Traveling nurse work from home jobs

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

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

Description & Requirements Maximus is seeking a Clinical Reviewer (Registered Nurse) to support the Tennessee (TN) Appeals area of the contract. In this role, the RN Clinical Reviewer is responsible for reviewing clinical cases, applying nursing judgment and regulatory guidelines, and ensuring each case is accurately assessed and routed to the appropriate department or escalated as needed. This position plays a critical role in maintaining compliance, supporting timely appeal resolutions, and ensuring high-quality, clinically sound decision-making. About the Program:Tennessee Long-Term Services and Supports (TN LTSS) refers to a coordinated system of programs and services designed to assist individuals who have chronic illnesses, disabilities, or functional limitations and need ongoing support to live as independently and safely as possible. TN LTSS includes a range of home- and community-based services (HCBS) and institutional care options that help individuals with activities of daily living, medical needs, and personal care, while prioritizing care in the least restrictive setting. The program supports older adults and individuals with physical, intellectual, or developmental disabilities through person-centered planning that promotes dignity, independence, and quality of life. Why Maximus? - Work/Life Balance Support - Flexibility tailored to your needs! - • Competitive Compensation - Bonuses based on performance included! - • Comprehensive Insurance Coverage - Choose from various plans, including Medical, Dental, Vision, Prescription, and partially funded HSA. Additionally, enjoy Life insurance benefits and discounts on Auto, Home, Renter's, and Pet insurance. - • Future Planning - Prepare for retirement with our 401K Retirement Savings plan and Company Matching. - •Paid Time Off Package - Enjoy PTO, Holidays, and extended sick leave, along with Short and Long Term Disability coverage. - • Holistic Wellness Support - Access resources for physical, emotional, and financial wellness through our Employee Assistance Program (EAP). - • Recognition Platform - Acknowledge and appreciate outstanding employee contributions. - • Tuition Reimbursement - Invest in your ongoing education and development. - • Employee Perks and Discounts - Additional benefits and discounts exclusively for employees. - • Maximus Wellness Program and Resources - Access a range of wellness programs and resources tailored to your needs. - • Professional Development Opportunities-Participate in training programs, workshops, and conferences. - •Licensures and Certifications-Maximus assumes the expenses associated with renewing licenses and certifications for its employees. Essential Duties and Responsibilities: - Review requests for services including admission, discharges and continued stays for adherence to clinical criteria, state and federal policy, and related requirements. - Issue approvals, denials or recommendations based on contract requirements. - Identify need for additional clinical documentation or consultation. - Complete documentation of activities within contract systems. - Communicate with providers, individuals and their designees, or state workers as required. - Performs other related duties as assigned. Minimum Requirements - Current Registered Nurse (RN) license valid in the state of practice is required - High School Degree or equivalent required - Minimum 2 years of clinical experience required - Minimum of one (1) year of registered nurse experience Preferred Requirements - Knowledge of mental health principles and practices - Experience in physical rehabilitation - Attention to detail Home Office Requirements - Maximus provides company-issued computer equipment and/or cell phone - Reliable high-speed internet service - Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity - Minimum 5 Mpbs upload speeds - Private and secure workspace #ClinicalServices EEO Statement Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics. Pay Transparency Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances. Accommodations Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at **************************. Minimum Salary $ 33.00 Maximum Salary $ 37.12

Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers. Perform concurrent and retrospective reviews of medical records to ensure accurate documentation of patient care. Educate healthcare providers on the importance of accurate and complete clinical documentation. Utilize clinical knowledge and expertise to identify opportunities for documentation improvement. Ensure compliance with regulatory requirements and guidelines. Participate in multidisciplinary team meetings to discuss documentation improvement strategies. Provide feedback to healthcare providers on documentation practices and areas for improvement. Maintain up-to-date knowledge of clinical documentation standards and best practices. Responsibilities * Facilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers. * Perform concurrent and retrospective reviews of medical records to ensure accurate documentation of patient care. * Educate healthcare providers on the importance of accurate and complete clinical documentation. * Utilize clinical knowledge and expertise to identify opportunities for documentation improvement. * Ensure compliance with regulatory requirements and guidelines. * Participate in multidisciplinary team meetings to discuss documentation improvement strategies. * Provide feedback to healthcare providers on documentation practices and areas for improvement. * Maintain up-to-date knowledge of clinical documentation standards and best practices. Qualifications * Registered Nurse (RN) with a current license from any state. * Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Improvement Practitioner (CDIP) certification. * Certified Coding Specialist (CCS) certification if they have the CCDS 2 certification. * Minimum of 3 years of clinical nursing experience. * Strong knowledge of clinical documentation standards and regulatory requirements. * Excellent communication and interpersonal skills. * Ability to work collaboratively with healthcare providers and multidisciplinary teams. * Proficiency in electronic health record (EHR) systems. Additional Skills * Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Improvement Practitioner (CDIP) certification. * Certified Coding Specialist (CCS) certification if they have the CCDS 2 certification. Work Environment Fully remote role. Schedule: Monday-Friday 9am-5pm with potential for flexibility as long as 40-hour weeks are maintained. Pay and Benefits The pay range for this position is $70000.00 - $120000.00/yr. Health, Vision, Dental, 401k If we find a local candidate (CT RN license in CT, they will receive Middlesex Health Benefits, If we find someone national w/o CT RN License then they will receive benefits through 3rd party organization- Mindlance (have been told this is very expensive so they prefer local). Have all the benefit info in a PDF when needed Workplace Type This is a fully remote position. Application Deadline This position is anticipated to close on May 9, 2025. 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 for other accommodation options.

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

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.

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: $55/hr onsite and $50/hr travel time Work Location: Birmingham, Alabama; 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!

Our Virtual Urgent Care team is looking for an experienced Physician Assistant or Nurse Practitioner to join their team. In this role, you will be providing virtual medical care to patients of varying type and acuity. This is a full-time night shift position. As we care for patients of all ages, we cannot consider Adult/Gerontology trained Nurse Practitioners. Qualifications Physician Assistant * Required Master's Degree Graduate of an accredited Physician Assistant educational program * LIC-Physician Assistant - STATE_MI State of Michigan Upon Hire required * CRT-Physician Asst Certified (PA-C) - NCCPA National Commission on Certification of Physician Assistants Upon Hire required * CRT-Basic Life Support (BLS) - AHA American Heart Association 90 Days required Or * CRT-Basic Life Support (BLS) - ARC American Red Cross 90 Days required * CRT-Pediatric Adv Life Support (PALS) - AHA American Heart Association 120 Days required * CRT-Adv Cardiovascular Life Support (ACLS) - AHA American Heart Association 120 Days required Nurse Practitioner * Required Master's Degree Nurse Practitioners who obtained their education and certification after 2000 must show evidence of completion of a master's, post-master's or doctorate from a Nurse Practitioner program that is accredited by the Commission on the Collegiate of Nursing Education or the National League for Nursing Accrediting Commission * 3 years of relevant experience current, relevant clinical experience * Previous experience functioning in a collaborative role as a Nurse Practitioner * LIC-Nurse Practitioner (NP) - State of Michigan * CRT-Basic Life Support (BLS) * CRT-Neonatal Resuscitation Program (NRP) * CRT-Pediatric Adv Life Support (PALS) Corewell Health West Medical Group The Corewell Health West Medical Group is part of a not-for-profit health system serving 13 counties in West Michigan. Corewell Health West is a region of Corewell Health, formerly the BHSH System (Beaumont Health and Spectrum Health) that provides care and coverage with an exceptional team of 60,000+ dedicated people-including more than 11,500 physicians and advanced practice providers and more than 15,000 nurses providing care and services in 22 hospitals, 300+ outpatient locations and several post-acute facilities-and Priority Health, a provider-sponsored health plan serving over 1.2 million members. Through experience and collaboration, we are reimagining a better, more equitable model of health and wellness. Corewell Health People are at the heart of everything we do, and the inspiration for our legacy of outstanding outcomes, innovation, strong community partnerships, philanthropy, and transparency. Corewell Health is a not-for-profit health system that provides health care and coverage with an exceptional team of 65,000+ dedicated people-including more than 12,000 physicians and advanced practice providers and more than 15,500 nurses providing care and services in 21 hospitals, 300+ outpatient locations and several post-acute facilities-and Priority Health, a provider-sponsored health plan serving more than 1.3 million members Through experience and collaboration, we are reimagining a better, more equitable model of health and wellness. For more information, visit corewellhealth.org. How Corewell Health cares for you * Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here. * On-demand pay program powered by Payactiv * Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more! * Optional identity theft protection, home and auto insurance, pet insurance * Traditional and Roth retirement options with service contribution and match savings * Eligibility for benefits is determined by employment type and status Primary Location SITE - 515 Michigan St NE - Grand Rapids Department Name Virtual Urgent Care - CHMG West Employment Type Full time Shift Variable (United States of America) Weekly Scheduled Hours 40 Hours of Work Variable Days Worked Variable Weekend Frequency Every third weekend CURRENT COREWELL HEALTH TEAM MEMBERS - Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only. Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief. Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category. An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team. You may request assistance in completing the application process by calling ************.

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

Department: Status: Full time Benefits Eligible: Yes Hours Per Week: 32 Schedule Details/Additional Information: Pay Range $34.90 - $52.35Schedule: Part-time, either 3 (10 hour) shifts or 4 (8 hour) shifts. Day/pm hours available. Every third weekend and holiday rotation. **Candidate MUST have 2+ years' acute care experience (ED, Urgent Care, ICU and some Med/Surg will be considered) is required within the last 4 years to be considered.** Due to complex requirements, remote work is NOT permitted from the following states: CA, CO, CT, HI, MA, MD, MN, NJ, MY, OR, RI, VT, WA Schedule: Part time position (30 or 32 hours) start times mornings 8a,9a or 10a, PMs 12p, 1p, 2p or later 8 hour or 10 hour shifts are available for different shifts MUST be available to work every 4th weekend and holiday rotation Major Responsibilities: Uses the nursing process and guidance of established protocols to assess the needs of the patient telephonically including the patient, guardian, or family in the conversation when necessary. Determines most appropriate level of care needed, provides detailed education, establishes a plan of care including interventions, and communicates follow up instructions to the patient. Escalates and collaborates with the appropriate on call provider when additional guidance is needed. Prioritizes patient interactions by acuity and need considering all available information and resources. Applies evidence-based practice to deliver patient care. Implements strategies to reduce patient risk and increase patient safety. Assesses patient and family readiness to learn and individualizes the approach as necessary. Works collaboratively to develop strategies to meet the learning needs of the patient and family. Supports shared governance activities and initiatives to improve processes and patient outcomes. Participates in department quality/process improvement initiatives aimed at enhancing the patient care experience. Participates in professional activities which contribute to personal professional development and the development of others. Seeks opportunities to be taught, coached, and mentored. Attends required meetings/educational programs and completes annual competencies in a timely manner. Demonstrates effective communication, feedback, and conflict resolution skills. Promotes collaboration with clinicians and other healthcare team members to coordinate patient-centered care. Promotes a culture of safety through identifying threats to patient safety and intervening to prevent patient harm. Reports patient safety events and near misses in a timely manner. Seeks to identify potential safety issues and assists in the implementation of corrective action. Applies ethical decision making, demonstrates respect and understanding for peers, and other clinical disciplines. Participates as an effective member of the patient care team to formulate an integrated, unbiased, individualized approach to care. Must be able to demonstrate knowledge and skills necessary to provide care appropriate to the age of the patients served. Must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient's status and interpret appropriate information needed to identify each patient's requirements relative to his/her age specific needs and provide the care advice/disposition outlined in the departments policies, procedures, and protocols. Schedules appointments with emphasis on making the appointment in correlation to the recommended end point of the protocol used. Collaborates with other health care team members to coordinate medical and nursing management of patient care, including procedures and medication refills. Accurately maintains and updates the patient's clinical records according to agency, State and Federal guidelines. Documents all call encounters utilizing the patient's Electronic Medical Record at the time of the call. Communicates information relating to the patient's physical and psychological status to the physician, Advanced Practice Clinician and/or additional members of the interdisciplinary team as appropriate. Provides pertinent and concise reports describing patient's response to medical and nursing plans of care. Participates in team meetings and works on special projects/tasks as assigned by leadership. Participates in the ongoing development of comprehensive health information resources, system and operational efficiencies and resources. Assists in interpreting department policies and procedures and advises staff on procedural changes. Licensure, Registration, and/or Certification Required: Registered Nurse license issued by the state in which the team member practices. Education Required: Associate's Degree (or equivalent knowledge) in Nursing. Experience Required: Typically requires 2+ years' of acute care experience, preferably within the last 4 years (ED, Urgent Care, ICU and some Med Surg will be considered). Knowledge, Skills & Abilities Required: Critical thinking skills necessary to independently determine and prioritize the needs of patients using sound judgment and strong problem-solving skills. Knowledge of a variety of healthcare specialties, including levels of care, symptom identification and proven treatment recommendations. Ability to incorporate past experience with established protocols. Excellent verbal communication skills demonstrating empathy, respect, restatement, open-ended questions, active listening and diplomacy with a diverse customer population. Ability to develop rapport and maintain positive, professional relationships with a variety of patients, staff and physicians. Proven ability to independently organize and prioritize work, managing multiple priorities and maintaining a flexible schedule in a fast paced, dynamic customer service environment. Excellent customer service and follow-up skills including the ability to stay calm during stressful situations. Demonstrated proficiency as a technology user with computers, internet, desktop software packages and multiple-line telephone systems. Ability to converse with customers/patients while researching and documenting calls on multiple systems. Knowledge of documentation techniques for communication Physical Requirements and Working Conditions: Required stable and secure internet connection Must have functional vision, touch, speech, and hearing. Required sitting a majority of the workday. Operates all equipment necessary to perform the job. Must have quiet space to make and receive phone calls Ability to lift 15 lbs. This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties. Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including: Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance Benefits and more Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and paid parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation's largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.

In the U.S., 60% of adults - more than 133 million people - live with at least one chronic condition. These patients need frequent, proactive support to stay healthy, yet our care system isn't built for that level of attention. With rising clinician shortages, strained infrastructure, and reactive care models, patients too often end up in the ER or the hospital when those outcomes could have been prevented. At Cadence, we're building a better system. Our mission is to deliver proactive care to one million seniors by 2030. Our technology and clinical care team extend the reach of primary care providers and support patients every day at home. In partnership with leading health systems, Cadence consistently monitors tens of thousands of patients to improve outcomes, reduce costs, and help patients live longer, healthier lives. The Cadence Health team seeks a PRN Registered Nurse that will be responsible for appropriately monitoring and triaging patients based on vitals and alerts; supporting the management of patient treatment plans and medications in collaboration with Cadence NPs and the patient's Physician. The role of PRN staff is to provide relief when regularly scheduled staff take time off for scheduled vacation, sick leave, or CME. This will cover shifts during the day, nights, weekends, and holidays. SCHEDULE REQUIREMENTS: Minimum of 4 shifts a month (if needed), with priority for nights/weekends if offered. 2 holiday requirements per year. 2 nights per quarter or 1 weekend per quarter if offered. WHAT YOU'LL DO: Respond to inbound patient clinical questions and escalations by phone (and/or text message). Follow standardized triage protocols for incoming calls and escalate appropriately (e.g. Schmitt - Thompson clinical telephonic triage guidelines). This can range from directing the patient to their clinic after-hours call line for non-urgent needs to sending the patient to the ER and/or dialing 911 for emergencies. Support clinical documentation for the patients' Cadence care team (NP, RN, and Patient Success); including documenting patient case notes in the Cadence platform and logging tickets/follow-up tasks in ZenDesk (dedicated ZenDesk training provided). Follow up with patients with abnormal readings to gather more information on their clinical status and triage appropriately. Monitor patient vitals, symptoms, and labs to identify patients in need of clinical interventions and appropriate escalation. Clinical documentation on alert resolution/follow-ups in the Cadence platform. Additional administrative support as needed: Follow up with patients who need rescheduling, reach out to patients who have had lapses in taking their vitals, and other administrative work. Ensure every healthcare interaction with Cadence is an exceptional experience that prioritizes the well-being of the patient and aligns with the goals of our health system partners. WHAT YOU'LL NEED: RN compact multi-state license, at least 1 additional state license either in CA, MI, IL, or AK, and a willingness to expand state licensure if needed as Cadence adds new markets. 3+ years of experience treating patients with chronic conditions including CHF, Hypertension, and/ or Diabetes patients either in an outpatient or inpatient setting. Passion for the patient/customer experience and systematically improving healthcare with digital innovation. Independent thinker/operator (comfortable working in a less structured environment). WHO WE ARE: Cadence Health was built around a simple promise: patients always come first. Our technology-enabled remote care model pairs continuous health insights with a highly skilled clinical Care Team, empowering seniors to stay healthier, avoid complications, and live more independent, fulfilling lives, all without the limits of a traditional office visit. Your expertise is the heart of our system. Nurse practitioners, registered nurses, medical assistants, patient-success coordinators, and other frontline clinicians are the face and beating heart of Cadence. You'll bring warmth, clinical precision, and the empathy that turns a virtual touchpoint into a human connection. Every chat, phone call, and care plan you deliver shapes how patients experience “what healthcare should be.” A modern toolkit to practice top-of-license care We've replaced reactive visits with real-time data, intelligent workflows, and seamless collaboration tools. That means you can spend less time on busywork and more time practicing at the top of your license, coaching patients, spotting risks early, and coordinating with physicians to keep care proactive and personal. Thriving in a fast-moving, mission-driven culture. Change excites us. Innovation fuels us. If you're energized by technology, eager to re-imagine care delivery, and motivated to improve outcomes for both patients and the providers who serve them, you'll feel at home here. We invest in continuous learning, clinical mentorship, and transparent growth paths so you can advance your skills while making a measurable impact every day. Join us in redefining healthy aging. If you're passionate about compassionate care and ready to transform how seniors across the country manage chronic conditions, recover after hospitalization, and age with confidence, let's talk. Together, we'll build a future where exceptional care is consistent, connected, and just a call away. WHAT YOU'LL GET: Cadence recognizes the unique needs of its diverse, distributed workforce and seeks to provide an inclusive work environment for its world-class clinicians and technologists. A company culture that is all about impact, shared growth mindset, empowerment, and integrity An opportunity to help improve the quality of life of millions of Americans A unique chance to support the development of an amazing product; Cadence's in-house clinicians are our super users and beta testers Laptop, Monitor, Keyboard and Mouse for remote working Expected compensation range: $35-$40/hour, and $10/hour additional for night shifts Location: Remote We are committed to equal opportunity and fairness regardless of race, color, religion, sex, gender identity, sexual orientation, nation of origin, ancestry, age, physical or mental disability, country of citizenship, medical condition, marital or domestic partner status, family status, family care status, military or veteran status or any other basis protected by local, state or federal laws. Candidates must be willing to comply with all pre-employment drug screening requirements and, where applicable, comply with additional drug screening requirements as a condition of continued employment in accordance with company policy and applicable law. *A notice to Cadence applicants: Our Talent team only directs candidates to apply through our official careers page at ********************************** Cadence will never refer you to external websites, ask for payment or personal information, or conduct interviews via messaging apps. We receive all applications through our website and anyone suggesting otherwise is not with Cadence.

Summary of Performance Expectations Provides professional nursing care and makes nursing care decisions that are appropriate for the age and condition of the patient, using the nursing process. Collaborates with other health care professionals to meet the needs of the patient. Responsible for adhering to CVMC/ departmental policies, procedures, and philosophy to deliver quality patient care, practicing within the guidelines of the North Carolina State Nurse Practice Act and abiding by the CVMC Nursing Bylaws. Education and Credentials: Required: Graduate of accredited nursing program. Current NC RN license or licensure from Nursing Compact State. BCLS certification. If the BCLS certification is not from the American Heart Association (AHA), an AHA certification is required within three months of employment date. Additional Requirements by Practice Area Birthing Center : ACLS and NRP within three months of employment date. Critical Care Unit: ACLS within three months of employment date. Day Surgery: ACLS and PALS within three months of employment date. Emergency Dept.: ACLS and PALS within three months of employment date.Non-Violent Crisis Intervention Certification within three months of employment date. Heart and Vascular Services: ACLS and PALS within three months of employment date. Infusion Center: Full-time RNs: Chemotherapy certified via ONS/ONCC Chemo/Immunotherapy Certificate Course within eight months of employment date; renewed every two years. Inpatient Rehabilitation: Quality Indicator credentialing within three months of employment date. Intermediate Care Unit: ACLS within three months of employment date. Level III Nursery: NRP within three months of employment date. STABLE within one year of employment date, renewal not required. Newborn Nursery: NRP within three months of employment date. STABLE within one year of employment date, renewal not required. Oncology: ONS/ONCC Chemotherapy/Immunotherapy Certificate Course within one year of employment date and renewed every two years. Radiation Oncology: ONS Radiation Oncology Certificate Program within one year of employment date. PACU: ACLS and PALS within three months of employment date. Pediatrics: PALS within three months of employment date. Psychiatry: Non-Violent Crisis Intervention Certification within three months of employment date and renewed at least bi-annually for the first year and annually thereafter. Preferred: BSN (BSN enrollment and completion requirements may apply), specialty course work and certification in area of practice. Work Experience: Required: No previous experience required, except as listed below. Incumbent should be proficient in the basic aspects of the job and able to assume call responsibilities as required within three months of employment date. Specific Work Experience Requirements: Heart and Vascular Services: six months of cardiac monitoring. Preferred: Critical Care Unit and PACU: six months of cardiac monitoring experience. All other units: Prior work experience in requested practice area.

Raleigh General Hospital Registered Nurse (RN), Clinical Instructor Job Type: PRN About our Health System Raleigh General is a 300 bed hospital located in Beckley, WV, and is part of Lifepoint Health, a diversified healthcare delivery network committed to making communities healthier with acute care, rehabilitation, and behavioral health facilities from coast to coast. From your first day to your next career milestone-your experience matters. Your experience matters At Raleigh General Hospital, we are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. Here, you're not just valued as an employee, but as a person. As a registered nurse (RN) 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. Job Summary Responsible for planning and presenting education programs as directed and for assisting the in-house patient education programs. Job Requirements Minimum Education Graduate of a Program in Discipline - Required Registered nurse graduated from a school of nursing. BSN and/or MSN preferred. Required SkillsRequires 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. Certifications: Basic Life Support (BLS) Advanced Cardiovascular Life Support (ACLS) - required if teaching course Pediatric Advanced Life Support (PALS) - required if teaching course - to be obtained within 6 months Evidence of proficient skills in teaching ability, creativity, communication, and in nursing procedure administration. Demonstrated ability to work with persons of diverse backgrounds and training experience. Demonstrated evidence of effective nurse-patient relationships with emphasis on patient teaching. Basic knowledge of Personal Computer. Required Licenses Current licensure by the State Board of Nursing Essential Functions Participates in and conducts orientation and education programs for hospital staff and community. Assists with planning, developing and implementing educational programs for hospital staff. Provides patient instruction and education. Assists in coordinating educational activities (conferences, seminars) within the hospital. Coordinating and/or teaching scheduled Childbirth classes. Delivers direct patient care appropriate to the age of patient served. Serves as primary contact between The Training Center and the hospital

About Us: Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. JOB SUMMARY: ESSENTIAL DUTIES AND RESPONSIBILITIES: Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member's performance objectives as outlined by the Team Member's immediate Leadership Team Member. Location: Remote within the United States ONLY Schedule: Monday - Friday, 8:00 AM - 5:00 PM As a Clinical Review Specialist (RN), you will have the unique opportunity to evaluate hospitalizations across the country while utilizing your medical knowledge and gaining experience as an expert advisor. You will perform retrospective clinical case reviews and draft appeals that focus on establishing the Medical Necessity of the services performed, both Inpatient and Outpatient. Essential Duties and Responsibilities: · Performs retrospective medical necessity reviews to determine appeal eligibility of clinical disputes/denials. · Constructs and documents a succinct and fact-based clinical case to support appeal utilizing appropriate medical necessity criteria and other pertinent clinical facts. o Pertinent clinical facts include, but are not limited to, documentation preventing a safe transfer/discharge or documentation of medical necessary services denied for no authorization. · Demonstrates ability to critically think, problem solve and make independent decisions supporting the clinical appeal process. Minimum Qualifications & Competencies: · RN License with strong clinical knowledge - Active unrestricted clinical license in at least one state within the United States. · Minimum of 2-3 years of writing appeals letters and clinical auditing. · Minimum of 2-3 years Utilization Review / Case Management experience within the last 5 years. · Must be familiar with the payer guidelines and EMR systems like Epic, Cerner or Meditech. · Managed care payor experience a plus in either Utilization Review, Case Management or Appeals. · Must have excellent attention to detail, written communication skills and be computer proficient. PHYSICAL DEMANDS: Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A is only intended as a guideline and is only part of the Team Member's function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE). Job Summary: The Clinical Auditor 2 performs audits of medical records on behalf of hospital clients for denials review, defense audits, disallowed charges, and utilization reviews. This position requires critical thinking and judgment and must demonstrate the ability to appropriately use standard criteria such as InterQual and Milliman (MCG) in addition to criteria established by state Medicaid programs or hospital policy. Audit and analysis must be accurate and consistently ensure a high level of quality, knowledge of laws, rules, regulations and guidelines necessary to ensure compliance and protection of information. Primary / Essential Functions: The Primary/ essential job duties may not be exhaustive. Clinical Staff Responsibilities: Performs audits of medical records to identify and/or defend charges, including: o Defense Audits o Patient Inquiry Audits o Disallowed Charges o Biller Requested Audits Completes analysis of records against established criteria, (e.g., InterQual, MCG, Medicare, Medicaid criteria), to determine if patient condition and/or care meets that criteria, including: o Avoidable day studies o Managed care, Medicare or Medicaid reconsiderations/appeals o Medicare or Medicaid RAC appeals or other specialized Audit Appeals (e.g. CERT, ZPIC, SMRC) Determine, request, and obtain appropriate supporting documentation from hospital, physicians, current medical literature and patient. Will compose appeal letters addressing and appealing both contract issues and medically related issues Organizes and prioritizes multiple cases concurrently to ensure departmental workflow and case resolution. Enter audit findings and/or data into Client's computer based system. Proficiently utilize multiple computer based systems to complete and document work (both Savista and client) Client based billing, Internal based billing, medical record and quality systems Microsoft Outlook, Word and Excel Function in a professional, efficient and positive manner Must be customer-service focused and exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence and commitment to profession Will help identify issues or challenges in the department, and come up with solutions or ideas to improve Maintain confidentiality of patient information and abide by all HIPAA related guidelines Competencies: · Puts Clients First · Drives for Results · Understands our Business · Thinks Innovatively · Values Differences · Builds Teamwork · Gains Trust · Communicates Effectively · Shows Accountability · Takes Action · Embraces Change · Makes Quality Decisions Physical / Mental Demands, Environment: 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. Must be able to use hands to finger, handle or feel, sit, stand, walk, lift up to 20 pounds, stoop, clean, bend, and reach with hands and arms. Must communicate clearly in English. Requires the ability to speak, read, write, see, and hear to perform essential duties of the job. Effective and positive human relations skills are required, including confidentiality, in order to appropriately interface with staff and clients. Must be able to perform multiple tasks and detailed work, problem solve, reason, and perform basic mathematical calculations. Equipment Used: Telephone, fax, calculator, computer, monitor, printer, hardware and software packages, computer peripheral equipment i.e. mouse and keyboard; and Microsoft software. Minimum Qualifications: Must be RN/Case Management /Utilization Review/Coding clinical certification with a BS/BA preferred otherwise equivalent years of technical experience 3 to 5 years of clinical experience or 3 to 5 years of clinical auditing experience in either case management, Medicare appeals, utilization review or denials management Knowledge of Milliman (MCG) or InterQual criteria preferred Experience in medical records review, claims processing or utilization/case management in a clinical practice or managed care organization Fundamental knowledge of Medicare/Medicaid Guidelines Proficiency in navigating the internet and multi-tasking with multiple electronic documentation systems simultaneously (toggling) Skilled with Microsoft Outlook, Word, Excel and EMR Savista is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $28.00 to $38.00. However, specific compensation for the role will vary within the above range based on many factors including but not limited to geographic location, candidate experience, applicable certifications, and skills. SAVISTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class. California Job Candidate Notice

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. Job Summary and Responsibilities Acentra Health is looking for a Clinical Reviewer - RN (Remote U.S.) to join our growing team. Job Summary: * Review medical records against criteria, contract requirements, and regulatory standards. Employ critical thinking to determine medical appropriateness while meeting production goals and QA standards. Ensure day-to-day processes align with NCQA, URAC, CMS, and other regulatory benchmarks, ensuring precision and compliance in medical record reviews. Responsibilities: * Review and interpret patient records, comparing them against criteria to determine medical necessity and appropriateness of care; assess if the medical record documentation supports the need for services. * Initiate a referral to the physician consultant and process physician consultant decisions, ensuring the reason for denial is described in sufficient detail in correspondence. * Abstract review-related data/information accurately and promptly using the appropriate means on an appropriate review tool. * Ensure accurate and timely submission of all administrative and review-related documents to the company. * Perform ongoing reassessment of the review process to identify improvement and/or change opportunities. * Foster positive and professional relationships and liaise with internal and external customers to ensure effective working relationships and team building, facilitating the review process. * Be responsible for attending training and scheduled meetings and maintaining and using current/updated information for review. * Maintain medical records confidentiality by properly using computer passwords, maintaining secured files, and adhering to HIPAA policies. * Utilize proper telephone etiquette and judicious use of other verbal and written communications, following company policies, procedures, and guidelines. * Actively cross-train to perform duties of other contracts within the company network to provide a flexible workforce to meet client/consumer needs. * Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules. The above list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary. Work Hours: * Monday through Friday, 8:00 AM until 5:00 PM within the Time Zone where you reside, plus: One day per week is a priority day that would be assigned to complete expedited cases received between 3:00 PM and 6:00 PM Central. Qualifications Required Qualifications/Experience: * Active, unrestricted Registered Nurse (RN) License in any state, or an RN compact state license. * Associate's, Bachelor's degree (or Diploma) in Nursing. * 2+ years of clinical experience in an acute OR med-surgical environment. * 1+ years of work experience in Utilization Review (UR), Utilization Management (UM), OR Prior Authorization. * 1+ years of knowledge of medical records, medical terminology, and disease process organization. * 1+ years of knowledge of InterQual criteria and/or Milliman Care Guidelines (MCG). Preferred Qualifications/Experience: * Knowledge of current National Committee for Quality Assurance (NCQA) standards. * Knowledge of Utilization Review Accreditation Commission (URAC) standards. * Knowledge of Medicare (CMS) guidelines. * Experience with Medical Appeals. * Experience with Medicare Advantage plans. * Medical Record Abstracting skills. * Clinical assessment and critical thinking skills. * Excellent verbal and written communication skills. * Ability to work in a team environment. * Flexibility and strong organizational skills. * Proficient in Microsoft Office and Internet/Web Navigation. #LI-SD1 Why us? We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes. We do this through our people. You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career. Thank You! We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search! ~ The Acentra Health Talent Acquisition Team Visit us at Acentra Health EEO AA M/F/Vet/Disability Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law. Benefits Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more. Compensation The pay range for this position is listed below. "Based on our compensation philosophy, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level." Pay Range USD $28.37 - USD $37.50 /Hr.

MOBILE PRIMARY CARE - Remote $23.00hr - $27.00hr About us: Mobile Primary Care is a home-based primary care practice that specializes in geriatric healthcare, serving New York State. About the Opportunity: A healthcare organization seeking a licensed LVN, LPN or RN to join their growing staff as a new Care Management Nurse. This role will be providing telephonic Care Management for patients throughout the health system under the direction of a patient's provider. The nurse utilizes nursing process to evaluate patient needs over the telephone and provide guidance and education to patients, adhering to organizational policies, procedures and guidelines. Provides high risk patients with chronic disease management and liaises between the patient, patient's family or caregiver, provider, provider's office, hospital, home care agency etc. This position is telephonic care coordination as directed by the patients provider. Position Responsibilities: Cooperatively develop and integrate patient centered provider care plan and goals with the client/family and other providers Work collaboratively with team members to provide outreach and engagement with the patient Work closely with in-office providers/staff members to: Provide patient education to assist with self-management Identify gaps or barriers in treatment plans Coordinate care enrolled patients including scheduling appointments Coordinate referrals Coordinate community resources as needed (ie: home health, DME etc) Educate members on disease processes Encourage members to make healthy lifestyle changes Actively maintain assigned caseload of patients Make outbound calls to assess members current health status Receive and respond to telephone calls from patients. Collecting health data and providing medical guidance under the direction of the patients provider Document calls according to established guidelines Connects patient's care team together with updated information as received Participation in education and in-service programs Performs on-call for region that you are assigned Additional duties as assigned Required Qualifications: Unrestricted and current license to practice as LVN/LPN/RN with a New York State license. 3 years of experience within Care Management setting or Case Coordinator either in the homecare, inpatient, physician practice or in-home case management setting Strong working knowledge of chronic disease states including chronic kidney disease, diabetes mellitus, chronic obstructive pulmonary disease and congestive heart failure and basic medical management of these states Must be highly motivated, result-oriented with strong skills in presenting, communicating, organizing and time management skills Strong organizational and interpersonal skills Excellent customer service skills demonstrated by positive feedback from patients/team Ability to identify problems and recommend solutions Demonstrates progressive proficiency with the utilization of available computer technology, including typing skills Demonstrates; leadership, communication, interpersonal and problem-solving skills Experience working with Electronic Health Record (EHR) Ability to sit and work at a computer for extended periods of time 60 words per minute typing Preferred Qualifications: Bilingual in Spanish

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

Nurses Focused Campus Staff Minister -- Georgia (Undergraduate Ministry) (Evergreen) Job Type: Part time God has called InterVarsity to plant and to build witnessing communities of students and faculty who follow Jesus on college and university campuses. Through these groups, we believe ever- increasing numbers of students and faculty from all ethnic groups and areas of the campus will be transformed by the Gospel. We expect to see campuses increasingly become places where people, ideas, and structures flourish to the glory of God. We confidently anticipate that our InterVarsity alumni will become change agents across the country and around the world. We pursue this calling by discerning and actively participating in what God is already doing on campus. This is the essence of being a Campus Staff Minister (CSM). ESSENTIAL COMMITMENTS/RESPONSIBILITIES Spiritual Growth As a Campus Staff Minister, you pursue maturity as a disciple of Jesus Christ so that your life and work increasingly reflect a growing love for God, God's Word, God's people of every ethnicity and culture, and God's purposes in the world. To do this, you will: Pursue a vibrant relationship with the triune God through engagement with Scripture, prayer, and worship, both individually and in community Develop self-leadership (growing in self-awareness, self-management, relational integrity, and resiliency) Embrace Scriptural standards for behavior and attitudes Campus Leadership As a Campus Staff Minister, you increase the number of witnessing communities, as well as the size, health, spiritual maturity, and campus-wide influence of existing witnessing communities of students and faculty by being a: Visionary Guide: You communicate and model InterVarsity's vision to see students and faculty transformed, campuses renewed, and world changers developed Create a culture of humble dependence on God and bold expectation in God's intention to start new witnessing communities throughout the campus and on new campuses Model - in person and through programs - InterVarsity's vision and Core Values, including a biblically-defined commitment to engage every ethnic and social group on campus Lead students and faculty - individually and collectively - through Scripture, prayer, teaching, and discipleship experiences, so that they articulate and align their ministry activities around this vision Set annual goals through prayer, research and reflection with your teams (students, faculty, and staff) for qualitative and quantitative growth, including conversions and leadership development Structural Architect: You create, develop, align, and leverage ministry plans, programs, teams, and structures to close the gap between current reality and the aspirational goals. Build leadership teams who trust and partner well with you and who demonstrate spiritual vitality, relational health, and mission alignment Develop and execute plans to achieve annual goals, evaluating and modifying the plan as needed throughout the year Increase momentum for the vision by aligning programs, structures, conferences, and teams around the goals Mobilize students and faculty to engage their relational networks with the gospel and to start new missional communities Under the direction of the Area Director, may supervise Ministry Interns and Campus Ministry Interns as delegated Missional Developer: You intentionally gather, invite, and develop diverse groups of students and faculty so that they not only encounter and follow Jesus as Savior and Lord but also advance the mission on campus as participants and leaders. Create ways for faculty and students to encounter and follow Jesus through Scripture, worship, prayer, mission experiences, conferences, etc. Equip students and faculty so that they think strategically about campus engagement and so that they proclaim - in word, deed, and power - the good news of Jesus, regularly inviting students and faculty to follow him as Savior and Lord Disciple students and faculty by equipping them to hear the Word, respond actively, and debrief and interpret the experience so that they grow in Christlikeness, reflect our Core Values, and develop ministry skills Invite, coach, and equip students and faculty to become increasingly effective participants and leaders, including starting new witnessing communities on campuses Organizational Collaboration As a Campus Staff Minister, you have joined a national mission. Therefore, you work with a network of other local, area, regional, and national InterVarsity staff and volunteers so that our work reflects Biblical standards of excellence, integrity, and partnership. Partner with and respond positively to the direction and coaching of your supervisors and national leaders Contribute to collaborative and productive team meetings and relationships Affiliate chapters under your care and submit Graduating Student Forms in order to increase our partnership with current students and alumni Use national ministry resources and tools, as requested, including recruiting and/or participating in local, regional, or national conferences as required Complete reporting, planning and review requirements in a timely way so that you and your supervisors can assess and improve your work as a CSM Comply with all InterVarsity policies and procedures Ministry Partnership Development As a Campus Staff Minister, you will develop a team of partners - churches and individuals (including alumni and community members) - who will resource the ministry financially, in prayer, or volunteer service that advances the mission. Raise 100% of the financial budget assigned by your supervisor Communicate regularly with your ministry partners, nurturing the relationship through visits, phone calls, emails and regular prayer letters Develop on-going, long-lasting partnership with alumni and volunteers Comply with all Ministry Partnership Policies Identify and invest in advocates who will build networks of volunteers and donors on InterVarsity's behalf Accomplish all other assigned tasks as appropriate QUALIFICATIONS (common to all levels of CSM) Annually affirm InterVarsity's Statement of Agreement (Doctrinal Basis and Purpose Statement). Abide by InterVarsity's Code of Conduct. Believe and behave consonantly with InterVarsity's Human Sexuality Theological Paper. Affirm and behave consonantly with InterVarsity's “Women in Ministry Statement of Affirmation” Bachelor's degree required for CSMs assigned to a four-year campus. A minimum of an Associate's degree required for CSMs assigned to a two-year campus or a community college Strong interpersonal skills (including ability to minister to diverse ethnic communities and faculty) Excellent verbal and written communication skills Demonstrated problem solving skills Familiarity with word processing, presentation, email, and spreadsheet software Experience working with nursing students and or a corner ministry, preferably in a planting context Track record of advocating for NCF and nursing student ministry Respected in the region, especially regarding nursing student ministry Basic understanding of the nursing student reality and NCF, with a desire to learn more Major Responsibilities: Because each region's context and needs vary, we expect exact responsibilities to change accordingly. Below are several broad areas of responsibility, with examples of how they might be implemented in a specific area/regional context. Coordinate and support existing ministry, working with local volunteers, student leaders, and local InterVarsity Staff to see sustainable chapters resourced In partnership with area/regional and NCF leadership, identify potential NCF planting campuses in the region. Examples: Each year, identify the top 3 campuses for NCF planting Create a 2- to 3-year NCF planting roadmap for the region, including identifying critical campuses and the strategies to support them. Promote NCF in the area/region with students, staff, staff directors, and NCF members/constituents. Examples: Host an NCF interest table/luncheon at a regional student conference/camp Vision-casting phone calls with 2-3 staff in the region who have expressed interest in nursing student ministry Send a semi-annual e-mail to local NCF members (provided by NCF nationally) to update them on nursing student ministry in the region Participation in other NCF and Regional programming as requested Time Commitment: 12+ hours/month (time commitment varies by time of year) . It can be done in conjunction with another role. Supervision Structure: (One of the unique aspects of NCF is that we are open and flexible regarding the supervision of a coordinator. We have coordinators at the area and regional levels, some supervised by NCF and others by the area or regional director. We want to be flexible about what works for all involved parties (NCF, staff, and area/region).) Supervised by NCF Student Ministry Director, Associate Student Ministry Director, Area Ministry Director, Regional Director, Associate Regional Director, or NCF Regional Coordinator. Support and Benefits: Opportunity to influence a whole movement. NCF Coordinators will play a significant role in shaping the future of InterVasity by working with volunteers as primary chapter leaders. This national leadership opportunity is rare in our many-layered InterVarsity organization and can be a strong resume builder. First to know about NCF opportunities. NCF Coordinators will be the first to know about scholarship opportunities, planting grants, new resources, etc. A free subscription (print, online, archives) to NCF's award-winning Journal of Christian Nursing , an excellent resource for nursing student ministry, now in its 41st year of publication. This position can be full-time or part-time; the salary of $42,540 will be prorated for part-time status. WORK ENVIRONMENT/PHYSICAL REQUIREMENTS The CSM position leads ministry in a college campus environment. A designated office space may or may not be available. The CSM is required to travel to on-campus and off- campus sites as appropriate. Off-campus travel includes, but is not limited to: student ministry conferences, Ministry Partnership Development meetings, and InterVarsity- sponsored training sessions, meetings, and conferences. The CSM is regularly required to communicate with others, and routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets, etc. Pay Range: $39,288.00 - $52,392.00 per year Pay: This position is funded through personal fundraising. Accordingly, compensation will vary based on the ability of the individual to secure a donor team to fund the cost of his/her salary. The anticipated salary range for this position on a full-time basis (40 hours/week) is dependent on a variety of factors, including location and cost of living. The actual salary received, including any geographic adjustment to account for location and cost of living, is subject to the individual's ability to raise funds necessary to cover the full amount of such salary within the range set forth in the job posting details. Benefits: We offer a competitive benefits package, including health care and retirement savings with a match. Eligibility is based on employee type and hours worked. Benefits include the following: 403(b) Retirement Savings Plan 403(b) matching contributions Dental insurance Employee assistance program Employee discounts Flexible work schedule Flexible spending accounts Health insurance Health savings account Life insurance Paid time off Parental leave Professional development assistance Vision insurance Equal Employment Opportunity: InterVarsity Christian Fellowship/USA is both an equal opportunity employer and a faith-based religious organization. We conduct hiring without regard to race, color, ancestry, national origin, citizenship, age, sex, marital status, parental status, membership in any labor organization, political ideology, or disability of an otherwise qualified individual. The status of InterVarsity Christian Fellowship/USA as an equal opportunity employer does not prevent the organization from hiring staff based on their religious beliefs so that all staff share the same religious commitment. Pursuant to the Civil Rights Act of 1964, Section 702 (42 U.S.C. 2000e 1(a)) InterVarsity Christian Fellowship/USA has the right to, and does, hire only candidates who agree with InterVarsity's Statement of Agreement: Purpose and Doctrinal Basis because InterVarsity believes that each and every staff plays a vital role in advancing InterVarsity's mission and purposes.