establish the need for inpatient, continued stay and length of stay, procedures and ancillary services. Note: InterQual - It is the policy of the Medical Affairs Utilization Management (UM) Department to use InterQual (IQ) criteria for the case review process when required. IQ criteria are objective clinical statements that assist in determining the medical appropriateness of a proposed intervention which is a combination of evidence-based standards of care, current practices, and consensus from licensed specialists and/or primary care physicians. IQ criteria are used as a screening tool to support a clinical rationale for decision making. Contacts servicing providers regarding treatment plans/plan of care and clarifies medical need for services. Reviews treatment plans/plan of care with provider for requested services/procedures, inpatient admissions or continued stay, clarifying medical information with provider if needed. Identifies and refers cases in which the plan of care/services are not meeting established criteria to the Medical Director for further evaluation determination. Performs early identification of members to evaluate discharge planning needs. Collaborates with case management staff or physician to determine alternative setting at times and provide support to facilitate discharge to the most appropriate setting. Reports potential utilization issues or trends to designated manager and recommendations for improvement. Appropriately refers cases to Case and Disease Management. Ensures request is covered within the member's benefit plan. Ensures utilization decisions are compliant with state, federal and accreditation regulations. Meets or exceeds regulatory turnaround time and departmental productivity goals when processing referral/authorization requests. Ensures that all key functions are documented via Care Management and Coordination Policy. Maintains the integrity of the system information by timely, accurate data entry. Performs additional duties assigned. Education: Active PA Licensed RN BSN Preferred Experience: Minimum of three (3) years of Neonatal Intensive Care clinical experience in a hospital or other health care setting. Prior discharge planning and/or utilization management experience is desirable. Medical management/precertification experience preferred. Knowledge, & Skills: Exceptional communication, problem solving, and interpersonal skills. Action oriented with strong ability to set priorities and obtain results. Team Player - builds team spirit and interdepartmental rapport, using effective problem solving and motivational strategy. Open to change, comfortable with new ideas and methods; creates and acts on new opportunities; is flexible and adaptable. Embrace the diversity of our workforce and show respect for our colleagues internally and externally. Excellent organizational planning and prioritizing skills. Ability to effectively utilize time management. Oriented in current trends of medical practice. Proficiency utilizing Microsoft Word, Outlook, Excel, SharePoint, and Adobe programs. Ability to learn new systems as technology advances. Please apply with your interest. You may also reach out to me Thank you, Ashu
    $61k-102k yearly est. 1d ago
  • RN Telephone Triage (Work from Home)

    Accessnurse

    Remote job

    Evenings, Weekend Only, Full-time & Part-time opportunities available (20hrs +) Hiring for evenings and weekends (*weekends and holidays are required) Incentives for Bilingual Spanish Telephone Triage RNs! AccessNurse is the premier provider of medical call center solutions, including 24/7 telephone nurse triage, and answering services. In business since 1996, AccessNurse serves more than 20,000 clinicians and practices, along with healthcare systems, health plans and Federally Qualified Health Centers (FQHCs) across the country. AccessNurse is a TeamHealth Company. The Telephone Triage Nurse role is a great alternative to bedside nursing working 12-hour shifts. This is an opportunity to work remote from home! Training and equipment are provided. Training classes are starting soon. Overview The Telephone Triage Nurse will take phone calls and help patients across the lifespan of the call and determine the best way to address their medical issues and concerns. Essential Duties and Responsibilities Assesses patient's symptoms utilizing a physician-written algorithms When appropriate, provide home care instructions using the approved, written guidelines as well as approved reference material provided Utilize all resources and guidelines to effectively assess, prioritize, advise, schedule classes or physician appointments, or refer calls when necessary to the appropriate medical facility, personnel or specialized community service Completes all documentation in the appropriate software Provides guidance recommending a variety of levels of care (e.g. home care, an office visit, emergency room) Responds to patient's questions Provides and documents health education to help patients manage their symptoms when indicated Consults with physicians as needed Job Requirements: Qualifications / Experience Current multi-state RN license with no restrictions; nurses currently holding a single-state RN license must obtain a multi-state license prior to being made a job offer 2+ years of nursing experience Proficiency using computers and type a minimum of 25 wpm Excellent listening and comprehension skills to determine key information by patient Professional, courteous telephone voice Ability to defuse conversations Ability to handle confidential information; HIPAA compliance is mandatory Flexibility with scheduling Remote Workstation / HIPAA Requirements Must have a high-speed internet connection Workstation must be in a room where door can be locked Desk should be large enough to hold 2 monitors, computer, accessories + hands-free headset REMOTE: Training Class Dates 100% ATTENDANCE IS REQUIRED 4-week Remote Training over Zoom Video Week 1: February 16th - February 20th M-F 9:00 am-5:00 pm EST Week 2: February 23rd - February 27th M-F 9:00 am-5:00 pm EST Week 3: March 2nd - March 6th M-F 2:00 pm-10:00 pm EST Week 4: Shift days/times with a preceptor will be discussed with education manager
    $43k-64k yearly est. 1d ago
  • RN for Trach and Vent Home Based Hospital Care

    Bayada Home Health Care 4.5company rating

    Remote job

    Job Description Come for the Flexibility, Stay for the Culture A variety of soft skills and experience may be required for the following role Please ensure you check the overview below carefully. BAYADA Home Health Care was founded on the principle that health care gets better when clients get better care at home-the place they most want to be. Delivering care is our highest priority and greatest joy. We care for people of all ages, diagnoses, and acuity levels, giving you the chance to explore and put your skills to work. Many clients require advanced care such as tracheostomy and ventilator management. We offer paid training to prepare you for the unique and rewarding environment you will provide care in, prioritizing your skillset confidence and knowledge. We are looking for nurses to help take care of our infant and pediatric trach and vent clients near Browns Mills, NJ. Training is offered for pediatrics and for pediatric trach and vent. Apply today to develop your skills to high-acuity, hospital-level care, in the home setting. BAYADA Offers Our RNs: One on one care Electronic documentation In-depth paid training and shadowing with award-winning simulation labs Short commute times - we match you with cases near your home 24/7 on call clinical support Available RN Shifts: 8-hour shifts 1st or 3rd shift PRN, Part-Time, or Full-Time RN Field Benefits Include: Weekly pay every Thursday PTO & sick time Medical, Dental, and Vision benefits Company-paid life insurance Employee Assistance Program Public Service Loan Forgiveness Partner 401K Preventive Care Coverage for ALL employees (PRN included) Pay: $34 to $36 per hour Apply now to join our team! NER-SJ-RX As an accredited, regulated, certified, and licensed home health care provider, BAYADA complies with all state/local mandates. BAYADA is celebrating 50 years of compassion, excellence, and reliability. Learn more about our 50th anniversary celebration and how you can join in here. BAYADA Home Health Care, Inc., and its associated entities and joint venture partners, are Equal Opportunity Employers. All employment decisions are made on a non-discriminatory basis without regard to sex, race, color, age, disability, pregnancy or maternity, sexual orientation, gender identity, citizenship status, military status, or any other similarly protected status in accordance with federal, state and local laws. Hence, we strongly encourage applications from people with these identities or who are members of other marginalized communities. xevrcyc Remote working/work at home options are available for this role.
    $34-36 hourly 1d ago
  • Service Care Coordinator RN - Remote in South Austin, TX

    Unitedhealth Group 4.6company rating

    Remote job

    At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together This is a Field Based role with a Home-Based office. Must be open to traveling up to 50 miles from home office based on business need. If you are located in or within commutable driving distance from South Austin, TX, you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: Assess, plan and implement care strategies that are individualized by patients and directed toward the most appropriate, at least restrictive level of care Identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays Medical Plan options along with participation in a Health Spending Account or a Health Saving account Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage 401(k) Savings Plan, Employee Stock Purchase Plan Education Reimbursement Employee Discounts Employee Assistance Program Employee Referral Bonus Program Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) More information can be downloaded at: uhgbenefits You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: Current and unrestricted Registered Nurse license in the state of Texas 2+ years of experience working within the community health setting or in a healthcare role Intermediate level of computer proficiency (including Microsoft Outlook, Teams) and ability to use multiple web applications Reside in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI) Valid driver's license, access to reliable transportation and the ability to travel in this 'assigned region' to visit Medicaid members in their homes and/or other settings, including community centers, hospitals, nursing facilities or providers' offices Reside in or within commutable driving distance from South Austin, TX Preferred Qualifications: 1+ years of experience with long-term care services and support, Medicaid or Medicare Knowledge of the principles of most integrated settings, including federal and State requirements like the federal home and community-based settings regulations Proven ability to create, edit, save and send documents, spreadsheets and emails Reside in South Austin, TX *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    $28.3-50.5 hourly 2d ago
  • Travel Nurse Trainer - Remote with Occasional Travel

    Dermave Spa

    Remote job

    Travel Nurse Trainer (RN/APRN) - Remote with Occasional Travel Employment Type: Full-Time | Work Schedule: 80% Remote / 20% Travel We are seeking a licensed RN or APRN with experience in aesthetic or med spa settings to develop training programs for nurses and estheticians. First two weeks will be on-site at a spa location to learn procedures, treatments, products, and equipment. Key Responsibilities Design and maintain training modules and educational content Lead virtual training sessions for clinical staff Conduct on-site orientation for new staff during travel assignments Provide mentorship and support to junior nurses across spa locations Collaborate with leadership to standardize clinical practices Qualifications Active RN or APRN license Aesthetic nursing or med spa experience required Flexible and able to travel occasionally Compensation & Benefits $22-$27 per hour Fully remote with occasional travel Company-covered travel expenses Supportive, education-focused work environment
    $22-27 hourly Auto-Apply 34d ago
  • 1099 Contracted Nurse Assessor - Nationwide Need

    Illumifin

    Remote job

    Registered Nurse - PRN visits Leave Shift Work Behind Consider our per diem opportunity to earn additional income as a Nurse Interviewer visiting clients at their place of residence. Complete questionnaires on their medical, functional and cognitive status. Flexible scheduling - The nurses can schedule visits Monday - Sunday, mornings, afternoons or evenings based on the client's and nurse's schedule. Flexible work - you can cover up to a 75 mile radius and work as little or as much as you want per month based on available cases in your area. Extra income - Work with illumifin whenever you need a little extra money, even if you have another job. No blood draws or specimen collections required. About the Role: As a RN with illumifin, you will utilize your critical thinking and assessment skills to complete the following: Obtain thorough cognitive and health assessment information as required. Comply with all assessment instructions and accurately complete assessments. Communicate promptly with illumifin regarding file status and appointment times. Return the assessment within 24 hours after the appointment. Respond promptly to any follow-up and clarification questions on submitted assessments. With E-Assessments training, you can complete assessments electronically using your cell phone, tablet, iPad or Laptop
    $94k-173k yearly est. 3h ago
  • HEDIS Review Nurse - Remote - Contract

    Hireops Staffing, LLC

    Remote job

    This is a contract assignment that will start right away and end on April 30th 2024 Review Nurse SUMMARY DESCRIPTION: The review nurse is responsible for medical record abstractions and overreads during the annual Healthcare Effectiveness Data and Information Set (HEDIS) survey. The review nurse is responsible for reviewing and accurately performing comprehensive review of medical records to abstract relevant clinical data during HEDIS. HEDIS abstractions are completed in accordance with NCQA guidelines and technical specifications. Additional responsibilities include but not limited to folder and file management, annotating medical records and saving completed documents with correct naming conventions on a shared drive as well as data entry into QSHR. ESSENTIAL FUNCTIONS: Abstract medical records Apply product/plan specific abstraction criteria/requirements during medical record review process Maintain defined productivity volumes Sustain accuracy rate of 95% during abstraction and data entry throughout the HEDIS survey Perform quality reviews of abstracted medical records as assigned Ensure open and honest communication with management/designee regarding development or assistance needed throughout project Escalate work related challenges/issues to Senior Director or designee Attend scheduled daily and ad-hoc meetings with HEDIS Project Manager, and /or Quality Management Specialist/ designee to discuss project status, open issues and productivity Comply with HIPAA, PHI, patient confidentiality, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies Other duties as assigned JOB REQUIREMENTS: Registered Nurse (RN)/ Licensed Practical Nurse ( LPN ) with unrestricted license 2 years' HEDIS abstraction/over-reading experience Data entry proficiency Working knowledge PDF, Word and Excel Excellent written and communication skills Database management Preferred Skills: Experience in Pediatrics, Cardiology, Endocrinology and/or Obstetrics QSHR proficiency
    $104k-171k yearly est. 60d+ ago
  • Clinical Research Nurse - Home Visits (PRN); Los Angeles, California

    WEP Clinical

    Remote job

    Are you a skilled, compassionate nurse looking for flexible work in clinical research? As a Clinical Research Nurse - Home Visits (PRN), you'll provide high-quality nursing care directly in patients' homes while supporting important research studies. This role is ideal for nurses who value flexibility, independence, enjoy local travel, and want to supplement their income with meaningful work. Key Points to Know: • You'll use your own vehicle to visit patients in their homes, typically within 1-2 hours of your location. • Shifts are PRN / per diem, meaning you'll work only when projects are available in your area; project frequency may vary. • Orientation, training, and project-specific instructions are provided before each assignment. • You will be compensated for all time spent on training, travel, and patient visits, including documentation. We are posting this role now and will be reviewing applications on a rolling basis between now and Christmas. Interviews will begin in the New Year , so you may experience a brief delay in hearing back from us during the holiday period. Thank you in advance for your patience - we look forward to connecting in January. Position: Clinical Research Nurse - Home Visits (PRN) Job Type: Contract, PRN, Per Diem Hourly Rate: $65/hr onsite and $50/hr travel time Work Location: Los Angeles, California; Drive up to 1-2 hours to patient homes in your area (travel time compensated!) Job Description: As a Clinical Research Nurse - Home Visits (PRN), you will play a crucial role in ensuring the successful execution of research studies in patient homes. You will be responsible for administering investigational medications/products, conducting patient assessments, collecting vital information, and adhering to study protocols with utmost accuracy and ethics. Your expertise and caring nature will help us maintain compliance with each study's protocol and safeguard the well-being of study patients. Principal Duties and Responsibilities: Deliver competent, high-quality nursing care to study patients in their homes. Accountable for the competent and confident delivery of high-quality clinical care to patients/participants. Ensure compliance with each study's protocol by providing thorough review and documentation at each subject study visit. Administer investigational medications/products as needed; Perform patient assessments to determine presence of side effects; notify Principal Investigator of findings/issues. Perform medical tests as outlined in protocol, including, but not limited to: vital signs, specimen collection, electrocardiograms; Process specimens and ship specimens per protocol. Provide patient education and medical information to study patients to ensure understanding of proper medication dosage, administration, and disease treatment. Responsible for adherence to clinical research policies to ensure ethical conduct and protect vulnerable populations. Communicate effectively, promoting open and trusting relationships. Qualifications: Relevant Nurse Licensure CH-GCP Certificate Graduate from an accredited BSN or Associate Degree in Nursing or Nursing Diploma program Minimum 2 years' post qualification acute care experience Clinical Research experience preferred BLS certification required Experience and knowledge of working in clinical research trials with ICH-GCP (Good Clinical Practice) Certification - (training can be provided) Good basic IT skills, utilizing mobile devices and Microsoft systems Trained in Handling and Transport of Hazardous Substances (training can be provided) A flexible schedule is essential Unencumbered driver's license, reliable car Benefits: Competitive hourly pay rate, including compensation for travel time. Flexible schedule to maintain work-life balance. Mileage reimbursement for travel expenses. Ongoing training and support to growth your clinical research skills Opportunity to make a meaning impact on patients' lives while contributing to cutting-edge medical research. Join our team and contribute to groundbreaking medical advancements through clinical research!
    $50-65 hourly Auto-Apply 60d+ ago
  • Telephone Triage Nurse (Remote)

    National Nurse Triage

    Remote job

    Part Time/Contract Position -Assess patient health problems over the phone and via secure video -Schedule appointments and refer patients -Advise and monitor simple home treatment interventions -Instruct patients in self evaluation -Use Schmitt/Thompson protocols to assess patients REQUIREMENTS: -At least 3 years experience as a Registered Nurse; preferably in the ICU, ED, Mother/Baby unit, Peds, Home Health & Hospice -Excellent critical thinking skills -Compassionate, caring attitude -Expertise and experience in disease management, coaching, crisis intervention -Excellent communication skills (written and spoken) - Highspeed Internet (DSL or Cable) -Laptop, PC or MAC -Dedicated work space -Flexibility with scheduling i.e. ability to work every other weekend and some holidays Requirements Compact RN license 3-4 Years of experience in Peds, OB, ICU, Med-Surg, Hospice, Home Health, Occupational Health Prefer experience with Schmitt-Thompson Pediatric and Adult protocols Comfortable working with EHR, Word, Excel, and other programs required for position
    $50k-89k yearly est. 60d+ ago
  • Clinical Review Nurse (Remote)

    Actalent

    Remote job

    Remote Clinical Review Nurse - Prior Authorization Employment Type: Full‑Time About the Role We are seeking an experienced Registered Nurse to join our team within a leading Managed Care Organization. This role is fully remote and focuses on reviewing clinical documentation to determine medical necessity, appropriateness of care, and alignment with established guidelines. The ideal candidate brings strong clinical judgment, excellent communication skills, and the ability to work independently in a fast‑paced environment. Key Responsibilities + Conduct clinical reviews of prior authorization requests for medical services, procedures, and medications. + Evaluate clinical documentation to determine medical necessity based on evidence‑based criteria and MCO guidelines. + Collaborate with providers, internal teams, and medical directors to gather additional information when needed. + Document all review decisions clearly, accurately, and in compliance with regulatory and organizational standards. + Maintain up‑to‑date knowledge of clinical guidelines, utilization management policies, and industry best practices. + Support quality improvement initiatives and contribute to process optimization within the UM department. Required Qualifications + Active Compact RN License (multistate). + 5+ years of recent acute care experience in a hospital setting, specifically on ER or ICU floors. + Strong understanding of clinical workflows, medical terminology, and acute care decision‑making. + Excellent critical thinking, assessment, and documentation skills. + Ability to work remotely with reliable internet access and a distraction‑free workspace. + Comfortable navigating electronic medical records and utilization management systems. What We Offer + Fully remote work environment. + Competitive compensation and benefits package. + Opportunities for professional growth within a large, mission‑driven organization. + Supportive team culture and strong clinical leadership. Job Type & Location This is a Contract position based out of San Antonio, TX. Pay and Benefits The pay range for this position is $35.00 - $40.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: - Medical, dental & vision - Critical Illness, Accident, and Hospital - 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available - Life Insurance (Voluntary Life & AD&D for the employee and dependents) - Short and long-term disability - Health Spending Account (HSA) - Transportation benefits - Employee Assistance Program - Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on Jan 24, 2026. About Actalent Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com (%20actalentaccommodation@actalentservices.com) for other accommodation options.
    $35-40 hourly 11d ago
  • Clinical Care Reviewer - RN - Must have a MSL License

    Caresource 4.9company rating

    Remote job

    Clinical Care Reviewer II is responsible for processing medical necessity reviews for appropriateness of authorization for health care services, assisting with discharge planning activities (i.e. DME, home health services) and care coordination for members, as well as monitoring the delivery of healthcare services. Essential Functions: Complete prospective, concurrent and retrospective review such as acute inpatient admissions, post-acute admissions, elective inpatient admissions, outpatient procedures, homecare services and durable medical equipment Identify, document, communicate, and coordinate care, engaging collaborative care partners to facilitate transitions to an appropriate level of care Engage with medical director when additional clinical expertise if needed Maintain knowledge of state and federal regulations governing CareSource, State Contracts and Provider Agreements, benefits, and accreditation standards Identify and refer quality issues to Quality Improvement Identify and refer appropriate members for Care Management Provide guidance to non-clinical staff Provide guidance and support to LPN clinical staff as appropriate Attend medical advisement and State Hearing meetings, as requested Assist Team Leader with special projects or research, as requested Perform any other job related duties as requested. Education and Experience: Associates of Science (A.S) Completion of an accredited registered nursing (RN) degree program required Three (3) years clinical experience required Med/surgical, emergency acute clinical care or home health experience preferred Utilization Management/Utilization Review experience preferred Medicaid/Medicare/Commercial experience preferred Competencies, Knowledge and Skills: Proficient data entry skills and ability to navigate clinical platforms successfully Working knowledge of Microsoft Outlook, Word, and Excel Effective oral and written communication skills Ability to work independently and within a team environment Attention to detail Proper grammar usage and phone etiquette Time management and prioritization skills Customer service oriented Decision making/problem solving skills Strong organizational skills Change resiliency Licensure and Certification: Current, unrestricted Registered Nurse (RN) Licensure in state(s) of practice required MCG Certification or must be obtained within six (6) months of hire required Working Conditions: General office environment; may be required to sit or stand for extended periods of time Travel is not typically required Compensation Range: $62,700.00 - $100,400.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Hourly Organization Level Competencies Fostering a Collaborative Workplace Culture Cultivate Partnerships Develop Self and Others Drive Execution Influence Others Pursue Personal Excellence Understand the Business This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.#LI-JM1
    $62.7k-100.4k yearly Auto-Apply 8d ago
  • Palliative Medicine Home-based Certified Registered Nurse Practitioner (CRNP)

    Schuylkill 3.2company rating

    Remote job

    Imagine a career at one of the nation's most advanced health networks. Be part of an exceptional health care experience. Join the inspired, passionate team at Lehigh Valley Health Network, a nationally recognized, forward-thinking organization offering plenty of opportunity to do great work. LVHN has been ranked among the "Best Hospitals" by U.S. News & World Report for 23 consecutive years. We're a Magnet(tm) Hospital, having been honored five times with the American Nurses Credentialing Center's prestigious distinction for nursing excellence and quality patient outcomes in our Lehigh Valley region. Finally, Lehigh Valley Hospital - Cedar Crest, Lehigh Valley Hospital - Muhlenberg, Lehigh Valley Hospital- Hazleton, and Lehigh Valley Hospital - Pocono each received an 'A' grade on the Hospital Safety Grade from The Leapfrog Group in 2020, the highest grade in patient safety. These recognitions highlight LVHN's commitment to teamwork, compassion, and technology with an unrelenting focus on delivering the best health care possible every day. Whether you're considering your next career move or your first, you should consider Lehigh Valley Health Network. Specialty: As the Division of Palliative Medicine and Hospice, we are a part of the fabric of care, with a fully integrated palliative care continuum to assure optimal patient experience. The clinician will be part of the OACIS (Optimizing Advanced Complex Illness Support)/Palliative Medicine practice, a nationally recognized, innovative palliative medicine service part of Lehigh Valley Health Network (LVHN) part of Jefferson Health. Position Responsibilities: In-home visits Symptom management and care coordination of home-based census Benefits: Attractive work schedule Highly competitive compensation with a superb benefits package Low-cost health insurance for employees and their families Generous CME allowance and time Top-tier retirement programs Malpractice insurance with tail coverage Relocation assistance Qualifications: A network champion for Palliative Care and a passion for clinical work A valid Pennsylvania license Seeking an experienced, certified nurse practitioner Lehigh Valley Health Network is an equal opportunity employer. In accordance with, and where applicable, in addition to federal, state and local employment regulations, Lehigh Valley Health Network will provide employment opportunities to all persons without regard to race, color, religion, sex, age, national origin, sexual orientation, gender identity, disability or other such protected classes as may be defined by law. All personnel actions and programs will adhere to this policy. Personnel actions and programs include, but are not limited to recruitment, selection, hiring, transfers, promotions, terminations, compensation, benefits, educational programs and/or social activities. **************************** Lehigh Valley Health Network does not accept unsolicited agency resumes. Agencies should not forward resumes to our job aliases, our employees or any other organization location. Lehigh Valley Health Network is not responsible for any agency fees related to unsolicited resumes. Work Shift: Day Shift Address: 3435 Winchester Rd Primary Location: Winchester Building Position Type: Onsite Union: Not Applicable Work Schedule: Department: 1012-35137 LVPG-L OACIS Palliative Medicine Outpatient
    $77k-108k yearly est. Auto-Apply 5d ago
  • Registered Nurse, Clinical Delivery

    Care Access 4.3company rating

    Remote job

    Care Access is working to make the future of health better for all. With hundreds of research locations, mobile clinics, and clinicians across the globe, we bring world-class research and health services directly to communities that often face barriers to care. We are dedicated to ensuring that every person has the opportunity to understand their health, access the care they need, and contribute to the medical breakthroughs of tomorrow. With programs like Future of Medicine , which makes advanced health screenings and research opportunities accessible to communities worldwide, and Difference Makers , which supports local leaders to expand their community health and wellbeing efforts, we put people at the heart of medical progress. Through partnerships, technology, and perseverance, we are reimagining how clinical research and health services reach the world. Together, we are building a future of health that is better and more accessible for all. To learn more about Care Access, visit ******************* How This Role Makes A Difference The Registered Nurse, Clinical Delivery (RN) in this role will manage the communication of critical and abnormal lab results to patients, ensuring compliance with state licensure requirements. This includes contacting patients, documenting communications, following up on lab escalations, and collaborating with providers to ensure all patient interactions are appropriately managed and documented. This role is also responsible for patient education, ensuring patients understand their lab results and any necessary next steps in their care, as well as providing study specific information that is tailored to the patient. Furthermore, they serve as a point of escalation for the Member Services team, addressing complex inquiries related to lab results and assisting in the resolution of patient concerns by providing clinical insights and ensuring patients receive accurate information and appropriate follow-up. The RN will liaise with the Clinical Conduct Team to investigate and resolve issues related to duplicate lab results or other concerning findings, as advised by the Medical Director. Lastly, they will assist in training and educating the Member Services team to improve patient interactions and enhance service quality. This role is critical in ensuring timely patient communication and maintaining compliance with clinical and legal standards. How You'll Make An Impact Receive and Review Lab Results from Pre-screening Program: Autonomously evaluate flagged abnormal, urgent, or critical lab findings to prepare them for patient communication, ensuring accuracy and timeliness. Patient Communication: Proactively contact patients to discuss abnormal and critical lab outcomes. Ensure focused and uninterrupted communication, adhering to protocols while delivering only legally permissible information within the RN scope of practice. Use communication techniques to convey complex medical information clearly in a way non-medical patients will understand. Understand that the results shared with the patients may have serious health implications for them and relay them in a compassionate manner. Patient Education: Develop and implement patient education initiatives to enhance understanding of lab result significance and promote informed decision-making. Ensure patients understand their lab results and any necessary next steps in their care. Critical Thinking: Independently utilize critical thinking to assess the urgency and implications of abnormal and critical lab results, prioritizing patient communication based on clinical significance. Documentation: Maintain comprehensive and precise documentation of communications in patient progress notes. Record abnormal and critical results, patient concerns, and subsequent actions. Ensure compliance with regulatory signature requirements. Time Management: Exhibit exceptional time management skills to efficiently manage multiple lab results and patient communications, prioritizing urgent cases promptly. Problem Solving Expertise: Apply advanced problem-solving abilities using medical training and experience to troubleshoot issues related to lab result discrepancies or data integrity. Data-Driven Decision Making: Leverage data analytics to identify patterns and trends in lab results, contributing to evidence-based practice and enhanced patient outcomes. Regulatory Knowledge: Maintain up-to-date knowledge of healthcare regulations and compliance standards to ensure all communications adhere to legal and ethical guidelines. Escalation to Providers: For questions beyond the RN's medical scope, escalate to a licensed, on call provider (NP/PA/MD/DO) and manage the completion of result delivery and accompanying required documentation. Member Services Team Escalations: Address lab-related escalations from the Member Services Team, such as result clarifications, data discrepancies, or additional test requests, and communicate resolutions back to the patient, documenting the outcome. The Expertise Required Strong analytical capabilities, exceptional communication skills, and a commitment to fostering a patient centered environment. Strong attention to detail and ability to manage multiple patients efficiently. Ability to work independently while collaborating with a larger clinical team. This role is pivotal in upholding clinical and legal standards through meticulous communication and patient care management. Precision in data analysis and documentation to ensure accuracy in lab results and reporting. Certifications/Licenses, Education, and Experience: Education: Active RN licensure with a commitment to compliance and regulatory standards. Compact Licensure required. Additional licenses may be required in addition. BSN or equivalent degree preferred. Experience: Minimum of 3 years of experience as a working nurse, clinical research, medical communications, and/or related field. Proficiency in Salesforce or other EMR systems for documenting patient interactions. Licensure Requirement: Compact licensure required, non-compact state license preferred. Willingness to maintain and obtain additional state licenses as needed. Must hold all licenses in good standing. Compact States [42]: RNs with compact licenses can practice in all 42 states in the compact, including Alabama, Arizona, Arkansas, Colorado, Florida, Texas, and more. Non-Compact States [8]: California, Nevada, Illinois, Hawaii, Alaska, Oregon, Minnesota, New York. How We Work Together Location: Remote within the United States. This role requires 100% of work to be performed in a remote office environment. Travel: This is a remote position with less than 10% travel requirements. Occasional planned travel may be required as part of the role. Physical demands associated with this position Include: The ability to use keyboards and other computer equipment. PTO and On-Call Coordination: Work within a structured on-call system to ensure coverage when team members are on leave. The expected salary range for this role is $70,000 - $100,000 USD per year for full time team members. Benefits & Perks (US Full Time Employees) Paid Time Off (PTO) and Company Paid Holidays 100% Employer paid medical, dental, and vision insurance plan options Health Savings Account and Flexible Spending Accounts Bi-weekly HSA employer contribution Company paid Short-Term Disability and Long-Term Disability 401(k) Retirement Plan, with Company Match Diversity & Inclusion We work with and serve people from diverse cultures and communities around the world. We are stronger and better when we build a team representing the communities we support. We maintain an inclusive culture where people from a broad range of backgrounds feel valued and respected as they contribute to our mission. We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to, and will not be discriminated against on the basis of, race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law. Care Access is unable to sponsor work visas at this time. If you need an accommodation to apply for a role with Care Access, please reach out to: ********************************
    $70k-100k yearly Auto-Apply 7d ago
  • Clinical Outcomes QA Nurse

    CSI Pharmacy

    Remote job

    At CSI Pharmacy (CSI), we are on a mission to provide Specialty Pharmacy services to patients with chronic and rare illnesses in need of complex care. CSI is a rapidly growing national Specialty Pharmacy. Whether you work directly with patients or behind the scenes in support of the business and its employees, you will use your expertise, experience, and skills to support our patients and our mission. Summary The Clinical Outcomes Quality Assurance Nurse will be responsible for the quality of the Outcomes program's documentation, implementing clinical best practices, and facilitating the efficient operation of the assigned department by performing a variety of clerical and administrative tasks. Salary Range: $72,000 - $87,000/yr (DOE) Schedule: (Remote) Monday - Friday, 8:30am - 4:30pm CST Travel: (Optional) Occasional travel for training, team get-togethers, conferences, etc. if willing Essential Duties and Responsibilities include the following. Other duties may be assigned, as necessary. Reviews/Approves all CSI outcomes forms Works with CSI nurses regarding outcome forms; edits/corrects as needed. Assists in outcomes charting, tracking, reporting, and updates. Communicates and responds to administrative inquiries. Communicates with patients via telecommunications to obtain necessary outcomes forms. Collects and records data obtained via telecommunications, mailed in forms, and electronic health care records system. Tracks and uploads outcomes forms to patient's scheduled visits. Attends designated meetings or Teams/Zoom calls as needed. Maintains effective working relationships with all members of CSI. Tracks prescriber partners who desire outcomes and/or are involved in research. Sends patient specific outcomes data to pharmacy via Monday.com research board as requested. Monitors outcomes data for trigger points to notify outcomes manager and/or pharmacy. Provides weekly status updates to leadership on Outcomes Management Team goals and accomplishments. Uploads outcomes and research forms into Monday.com research board. Performs other related duties as assigned or requested. QUALIFICATION REQUIREMENTS 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. Excellent verbal and written communication skills. Excellent interpersonal and customer service skills. Proficient in Microsoft Office or related software. Excellent organizational skills and attention to detail. Ability to work independently. Provide the highest level of professionalism, responsiveness, and communication. Must possess the ability to multi-task and frequently change direction. Education and/or Experience Associate degree in nursing or Bachelor of Science in nursing RN license, unencumbered Experience in home-infusion of chronic disorders preferred 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. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, climb stairs, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. The employee frequently lifts and/or moves up to 20 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus. 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. This job generally operates in a clerical office setting. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, and fax machines. While performing the duties of this position, the employee may travel by automobile and be exposed to changing weather conditions. COMMENTS This description is intended to describe the essential job functions, the general supplemental functions, and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities, and requirements of a person so classified. Other functions may be assigned, and management retains the right to add or change the duties at any time. NOTICE: Successful completion of a drug screen prior to employment is part of our background process, which includes medical and recreational marijuana. By supplying your phone number, you agree to receive communication via phone or text. CSI Pharmacy is an Equal Opportunity Employer
    $72k-87k yearly Auto-Apply 7d ago
  • Home Infusion Nurse, 32 Hours - Accredo - Eugene, OR

    The Cigna Group 4.6company rating

    Remote job

    Home Infusion Registered Nurse - Accredo Take your nursing skills to the next level by helping to improve lives with Accredo, the specialty pharmacy division of Evernorth Health Services. We are looking for dedicated registered nurses like you to administer intravenous medications to patients in their homes. As a Home Infusion Registered Nurse at Accredo, you'll travel to patients' homes to provide critical infusion medications. However, this job is about more than just administering meds; it's about building relationships with patients and seeing the positive impact of your care. You'll work independently, making decisions that lead to the best outcomes for your patients. You'll drive growth in your career by challenging yourself to use your nursing skills, confidence, and positive attitude to handle even the toughest situations, with the support from your team. For more than 30 years, Accredo by Evernorth has delivered dedicated, first-class care and services for patients. We partner closely with prescribers, payers, and specialty manufacturers. Bring your drive and passion for purpose. You'll get the opportunity to make a lasting impact on the lives of others. How you'll make a difference and improve lives: Empower Patients: Focus on the overall well-being of your patients. Work with pharmacists and therapeutic resource centers to ensure that patients' needs are met and to help them achieve their best health. Administer Medications: Take full responsibility for administering IV infusion medications in patients' homes. Provide follow-up care and manage responses to ensure their well-being. Stay Connected: Be the main point of contact for updates on patient status. Document all interactions, including assessments, treatments, and progress, to keep track of their journey. Requirements: Active RN license in the state where you'll be working and living 2+ years of RN experience 1+ year of experience in critical care, acute care, or home healthcare Strong skills in IV insertion Valid driver's license Willingness to travel to patients' homes within a large geographic region Ability to work 32 hours a week (can include days, evenings, and weekends, per business need) Flexibility to work different shifts on short notice and be available for on-call visits as needed If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ...@cigna.com for support. Do not email ...@cigna.com for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
    $82k-117k yearly est. 9d ago
  • Clinical Review Nurse - Remote

    Arc Group 4.3company rating

    Remote job

    Job DescriptionCLINICAL REVIEW NURSE - REMOTE ARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote. These are direct hire FTE positions with salary, benefits, etc. This is a fantastic opportunity to join a dynamic and well-respected organization offering tremendous career growth potential. At ARC Group, we are committed to fostering a diverse and inclusive workplace where everyone feels valued and respected. We believe that diverse perspectives lead to better innovation and problem-solving. As an organization, we embrace diversity in all its forms and encourage individuals from underrepresented groups to apply. 100% REMOTE! Candidates must currently have PERMANENT US work authorization. Sorry, but we are not considering any candidates from outside companies for this position (no C2C, 3rd party / brokering). SUMMARY STATEMENT The Clinical Review Nurse is responsible for reviewing and making medical determinations as to the validity of health claims and levels of payment in meeting national and local policies as well as accepted medical standards of care. The incumbent applies clinical knowledge to assess the medical necessity, level of services and appropriateness of care which may include cases requiring prior authorization, complex pre-payment medical review or post-payment medical review. ESSENTIAL DUTIES & RESPONSIBILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This list of essential job functions is not exhaustive and may be supplemented as necessary. 90% of time will be spent on one or more of the following activities depending on assignments: Review and analyze pre and post pay complex health care claims from a medical perspective, inclusive of prior authorization: Perform clinical review work as assigned; may provide guidance to other team members and accurately interpret and apply broad CMS guidelines to specific and highly variable situations. Conduct review of claim data and medical records to make clinical decisions on the coverage, medical necessity, utilization and appropriateness of care per national and local policies, as well as accepted medical standards of care. Review provider practices and identify issues of concern, overpayment and need for corrective action as necessary; includes surfacing potential fraud and abuse or practice concerns. May develop recommendations for further corrective action based on medical review findings. May refer for review, or implement, corrective action related to medical review activities. May process claims and complete project work in the appropriate computer system(s). The remaining 10% of time will be spent on the following activities depending on assignments: Identify providers needing education and individually educate providers who are subject to medical review processes: Initiate or participate in provider teaching activities, creating written teaching material, providing one on one education or education to a group as a result of a medical review (e.g., probe, progressive corrective action, consent, etc.) or appeal. This may involve discussion with CMS leaders and leaders in the provider community. Participate in special projects as assigned. REQUIRED QUALIFICATIONS * Valid nursing degree * 2 years' clinical experience * Excellent written and oral communication skills * Demonstrated experience with evaluating medical and health care delivery issues (e.g., Inpatient Rehab Facility) * Strong computer skills to include Microsoft Office proficiency * Valid unrestricted Registered Nurse (RN) license PREFERRED QUALIFICATIONS * Inpatient Rehabilitation Facility Experience * Bachelor of Science in Nursing (BSN) * Insurance industry experience * Certified Coder ARC Group is a Forbes-ranked a top 20 recruiting and executive search firm working with clients nationwide to recruit the highest quality technical resources. We have achieved this by understanding both our candidate's and client's needs and goals and serving both with integrity and a shared desire to succeed. At ARC Group, we are committed to providing equal employment opportunities and fostering an inclusive work environment. We encourage applications from all qualified individuals regardless of race, ethnicity, religion, gender identity, sexual orientation, age, disability, or any other protected status. If you require accommodations during the recruitment process, please let us know. Position is offered with no fee to candidate.
    $48k-67k yearly est. 7d ago
  • Registered Nurse (RN) Clinical Documentation Denials Auditor

    Inova Health System 4.5company rating

    Remote job

    Inova Health is looking for a dedicated Registered Nurse (RN) Clinical Documentation Denials Auditor to join the team. This role will be fully-time remote, Monday-Friday, regular business hours 8:00 AM - 4:30 PM (flexible). Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation. Featured Benefits: Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program. Retirement: Inova matches the first 5% of eligible contributions - starting on your first day. Tuition and Student Loan Assistance: offering up to $5,250 per year in education assistance and up to $10,000 for student loans. Mental Health Support: offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost. Work/Life Balance: offering paid time off, paid parental leave, flexible work schedules, and remote and hybrid career opportunities. Registered Nurse (RN) Clinical Documentation Denials Auditor Job Responsibilities: Evaluates specificity and completeness of physician documentation to ensure optimal coding (e.g. mortality outcomes using APR-DRG, SOI and ROM, appropriate reduction of complications based on PSI and HAC, revenue assurance outcomes based on reimbursement DRG (MS-DRG), documentation of significant chronic conditions affecting resource utilization based on HCC). Summarizes audit findings for individual records along with specific documentation guidelines to improve expected clinical outcomes for an individual physician, physician practice, or specialty. Conducts follow-up audits (i.e. concurrent or post-discharge) with routine feedback until documentation practice comes into line with expected clinical outcomes. Works with Clinical Documentation Improvement (CDI) Director and Lead Auditor on other work related to physician audits and education programs. Demonstrates proficiency with Cobius to access external audit work, record summary results and upload appeal letters. Demonstrates proficiency with Encompass 360 and HDM audit functions to review electronic medical records with advanced functions (i.e. ex, auto-suggest and search) and record detail coding audit results. Showcases proficiency in reviewing records in Epic electronic medical records - which may be the only option for audits of older records. Demonstrates proficiency in writing effective appeal letters that include appropriate coding guidelines and medical references. Identifies trends in external audit findings related to coding quality and physician documentation. Prepares educational communications related to these findings. Evaluates physicians' documentation, diagnostic reports, and clinical findings for validation of diagnoses. Processes the requests for second opinion reviews when clinical validity is not supported or in question. May perform additional duties as assigned. Minimum Qualifications: Certification: Certified Coding Specialist / Certified Clinical Documentation Specialist; ACDIS/AHIMA certification, CCDS or CDIP Licensure: Current RN license and eligible to practice in VA Experience: Seven years of recent CDI, DRG validation or coding audit experience in an acute hospital setting with clinician training as RN, BSN, NP, PA or MD; Coding certification CCS and CDI certification CCDS or CDIP Education: Associate Degree in Nursing or Medicine. Preferred Qualifications: Experience: Recent coding experience. Clinical background and coding + denials knowledge. Experience writing denials & appeals. Outpatient and/or inpatient experience. Knowledge to identify clinical indicators (example: sepsis). EPIC experience. Certifications: CCDS Skills: presenting Remote Eligibility: This position is eligible for remote work for candidates residing in the following states - VA, MD, DC, DE, FL, GA, NC, OH, PA, SC, TN, TX, WV
    $57k-90k yearly est. Auto-Apply 60d ago
  • Student Nurse Intern - Variable Shifts

    Stormont Vail Health 4.6company rating

    Remote job

    Part time Shift: Variable Less than 12 hour shift (United States of America) Hours per week: 0 Job Information Exemption Status: Non-Exempt This experienced student team member is in their last semester of an accredited nursing program. Nurse Interns are team members typically work exclusively with their preceptors to bridge the gap from learner to perform as they end their practicum prior to begining their career as a Registered Nurse at Stormont Vail Health. They are a part of the care delivery team under the direction of and be assistive to, a Registered Nurse to provide delegated, direct patient care intervention, including the performance of non-sterile procedures. Responsible to provide a safe environment for their assigned patients; to complete the assigned work; to monitor the patient for changes in condition and to report those changes to the RN/LPN. Education Qualifications A current nursing student in good standing and would start in this role no more than 4 weeks prior to starting their last semester. Required Experience Qualifications Intent to continue nursing career after graduation at Stormont Vail Health and has accepted an offer for a RN position. Required Experience in an office or clinic setting. Preferred Skills and Abilities Knowledgeable of and follows proper technique for patient care. (Required proficiency) Communicates pertinent patient information to appropriate staff in a timely manner. (Required proficiency) Functions with an awareness and application of safety issues as identified within the institution. (Required proficiency) Participates actively in educational activities for department. (Required proficiency) Demonstrates competency in selected psychomotor skills. (Required proficiency) Licenses and Certifications First Responder - RQI Required within 90 days. What you will do Knowledgeable of and follows correct techniques in the collection and labeling of specimens; assists in appropriate procedures under the guidance of a preceptor. Will spend the majority of time directly with the RN Preceptor observing direct patient care duties. Student Nurse Interns will perform expanded skills under the direct supervision of their nurse preceptor (see RN Student Nurse Intern - Learn While you Work Document). Implements identified plan through coordination of care with interdisciplinary care team to employ strategies to promote health and wellness. Collaborative with interdisciplinary care team encompassing strategies to achieve expected outcomes. Assumes responsibility for patient safety by utilizing appropriate channels to communicate patient safety and patient care issues to appropriate bodies. Communicate pertinent data and information relative to the patient, situation, or setting in a timely manner. Applies proper techniques with hand washing, care and cleaning of exam rooms and equipment and determination of when and how to use personal protective clothing/equipment. Maintains cleanliness of equipment, examination and patient rooms. Promote infection prevention through use of standard precautions, proper procedure in dressing changes, wound care, hand hygiene and cleanliness of the patient rooms/department Provide assistance with activities of daily living (ADL'S), accurate measurement and recording of weight, height, vital signs and report any changes to assigned nurse. Obtains vital signs, medication list, allergies, and patient questionnaires, screenings and history information accurately. Applies appropriate technique while performing EKG, and vital signs. Performs other related nursing tasks and duties under the supervision of a preceptor at all times. Delivers care guided by Jean Watson's Theory of Human Caring illustrated by creating caring relationships, taking time to have uninterrupted moments with patients and displaying unconditional acceptance and respect. Promotes a mutually respectful environment that encourages the exchange of ideas and supports the effectiveness of professional relationships and integrates ethics in all aspects of practice. Demonstrates advocacy in all roles and settings. Practices Diversity, Equity and Inclusion principles in their daily work by respecting others' uniqueness, perspectives, backgrounds or beliefs. Communicates effectively in all areas of professional practice. Supports students to enhance their knowledge, skills, and abilities. Commits to lifelong learning through critical thinking, self-reflection, and inquiry for personal growth and development. Demonstrates willingness to participate in process of evolution the scope of the Stormont Vail Health professional practice model Responsible for understanding and showing respect for patients' rights including confidentiality of patient information. Utilizes appropriate resources to provide, and sustain evidence-based nursing services that are safe, effective, and financially responsible, and used judiciously. Required for All Jobs Complies with all policies, standards, mandatory training and requirements of Stormont Vail Health Performs other duties as assigned Patient Facing Options Position is Patient Facing Remote Work Guidelines Workspace is a quiet and distraction-free allowing the ability to comply with all security and privacy standards. Stable access to electricity and a minimum of 25mb upload and internet speed. Dedicate full attention to the job duties and communication with others during working hours. Adhere to break and attendance schedules agreed upon with supervisor. Abide by Stormont Vail's Remote Worker Policy and will review and acknowledge the Remote Work Agreement annually. Remote Work Capability On-Site; No Remote Scope No Supervisory Responsibility No Budget Responsibility No Budget Responsibility Physical Demands Balancing: Occasionally 1-3 Hours Carrying: Occasionally 1-3 Hours Climbing (Ladders): Rarely less than 1 hour Climbing (Stairs): Occasionally 1-3 Hours Crawling: Rarely less than 1 hour Crouching: Occasionally 1-3 Hours Driving (Automatic): Rarely less than 1 hour Driving (Standard): Rarely less than 1 hour Eye/Hand/Foot Coordination: Frequently 3-5 Hours Feeling: Frequently 3-5 Hours Grasping (Fine Motor): Frequently 3-5 Hours Grasping (Gross Hand): Frequently 3-5 Hours Handling: Frequently 3-5 Hours Hearing: Occasionally 1-3 Hours Kneeling: Rarely less than 1 hour Lifting: Occasionally 1-3 Hours up to 50 lbs Operate Foot Controls: Rarely less than 1 hour Pulling: Frequently 3-5 Hours up to 50 lbs Pushing: Frequently 3-5 Hours up to 50 lbs Reaching (Forward): Occasionally 1-3 Hours up to 25 lbs Reaching (Overhead): Occasionally 1-3 Hours up to 25 lbs Repetitive Motions: Occasionally 1-3 Hours Sitting: Occasionally 1-3 Hours Standing: Frequently 3-5 Hours Stooping: Occasionally 1-3 Hours Talking: Frequently 3-5 Hours Walking: Frequently 3-5 Hours Working Conditions Burn: Rarely less than 1 hour Chemical: Rarely less than 1 hour Combative Patients: Occasionally 1-3 Hours Dusts: Rarely less than 1 hour Electrical: Rarely less than 1 hour Infectious Diseases: Frequently 3-5 Hours Mechanical: Rarely less than 1 hour Needle Stick: Occasionally 1-3 Hours Noise/Sounds: Occasionally 1-3 Hours Poor Ventilation, Fumes and/or Gases: Rarely less than 1 hour Radiant Energy: Rarely less than 1 hour Risk of Exposure to Blood and Body Fluids: Rarely less than 1 hour Risk of Exposure to Hazardous Drugs: Rarely less than 1 hour Hazards (other): Rarely less than 1 hour Vibration: Rarely less than 1 hour Wet and/or Humid: Rarely less than 1 hour Stormont Vail is an equal opportunity employer and adheres to the philosophy and practice of providing equal opportunities for all employees and prospective employees, without regard to the following classifications: race, color, ethnicity, sex, sexual orientation, gender identity and expression, religion, national origin, citizenship, age, marital status, uniformed service, disability or genetic information. This applies to all aspects of employment practices including hiring, firing, pay, benefits, promotions, lateral movements, job training, and any other terms or conditions of employment. Retaliation is prohibited against any person who files a claim of discrimination, participates in a discrimination investigation, or otherwise opposes an unlawful employment act based upon the above classifications.
    $19k-27k yearly est. Auto-Apply 60d+ ago

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