Utilization review nurse jobs in Doylestown, PA - 174 jobs

Job DescriptionDescription: The Renfrew Center of Philadelphia, offers an unmatched opportunity, in the field of eating disorders, for a Utilization Review Coordinator to work in an environment that changes lives. The Renfrew Center has opportunities for individuals of all backgrounds, that have the desire and passion to foster a positive outcome and impact on our patients' lives. The Renfrew Center's research-based treatment model, for eating disorders, is focused on treating the whole person and helping them lead a rich and fulfilling life. Our commitment to you - We are committed to providing every employee the opportunity for personal and professional development through: 401(k) with company match Healthcare benefits Vacation and sick days Employee referral program Employee discounts to various stores, amusement parks, events, etc. Continuing education (CE) programs and training Advancement opportunities within the organization Position Responsibilities: Complete daily treatment pre-certifications with insurance/managed care companies. Complete daily concurrent reviews with insurance/managed care companies. Understand and present acuity, rationale for continued stay, treatment goals and discharge criteria from a medical record. Be familiar with various managed care companies medical necessity criterion and appropriate application, to guide the concurrent review process. Maintain accurate and complete documentation, including computer documentation. Participate and effectively collaborate with a treatment team as an active team member. Demonstrate an understanding of the functional/developmental age of the individual served. Requirements: Education, Competencies and Credentials: Master's degree in Human Services, Psychology, or Social Work required. A minimum of 1-2 years of training/working in a residential or health care facility is required. Previous experience working with eating-disorder patients is highly preferred. Familiarity with psychiatric disorders is required. Hours: 40 hours per week, Monday through Friday. The Renfrew Center provides women with the tools they need to succeed - in recovery and life. Offering a warm, nurturing environment, Renfrew emphasizes respect for the unique psychology of women, the importance of a collaborative, therapeutic relationship, and the belief that every woman needs to actively participate in her growth and recovery. The Renfrew Center - An Equal Employment Opportunity Employer, devoted to diversity, equity, and inclusion.

About us: Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ “Superior” by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide. Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path! Benefits: We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer! Competitive compensation Healthcare benefits package that begins on first day of employment 401K retirement plan with company match Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays Up to 6 weeks of parental and bonding leave Hybrid work schedule (3 days in the office, 2 days from home) Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation) Tuition reimbursement after 6 months of employment Numerous opportunities for continued training and career advancement And much more! Responsibilities The Utilization Review Nurse's duties will include, but are not limited to: Support internal claims adjusting staff in the review of workers' compensation claims Review records and requests for UR, which may arrive via mail, e-mail, fax, or phone Meet required decision-making timeframes Clearly document all communication and decision-making within our insurance software system Establish collaborative relationships and work as an intermediary between clients, patients, employers, providers, and attorneys Utilize good clinical judgment, careful listening, and critical thinking and assessment skills Track ongoing status of all UR activity so that appropriate turn-around times are met Maintain organized files containing clinical documentation of interactions with all parties of every claim Send appropriate letters on each completed UR Qualifications Active Licensed Practical Nurse and/or Registered Nurse License 1+ years of utilization review experience at a managed care plan or provider organization 2 + years' clinical experience preferably in case management, rehabilitation, orthopedics, or utilization review Excellent oral and written communication skills, including outstanding phone presence Strong interpersonal and conflict resolution skills Experience in a fast-paced, multi-faceted environment The ability to set priorities and work both autonomously and as a team member Well-developed time-management and organization skills Excellent analytical skills Working knowledge of: Microsoft Word, Excel, and Outlook

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career! Job Description • Evaluate clinical information submitted by providers against plan review criteria and benefit guidelines • Utilize clinical information to determine if criteria for medical necessity and benefit guidelines are met • Document pertinent case information for approvals and denials- refer cases failing to meet Interqual to Medical Director • Act as liaison to ensure services are provided in the least restrictive, most cost effective and clinically appropriate setting • ID and resolve problems that could interfere with provider's continuity and coordination of care of members- refer unresolved problems to the manager Qualifications • Clear and active RN license in state of PA • Minimum AS in nursing • 2 years' experience in acute care hospital AND • 2 years' experience in managed care, quality assurance or utilization review setting Additional Information Hours for this Position: 40 hours a week M-F, daytime hours Advantages of this Opportunity: • Competitive salary, negotiable based on relevant experience • Benefits offered, Medical, Dental, and Vision • Fun and positive work environment • Right to Hire opportunity • Can start as early as next week Interested in being considered? If you are interested in applying to this position, please contact Steph Zymowski at 407-636-7030 ext.220 and click the Green I'm Interested Button to email your resume.

Formulary Strategy & Utilization Review Pharmacist Shape the drug benefit landscape-analyze and optimize medication use. Key Responsibilities: Review prescribing trends and propose cost-saving alternatives. Maintain evidence-based formularies across multiple payers. Conduct retrospective DUR and prepare stakeholder reports. Qualifications: PharmD with managed care, DUR, or pharmacy benefit experience. Strong Excel/data analytics background preferred. Understanding of clinical guidelines and P&T processes. Why Join Us? Join a top-tier managed care team Hybrid flexibility Strategic and data-driven focus

**his position is responsible for performing RN duties using established guidelines to ensure appropriate level of care as well as planning for the transition to the continuum of care. Performs duties and types of care management as assigned by management.** **Responsibilities:** 1. Assesses patient's clinical need against established guidelines and/or standards to ensure that the level of care and length of stay of the patient are medically appropriate for inpatient stay. 2. Evaluates the necessity, appropriateness and efficiency of medical services and procedures provided. 3. Coordinates and assists in implementation of plan for members. 4. Monitors and coordinates services rendered outside of the network, as well as outside the local area, and negotiate fees for such services as appropriate. Coordinates with patient, family, physician, hospital and other external customers with respect to the appropriateness of care from diagnosis to outcome. 5. Coordinates the delivery of high quality, cost-effective care supported by clinical practice guidelines established by the plan addressing the entire continuum of care. 6. Monitors patient's medical care activities, regardless of the site of service, and outcomes for appropriateness and effectiveness. 7. Advocates for the member/family among various sites to coordinate resource utilization and evaluation of services provided. 8. Encourages member participation and compliance in the case/disease management program efforts. 9. Documents accurately and comprehensively based on the standards of practice and current organization policies. 10. Interacts and communicates with multidisciplinary teams either telephonically and/or in person striving for continuity and efficiency as the member is managed along the continuum of care. 11. Understands fiscal accountability and its impact on the utilization of resources, proceeding to self-care outcomes. 12. Evaluates care by problem solving, analyzing variances and participating in the quality improvement program to enhance member outcomes. 13. Completes other assigned functions as requested by management. Core Individual Contributor Competencies. Personal and professional attributes that are critical to successful performance for Individual Contributors: Customer Focus, Accountable, Learn, Communicate. **Qualifications:** **Education/Experience** 1. Requires an associate's or bachelor's degree (or higher) in nursing and/or a health related field OR accredited diploma nursing school. 2. Requires a minimum of two (2) years clinical experience. **Additional licensing, certifications, registrations:** 1. Requires an active New Jersey Registered Nurse License. **Knowledge:** - Prefers proficiency in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint) and Lotus Notes; prefers knowledge in the use of intranet and internet applications. - Prefers working knowledge of case/care management principles. - Prefers working knowledge of principles of utilization management. - Prefers basic knowledge of health care contracts and benefit eligibility requirements. - Prefers knowledge of hospital structures and payment systems. **Skills and Abilities:** - Analytical - Compassion - Interpersonal & Client Relationship Skills - Judgment - Listening - Planning/Priority Setting - Problem Solving - Team Player - Time Management - Written/Oral Communication & Organizational Skills **About US Tech Solutions:** US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit *********************** (********************************** . US Tech Solutions is 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, or status as a protected veteran.

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a five-time Magnet-Recognized health system for nursing excellence and is comprised of 2 hospitals. Capital Health Medical Group is made up of more than 250 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region. Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates. The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time). Pay Range: $39.40 - $59.19 Scheduled Weekly Hours: 40 Position Overview Performs chart review of identified patients to identify quality, timeliness and appropriateness of patient care. Conducts admission reviews for Medicare, Medicaid beneficiaries, as well as private insurers and self pay patients, based on appropriate guidelines. Uses these criteria guidelines to screen for appropriateness for inpatient level of care or observation services based on physician certification (physicians H&P, treatment plan, potential risks and basis for expectation of a 2 midnight stay). Refers cases as appropriate, to the UR physician advisor for review and determination. Gathers clinical information to conduct continued stay utilization review activities with payers on a daily basis. Performs concurrent and retrospective clinical reviews with various payers, utilizing the appropriate guidelines as demonstrated by compliance with all applicable regulations, policies and timelines. Adheres to CMS guidelines for utilization reviews as evidenced by utilization of the relevant guidelines and appropriate referrals to the physician advisor and the UR Committee. Identifies, develops and implements strategies to reduce length of stay and resource consumption. . Confers proactively with admitting physician to provide coaching on accurate level of care determinations at point of hospital entry. Keeps current on all regulatory changes that affect delivery or reimbursement of acute care services. Uses knowledge of national and local coverage determinations to appropriately advise physicians. Understands and applies federal law regarding the use of Hospital Initiated Notice of Non-Coverage (HINN) and Lifetime Reserve Days letters. Identifies and records consistently any information on any progression of care or patient flow barriers using the Avoidable Days tool in the Utilization software program. Consults with medical staff, care team and case managers as necessary to resolve immediate progression of care barriers through appropriate administrative and medical channels. Engages care team colleagues in collaborative problem solving regarding appropriate utilization of resources. Recognizes and responds appropriately to patient safety and risk factors. Represents Utilization Management at various committees, professional organizations an physician groups as needed. Promotes the use of evidence based protocols and or order sets to influence high quality and cost effective care. Identifies, develops and implements strategies to reduce lengths of stay and resource consumption in the patient population. Participates in performance improvement activities. Promotes medical documentation that accurately reflects findings and interventions, presence of complication or comorbidities, and patient's need for continued stay. Identifies and records episodes of preventable delays or avoidable days due to failure of progression of care processes. Maintains appropriate documentation in the Utilization software system on each patient to include specific information of all resource utilization activities. Participates actively in daily huddles, patient care conferences, and hospitalist or nurse handoff reports to maintain knowledge about intensity of services and the progression of care. Identifies potentially wasteful or misused resources and recommends alternatives if appropriate by analyzing clinical protocols. Maintains related continuing education credits = 15 per calendar year. MINIMUM REQUIREMENTS Education: Minimum of Associate's degree in Nursing. Graduate of an accredited school of nursing. CPHQ, CCM or CPUR preferred. Experience: Three years of clinical nursing or two years quality management, utilization review or discharge planning experience. Other Credentials: Registered Nurse - NJ Knowledge and Skills: Three years of clinical nursing or two years quality management, utilization review or discharge planning experience. CPHQ, CCM or CPUR preferred. Special Training: Basic computer skills including the working knowledge of Microsoft Office, UR software and EMR. Possesses familiarity with MCG guidelines. Mental, Behavioral and Emotional Abilities: Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Usual Work Day: 8 Hours PHYSICAL DEMANDS AND WORK ENVIRONMENT Frequent physical demands include: Sitting , Standing , Walking Occasional physical demands include: Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Keyboard use/repetitive motion , Talk or Hear Continuous physical demands include: Lifting Floor to Waist 10 lbs. Lifting Waist Level and Above 5 lbs. Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Accurate Color Discrimination, Accurate Depth Perception, Accurate Hearing Anticipated Occupational Exposure Risks Include the following: N/A This position is eligible for the following benefits: Medical Plan Prescription drug coverage & In-House Employee Pharmacy Dental Plan Vision Plan Flexible Spending Account (FSA) - Healthcare FSA - Dependent Care FSA Retirement Savings and Investment Plan Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance Supplemental Group Term Life & Accidental Death & Dismemberment Insurance Disability Benefits - Long Term Disability (LTD) Disability Benefits - Short Term Disability (STD) Employee Assistance Program Commuter Transit Commuter Parking Supplemental Life Insurance - Voluntary Life Spouse - Voluntary Life Employee - Voluntary Life Child Voluntary Legal Services Voluntary Accident, Critical Illness and Hospital Indemnity Insurance Voluntary Identity Theft Insurance Voluntary Pet Insurance Paid Time-Off Program The pay range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining base salary and/or rate, several factors may be considered including, but not limited to location, years of relevant experience, education, credentials, negotiated contracts, budget, market data, and internal equity. Bonus and/or incentive eligibility are determined by role and level. The salary applies specifically to the position being advertised and does not include potential bonuses, incentive compensation, differential pay or other forms of compensation, compensation allowance, or benefits health or welfare. Actual total compensation may vary based on factors such as experience, skills, qualifications, and other relevant criteria.

HealthPlus Staffing is seeking a Nurse Case Manager in Philadelphia, PA. The Case Manager will provide help to pregnant women and children in getting the health care and social services needed. Job Requirements: Bachelor's degree with major course work in sociology, social work, social welfare, psychology, gerontology, anthropology, other related social sciences, criminal justice, theology, nursing, healthcare administration, counseling, or education or Registered Nurse Licensed Practical Nurse or Certified Nurse Assistant (CNA) or Medical Assistant plus two (2) years of mental health direct care experience. Individuals using these criteria must receive a written waiver from the DBHIDS prior to hire. Must have Active nurse License in the state of Illinois Compensation: Commensurate on experience Benefits: Full Benefits Pediatrics Schedule: Monday to Friday Location: Philadelphia, PA Reliably commute or planning to relocate before starting work (Required) Education: Bachelor's (Preferred) Experience: Nursing: 1 year (Preferred) For more info please reach out to us at Recruitment@HealthPlusStaffing.com or call at 561-291-7787

Job Description Hospice Nurse Case Manager Full-time | Philadelphia, PA | Monday-Friday with occasional on-call rotation We are seeking a compassionate and experienced Hospice Nurse Case Manager to join a dedicated interdisciplinary team providing high-quality end-of-life care to patient's in their residence. The ideal candidate is a skilled clinician who thrives on building strong relationships with patients and families, coordinating care plans, and ensuring that each individual's final journey is met with dignity, comfort, and compassion. You'll be joining a passionate teams of physicians, NPs, chaplains, social workers, and aides. Responsibilities: Manage a caseload of hospice patients, conducting comprehensive assessments and developing individualized care plans. Provide direct skilled nursing care and education to patients and caregivers in the home setting. Coordinate care with physicians, social workers, chaplains, and other members of the hospice team to ensure holistic, patient-centered care. Monitor patient status and adjust care plans as needed to maintain optimal comfort and symptom management. Document assessments, interventions, and communications in accordance with state, federal, and agency guidelines. Serve as a clinical resource and advocate for patients and families, ensuring their physical, emotional, and spiritual needs are met. Participate in regular interdisciplinary team meetings and case conferences. Rotate in after-hours or weekend on-call coverage as assigned. Qualifications: Current Registered Nurse (RN) license in the state of Pennsylvania Minimum of 1-2 years of hospice or home health nursing experience strongly preferred. Strong clinical assessment, communication, and organizational skills. Empathetic, patient-centered approach with the ability to support families during emotionally challenging times. Valid driver's license, reliable transportation Benefits: Competitive salary and mileage reimbursement Comprehensive health, dental, and vision insurance Paid time off and retirement plan options Ongoing training and professional development opportunities Supportive and collaborative work environment

The AOT Outreach Nurse Coordinator works closely with medical and program leadership. Supporting the liver and kidney transplant programs by coordinating the delivery of care for the transplant patients in the satellite clinics throughout the Temple service area. Serves as a liaison between Temple University Hospital and our partner organizations to improve the delivery of care. Under the direction of the Director Clinical Transplant Services, partners with the QAPI team to develop and report on quality improvement projects related to Temple's AOT satellite clinics. Supports the outreach and education coordinator as needed to provide clinical support for dialysis center visits. Demonstrates a thorough knowledge of nursing theory and practice involved in providing nursing care. Familiarity with organization and function of departments, policies, procedures and regulations. Orchestrates the care of patients with end stage organ disease. This position requires regular travel between Temple University Hospital and Satellite locations. Education Bachelor's Degree in Nursing from an accredited Nursing program. Required Master's Degree in Nursing from an accredited Nursing program. Preferred Experience 3 years experience in nursing. Required General Experience and knowledge of Electronic Medical Record. Required General Experience in a Transplant program. Preferred Licenses PA Registered Nurse License Required Multi State Compact RN License Required Or '394677

Company DescriptionJobs for Humanity is partnering with Cooper University Health Care to build an inclusive and just employment ecosystem. Therefore, we prioritize individuals coming from the following communities: Refugee, Neurodivergent, Single Parent, Blind or Low Vision, Deaf or Hard of Hearing, Black, Hispanic, Asian, Military Veterans, the Elderly, the LGBTQ, and Justice Impacted individuals. This position is open to candidates who reside in and have the legal right to work in the country where the job is located. Company Name: Cooper University Health Care Job Description About us At Cooper University Health Care, our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols. We have a commitment to its employees by providing competitive rates and compensation, a comprehensive employee benefits programs, attractive working conditions, and the chance to build and explore a career opportunity by offering professional development. Discover why Cooper University Health Care is the employer of choice in South Jersey. Short Description Clinical application of the knowledge and skill in the following areas: Pharmacology, principals and application of chemotherapy administration, side effects and appropriate nursing intervention, chemotherapy, liaison for patients/families receiving treatment. Evaluates patients in need of intravenous treatment or medication and plans, implements and documents nursing care. Determines appropriate venipuncture site and administers intravenous therapeutic treatments, which includes chemotherapy/biotherapy, blood components, fluid and electrolyte replacements, and other oncology treatments as prescribed. Provides information and education to patients and families regarding intravenous treatment and/or side effect management. Experience Required 3 years of oncology experience preferred. Education Requirements BSN; Graduate of NLN accredited School of Nursing. License/Certification Requirements Current NJ-RN License (Registered Nurse); Curretn NJ-BLS Certification (Basic Life Support) Oncology Nursing Society Chemotherapy/Biotherapy certification (ONS ONCC) within 8 weeks of hire.

Monarch/Brandywine Senior Living Company Culture and Values: At Monarch Communities, we value compassion, innovation, and community. Our team is committed to making a meaningful impact on the lives of our residents and fostering a collaborative and supportive work environment. Job Description Led by the community's Health and Wellness Director (RN), our Wellness Nurse is a Licensed Practical Nurse (LPN) who provides direct nursing care to the Residents with an emphasis on holistic wellness. They also help supervise the day-to-day nursing activities performed by care staff of Certified Nursing Assistants. Schedule: The Wellness Nurse (LPN) is a full-time (at least 30 hours per week) and/or part-time (22-29 hours per week) 3:00pm - 11:00 pm Salary Range: $32.00 - $34.00 Hourly Responsibilities and Duties Monitors the health, safety, and well-being of all residents Assisting in training and monitoring of medication administration Supervise care staff in accordance with current state regulations and community policies Maintaining clinical quality assurance in accordance with federal, state and local standards Promote the highest degree of service to our residents while leading and demonstrating the mission of the company Conduct thorough resident assessments Qualifications Graduation from an accredited School of Nursing, with current LPN license At least 2 years' experience with long-term care, assisted living, home health or hospital setting preferred Experience working with residents with Alzheimer's or other related dementias Ability to handle multiple tasks Knowledge of federal and state regulations, and of nursing practices, techniques and methods applied to health and wellness resident Proficiency in computer skills, Microsoft Office (Windows, Outlook, Excel) with the ability to learn new applications While performing the duties of this job, the associate is often required to stand, walk, sit, use fine and gross motor skills, reach with hands and arms, balance, stoop, kneel, crouch, talk, hear, and smell. An individual in this position will be required to lift or carry weight in up to 50 lbs. Intermittent physical activity includes lifting and supporting residents. The associate must use proper body mechanics. Additional Information Benefits Offered (Full Time): Health Insurance: Medical/Rx, Dental, and Vision Ancillary Benefits: Life Insurance/AD&D, Short Term Disability and Long-Term disability Basic Life & Accidental Death & Dismemberment (AD&D) Insurance FSA (Commuter/Parking) Employee Assistance Program (EAP) 401(k) Retirement with Company Match Paid Time Off (PTO) and Holidays Tuition Reimbursement Other Compensation Programs: Employee Referral Bonus Resident Referral Bonus Benefits Offered (for Part-Time Employees): Paid Time Off (PTO) and Holidays Flexible Schedule On the job training Employee Assistance Program (EAP) Free Parking Other Compensation Programs: Employee Referral Bonus Resident Referral Bonus Equal Opportunity Statement: Monarch Communities and Brandywine Senior Living is an Equal Opportunity Employer. We comply with all applicable federal, state, and local laws. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Join our Haverford team in Haverford, PA as a Nurse and inspire young minds at camp! Are you ready for an unforgettable summer adventure? At ESF Camps, we are on a mission to create an extraordinary summer experience for campers from preschool to 8th grade, and we are looking for energetic, passionate people to join us and make a positive impact while having a blast! The Camp Nurse ensures the health and safety of all on-site campers, Team members, and visitors; obtains and maintains health records and documents; administers basic first aid and medications and responds to emergencies as necessary. Why ESF? * Inspire Young Minds: Make a meaningful difference in the lives of children while receiving comprehensive training and support. * Unleash Your Potential: We offer opportunities for internships, fieldwork, and continuing education credits. * Become a Leader: Gain valuable leadership experience as you supervise and mentor children. * Positive Environment: Experience being part of a team guided by ESF Core Values. Extra Perks: * Convenient Summer Schedule: Enjoy nights and weekends off. * Employee Referral Bonus Program: Increase your earnings through referrals from your network. * Free Certifications: Reimbursements available for qualified roles. * Camp Tuition: Enjoy a significantly discounted tuition rate exclusively for Team members' children. Requirements: * Education & Certifications: * Valid license as a professional Registered Nurse or Licensed Practical Nurse. * CPR/AED Certification is required. * Graduation from an NLN accredited program - BS in Nursing (preferred) * Basic Life Support, Pediatric Advanced Life Support, Advanced Cardiovascular Life Support Certifications (preferred) * Experience: * Pediatric nursing experience or other experience working with children. * Proven success in working with children and young adults with medical conditions, including food allergies, diabetes, and seizure disorders. * Proven success in working with children and young adults with special needs and/or disabilities. * Hours: Typically, between 7:30 am-3:30 pm or between 10:30 am-6:30 pm, Monday - Friday. Hours may vary by camp location. * Schedule Commitment: Any schedule changes must be pre-approved by the site director. * Required Training: Complete all required ESF and state-mandated training and onboarding. * Dress Code: Maintain the "ESF Look" (camp uniform) and embody the spirit of the camp. Essential Job Responsibilities: * Provide Care: Provide medical care for campers as needed. Administer appropriate care in compliance with ESF Standards, Policies, Guidelines, and Procedures. * Teach & Inspire: Educate Team members on health and safety policies and procedures, including but not limited to, basic first aid, Epi-Pen, and rescue inhaler administration, and serve as a resource for emergency response procedures. * Nurse's Office & Health Forms: * Collect and maintain camper and team member health records in accordance with ESF Policies * Manage Camp Nurse's office/area and ensure the office/area is clean and organized - Maintain supply inventory and order as necessary. * Teamwork: Work effectively with co-workers, typically one other Nurse on site, as a team and collaborate on various responsibilities * Be the Ultimate Role Model: Supervise campers, while fostering a positive and safe environment. * Demonstrate ESF Core Values & Code daily, from "Gratitude" to "Bring It" daily. * Model the ESF Virtues of Character (Gratitude, Respect, Trustworthiness, Effort, Kindness, Positivity, Resilience, Community) in camp daily. * Adhere to all company policies. * Communication: * Maintain clear, concise, and engaging communication with campers, families, peers, and our leadership team. * Serve as a liaison between ESF Camps and parents/guardians - Assist parents and Team members with medical and health questions. Reporting Relationships: * Reports directly to and takes direction from the Site Director and Assistant Site Director regarding daily camp operations. * Reports directly to and takes direction from the Director of Nursing and Camp Medical Doctor regarding nursing practice. Additional Responsibilities: * Push/pull, lift, and carry a minimum of thirty-five (35) pounds across campus. Work outside, upright, and mobile for six (6) to eight (8) hours per day * Respond to emergencies, including running (up to 1 mile in some cases) and ascending stairs without undue exertion. This job description is subject to change at any time.

Full-time Description The Renfrew Center of Philadelphia, offers an unmatched opportunity, in the field of eating disorders, for a Utilization Review Coordinator to work in an environment that changes lives. The Renfrew Center has opportunities for individuals of all backgrounds, that have the desire and passion to foster a positive outcome and impact on our patients' lives. The Renfrew Center's research-based treatment model, for eating disorders, is focused on treating the whole person and helping them lead a rich and fulfilling life. Our commitment to you - We are committed to providing every employee the opportunity for personal and professional development through: 401(k) with company match Healthcare benefits Vacation and sick days Employee referral program Employee discounts to various stores, amusement parks, events, etc. Continuing education (CE) programs and training Advancement opportunities within the organization Position Responsibilities: Complete daily treatment pre-certifications with insurance/managed care companies. Complete daily concurrent reviews with insurance/managed care companies. Understand and present acuity, rationale for continued stay, treatment goals and discharge criteria from a medical record. Be familiar with various managed care companies medical necessity criterion and appropriate application, to guide the concurrent review process. Maintain accurate and complete documentation, including computer documentation. Participate and effectively collaborate with a treatment team as an active team member. Demonstrate an understanding of the functional/developmental age of the individual served. Requirements Education, Competencies and Credentials: Master's degree in Human Services, Psychology, or Social Work required. A minimum of 1-2 years of training/working in a residential or health care facility is required. Previous experience working with eating-disorder patients is highly preferred. Familiarity with psychiatric disorders is required. Hours: 40 hours per week, Monday through Friday. The Renfrew Center provides women with the tools they need to succeed - in recovery and life. Offering a warm, nurturing environment, Renfrew emphasizes respect for the unique psychology of women, the importance of a collaborative, therapeutic relationship, and the belief that every woman needs to actively participate in her growth and recovery. The Renfrew Center - An Equal Employment Opportunity Employer, devoted to diversity, equity, and inclusion.

About us: Good things are happening at Berkshire Hathaway GUARD Insurance Companies. We provide Property & Casualty insurance products and services through a nationwide network of independent agents and brokers. Our companies are all rated A+ “Superior” by AM Best (the leading independent insurance rating organization) and ultimately owned by Warren Buffett's Berkshire Hathaway group - one of the financially strongest organizations in the world! Headquartered in Wilkes-Barre, PA, we employ over 1,000 individuals (and growing) and have offices across the country. Our vision is to be a leading small business insurance provider nationwide. Founded upon an exceptional culture and led by a collaborative and inclusive management team, our company's success is grounded in our core values: accountability, service, integrity, empowerment, and diversity. We are always in search of talented individuals to join our team and embark on an exciting career path! Benefits: We are an equal opportunity employer that strives to maintain a work environment that is welcoming and enriching for all. You'll be surprised by all we have to offer! Competitive compensation Healthcare benefits package that begins on first day of employment 401K retirement plan with company match Enjoy generous paid time off to support your work-life balance plus 9 ½ paid holidays Up to 6 weeks of parental and bonding leave Hybrid work schedule (3 days in the office, 2 days from home) Longevity awards (every 5 years of employment, receive a generous monetary award to be used toward a vacation) Tuition reimbursement after 6 months of employment Numerous opportunities for continued training and career advancement And much more! Responsibilities The Utilization Review Nurse's duties will include, but are not limited to: Support internal claims adjusting staff in the review of workers' compensation claims Review records and requests for UR, which may arrive via mail, e-mail, fax, or phone Meet required decision-making timeframes Clearly document all communication and decision-making within our insurance software system Establish collaborative relationships and work as an intermediary between clients, patients, employers, providers, and attorneys Utilize good clinical judgment, careful listening, and critical thinking and assessment skills Track ongoing status of all UR activity so that appropriate turn-around times are met Maintain organized files containing clinical documentation of interactions with all parties of every claim Send appropriate letters on each completed UR Qualifications Active Licensed Practical Nurse and/or Registered Nurse License 1+ years of utilization review experience at a managed care plan or provider organization 2 + years' clinical experience preferably in case management, rehabilitation, orthopedics, or utilization review Excellent oral and written communication skills, including outstanding phone presence Strong interpersonal and conflict resolution skills Experience in a fast-paced, multi-faceted environment The ability to set priorities and work both autonomously and as a team member Well-developed time-management and organization skills Excellent analytical skills Working knowledge of: Microsoft Word, Excel, and Outlook

Drug Utilization Review Pharmacist - Ensure Safe and Effective Use of Medications A confidential managed care organization is seeking a skilled Drug Utilization Review (DUR) Pharmacist to support quality prescribing and improve patient outcomes. This role is ideal for pharmacists who enjoy analyzing medication use, applying clinical guidelines, and collaborating with providers to promote safe, cost-effective care. Key Responsibilities Conduct prospective, concurrent, and retrospective drug utilization reviews. Evaluate prescribing patterns against clinical guidelines and formulary criteria. Identify potential drug interactions, duplications, and inappropriate therapy. Prepare recommendations for prescribers to optimize therapy and reduce risk. Document reviews and ensure compliance with state, federal, and health plan requirements. Contribute to quality improvement initiatives and pharmacy program development. What You'll Bring Education: Doctor of Pharmacy (PharmD) or Bachelor of Pharmacy degree. Licensure: Active and unrestricted pharmacist license in the U.S. Experience: Managed care, PBM, or health plan experience preferred - but hospital and retail pharmacists with strong clinical skills are encouraged to apply. Skills: Analytical mindset, detail-oriented, and excellent written and verbal communication. Why This Role? Impact: Shape prescribing decisions that affect thousands of patients. Growth: Build expertise in managed care and population health pharmacy. Flexibility: Many DUR roles offer hybrid or fully remote schedules. Rewards: Competitive salary, benefits, and career advancement opportunities. About Us We are a confidential healthcare partner providing managed care pharmacy services nationwide. Our DUR pharmacists play a key role in ensuring that medications are used safely, appropriately, and cost-effectively across diverse patient populations. Apply Today Advance your career in managed care pharmacy - apply now for our Drug Utilization Review Pharmacist opening and help lead the way in improving medication safety and outcomes.

Your Tomorrow is Here! Temple Health is a dynamic network of outstanding hospitals, specialty centers, and physician practices that is advancing the fight against disease, pushing the boundaries of medical science, and educating future healthcare professionals. Temple Health consists of Temple University Hospital (TUH), Fox Chase Cancer Center, TUH-Jeanes Campus, TUH-Episcopal Campus, TUH-Northeastern Campus, Temple Physicians, Inc., and Temple Transport Team. Temple Health is proudly affiliated with the Lewis Katz School of Medicine at Temple University. To support this mission, Temple Health is continuously recruiting top talent to join its diverse, 10,000 strong workforce that fosters a healthy, safe and productive environment for its patients, visitors, students and colleagues alike. At Temple Health, your tomorrow is here! Equal Opportunity Employer/Veterans/Disabled 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, or protected veteran status and will not be discriminated against on the basis of disability. The AOT Outreach Nurse Coordinator works closely with medical and program leadership. Supporting the liver and kidney transplant programs by coordinating the delivery of care for the transplant patients in the satellite clinics throughout the Temple service area. Serves as a liaison between Temple University Hospital and our partner organizations to improve the delivery of care. Under the direction of the Director Clinical Transplant Services, partners with the QAPI team to develop and report on quality improvement projects related to Temple's AOT satellite clinics. Supports the outreach and education coordinator as needed to provide clinical support for dialysis center visits. Demonstrates a thorough knowledge of nursing theory and practice involved in providing nursing care. Familiarity with organization and function of departments, policies, procedures and regulations. Orchestrates the care of patients with end stage organ disease. This position requires regular travel between Temple University Hospital and Satellite locations. Education Bachelor's Degree in Nursing from an accredited Nursing program. Required Master's Degree in Nursing from an accredited Nursing program. Preferred Experience 3 years experience in nursing. Required General Experience and knowledge of Electronic Medical Record. Required General Experience in a Transplant program. Preferred Licenses PA Registered Nurse License Required Multi State Compact RN License Required Or Your Tomorrow is Here! Temple University Hospital is a nationally respected teaching hospital on Temple University's bustling Health Sciences Center campus. The hospital provides a comprehensive array of healthcare services both basic and complex to patients from around the corner, across the country and around the world. As the chief clinical training site for the Lewis Katz School of Medicine at Temple University, the hospital provides a dynamic environment for high-quality care, teaching, and cutting edge research.

Monarch/Brandywine Senior Living Company Culture and Values: At Monarch Communities, we value compassion, innovation, and community. Our team is committed to making a meaningful impact on the lives of our residents and fostering a collaborative and supportive work environment. Job Description Led by the community's Health and Wellness Director (RN), our Wellness Nurse is a Licensed Practical Nurse (LPN) who provides direct nursing care to the Residents with an emphasis on holistic wellness. They also help supervise the day-to-day nursing activities performed by care staff of Certified Nursing Assistants. Schedule: The Wellness Nurse (LPN) is full-time (at least 30 hours per week) 3pm - 11pm and/or part-time (22-29 hours per week) 3pm - 11pm including every other weekend. Salary Range: $34.00 - $36.00 Hourly Responsibilities and Duties Monitors the health, safety, and well-being of all residents Assisting in training and monitoring of medication administration Supervise care staff in accordance with current state regulations and community policies Maintaining clinical quality assurance in accordance with federal, state and local standards Promote the highest degree of service to our residents while leading and demonstrating the mission of the company Conduct thorough resident assessments Qualifications Graduation from an accredited School of Nursing, with current LPN license At least 2 years' experience with long-term care, assisted living, home health or hospital setting preferred Experience working with residents with Alzheimer's or other related dementias Ability to handle multiple tasks Knowledge of federal and state regulations, and of nursing practices, techniques and methods applied to health and wellness resident Proficiency in computer skills, Microsoft Office (Windows, Outlook, Excel) with the ability to learn new applications While performing the duties of this job, the associate is often required to stand, walk, sit, use fine and gross motor skills, reach with hands and arms, balance, stoop, kneel, crouch, talk, hear, and smell. An individual in this position will be required to lift or carry weight in up to 50 lbs. Intermittent physical activity includes lifting and supporting residents. The associate must use proper body mechanics. Additional Information Benefits Offered (Full Time): • Health Insurance: Medical/Rx, Dental, and Vision • Ancillary Benefits: Life Insurance/AD&D, Short Term Disability and Long-Term disability • Basic Life & Accidental Death & Dismemberment (AD&D) Insurance • FSA (Commuter/Parking) • Employee Assistance Program (EAP) • 401(k) Retirement with Company Match • Paid Time Off (PTO) and Holidays • Tuition Reimbursement Other Compensation Programs: • Employee Referral Bonus • Resident Referral Bonus Benefits Offered (for Part-Time Employees): Paid Time Off (PTO) Flexible Schedule On the job training Employee Assistance Program (EAP) Free Parking Other Compensation Programs: Employee Referral Bonus Resident Referral Bonus Equal Opportunity Statement: Monarch Communities and Brandywine Senior Living is an Equal Opportunity Employer. We comply with all applicable federal, state, and local laws. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Join our Haverford team in Haverford, PA as a Nurse and inspire young minds at camp! Are you ready for an unforgettable summer adventure? At ESF Camps, we are on a mission to create an extraordinary summer experience for campers from preschool to 8th grade, and we are looking for energetic, passionate people to join us and make a positive impact while having a blast! The Camp Nurse ensures the health and safety of all on-site campers, Team members, and visitors; obtains and maintains health records and documents; administers basic first aid and medications and responds to emergencies as necessary. Why ESF? Inspire Young Minds: Make a meaningful difference in the lives of children while receiving comprehensive training and support. Unleash Your Potential: We offer opportunities for internships, fieldwork, and continuing education credits. Become a Leader: Gain valuable leadership experience as you supervise and mentor children. Positive Environment: Experience being part of a team guided by ESF Core Values. Extra Perks: Convenient Summer Schedule: Enjoy nights and weekends off. Employee Referral Bonus Program: Increase your earnings through referrals from your network. Free Certifications: Reimbursements available for qualified roles. Camp Tuition: Enjoy a significantly discounted tuition rate exclusively for Team members' children. Requirements: Education & Certifications: Valid license as a professional Registered Nurse or Licensed Practical Nurse. CPR/AED Certification is required. Graduation from an NLN accredited program - BS in Nursing (preferred) Basic Life Support, Pediatric Advanced Life Support, Advanced Cardiovascular Life Support Certifications (preferred) Experience: Pediatric nursing experience or other experience working with children. Proven success in working with children and young adults with medical conditions, including food allergies, diabetes, and seizure disorders. Proven success in working with children and young adults with special needs and/or disabilities. Hours: Typically, between 7:30 am-3:30 pm or between 10:30 am-6:30 pm, Monday - Friday. Hours may vary by camp location. Schedule Commitment: Any schedule changes must be pre-approved by the site director. Required Training: Complete all required ESF and state-mandated training and onboarding. Dress Code: Maintain the "ESF Look" (camp uniform) and embody the spirit of the camp. Essential Job Responsibilities: Provide Care: Provide medical care for campers as needed. Administer appropriate care in compliance with ESF Standards, Policies, Guidelines, and Procedures. Teach & Inspire: Educate Team members on health and safety policies and procedures, including but not limited to, basic first aid, Epi-Pen, and rescue inhaler administration, and serve as a resource for emergency response procedures. Nurse's Office & Health Forms: Collect and maintain camper and team member health records in accordance with ESF Policies Manage Camp Nurse's office/area and ensure the office/area is clean and organized - Maintain supply inventory and order as necessary. Teamwork: Work effectively with co-workers, typically one other Nurse on site, as a team and collaborate on various responsibilities Be the Ultimate Role Model: Supervise campers, while fostering a positive and safe environment. Demonstrate ESF Core Values & Code daily, from “Gratitude” to “Bring It” daily. Model the ESF Virtues of Character (Gratitude, Respect, Trustworthiness, Effort, Kindness, Positivity, Resilience, Community) in camp daily. Adhere to all company policies. Communication: Maintain clear, concise, and engaging communication with campers, families, peers, and our leadership team. Serve as a liaison between ESF Camps and parents/guardians - Assist parents and Team members with medical and health questions. Reporting Relationships: Reports directly to and takes direction from the Site Director and Assistant Site Director regarding daily camp operations. Reports directly to and takes direction from the Director of Nursing and Camp Medical Doctor regarding nursing practice. Additional Responsibilities: Push/pull, lift, and carry a minimum of thirty-five (35) pounds across campus. Work outside, upright, and mobile for six (6) to eight (8) hours per day Respond to emergencies, including running (up to 1 mile in some cases) and ascending stairs without undue exertion. This job description is subject to change at any time.

Monarch/Brandywine Senior Living Company Culture and Values: At Monarch Communities, we value compassion, innovation, and community. Our team is committed to making a meaningful impact on the lives of our residents and fostering a collaborative and supportive work environment. Job Description Led by the community's Health and Wellness Director (RN), our Wellness Nurse is a Licensed Practical Nurse (LPN) who provides direct nursing care to the Residents with an emphasis on holistic wellness. They also help supervise the day-to-day nursing activities performed by care staff of Certified Nursing Assistants. Schedule: The Wellness Nurse (LPN) is a full-time (at least 30 hours per week) 11pm - 7am Salary Range: $34.00 - $36.00 Hourly Responsibilities and Duties Monitors the health, safety, and well-being of all residents Assisting in training and monitoring of medication administration Supervise care staff in accordance with current state regulations and community policies Maintaining clinical quality assurance in accordance with federal, state and local standards Promote the highest degree of service to our residents while leading and demonstrating the mission of the company Conduct thorough resident assessments Qualifications Graduation from an accredited School of Nursing, with current LPN license At least 2 years' experience with long-term care, assisted living, home health or hospital setting preferred Experience working with residents with Alzheimer's or other related dementias Ability to handle multiple tasks Knowledge of federal and state regulations, and of nursing practices, techniques and methods applied to health and wellness resident Proficiency in computer skills, Microsoft Office (Windows, Outlook, Excel) with the ability to learn new applications While performing the duties of this job, the associate is often required to stand, walk, sit, use fine and gross motor skills, reach with hands and arms, balance, stoop, kneel, crouch, talk, hear, and smell. An individual in this position will be required to lift or carry weight in up to 50 lbs. Intermittent physical activity includes lifting and supporting residents. The associate must use proper body mechanics. Additional Information Benefits Offered (Full Time): Health Insurance: Medical/Rx, Dental, and Vision Ancillary Benefits: Life Insurance/AD&D, Short Term Disability and Long-Term disability Basic Life & Accidental Death & Dismemberment (AD&D) Insurance FSA (Commuter/Parking) Employee Assistance Program (EAP) 401(k) Retirement with Company Match Paid Time Off (PTO) and Holidays Tuition Reimbursement Other Compensation Programs: Employee Referral Bonus Resident Referral Bonus Equal Opportunity Statement: Monarch Communities and Brandywine Senior Living is an Equal Opportunity Employer. We comply with all applicable federal, state, and local laws. We celebrate diversity and are committed to creating an inclusive environment for all employees.