Utilization review nurse jobs in Gladeview, FL - 119 jobs

University of Miami is seeking a Registered Nurse (RN) SICU - Surgical Intensive Care Level I for a nursing job in Miami, Florida. Job Description & Requirements Specialty: SICU - Surgical Intensive Care Discipline: RN Duration: Ongoing 36 hours per week Shift: 12 hours Employment Type: Staff The Surgical Intensive Care Department has an exciting opportunity for a Full Time Registered Nurse to work in UTower. The Staff Nurse (RN) is a registered professional nurse who prescribes, coordinates, evaluates and delivers patient care through collaborative efforts with members of the interdisciplinary team in accordance with the nursing process and standards of care and practices. The Registered Nurse also directs and guides patient and family teaching. Minimum Qualifications: Education: Graduate from an accredited school of nursing, Bachelor's degree (BSN) preferred. RNs hired with an Associates (ASN) degree have 2 years to complete the BSN degree. Certification and Licensing: Valid Florida Registered Nurse License, BLS/ACLS certification required Experience: Minimum 2 years of critical care nursing experience. The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more. University of Miami Job ID #R100092768. About University of Miami The University of Miami is considered among the top tier institutions of higher education in the U.S. for its academic excellence, superior medical care, and cutting-edge research. At the U, we are committed to attracting a talented workforce to support our common mission of transforming lives through teaching, research, and service. Through our values of Diversity, Integrity, Responsibility, Excellence, Compassion, Creativity and Teamwork (DIRECCT) we strive to create an environment where everyone contributes in making the University a great place to work. We are one of the largest private employers in Miami-Dade County; home to more than 16,000 faculty and staff from all over the world. Benefits Holiday Pay 403b retirement plan Sick pay Wellness and fitness programs Employee assistance programs Medical benefits Dental benefits Vision benefits Benefits start day 1 Continuing Education Sign-On bonus

The purpose of this position is to conduct initial, concurrent, retrospective chart review for clinical, financial and resource utilization. Coordinates with healthcare Team for optimal efficient patient outcomes, while decreasing length of stay and avoid delays and denied days. They are accountable for a designated patient caseload and provides intervention and coordination to decrease avoidable delays denial of reimbursement. Specific functions within this role include: Screens pre-admission, admission process using established criteria for all points of entry, Facilitates communication between payers, review agencies and healthcare team, Identify delays in treatment or inappropriate utilization and serves as a resource, Coordinates communication with physicians, Identify opportunities for expedited appeals and collaborates resolve payer issues and ensures, maintains effective communication with Revenue Cycle Departments. Estimated pay range for this position is $45.00 / hour depending on shift as applicable. Degrees: * Associates. Licenses & Certifications: * Registered Nurse. Additional Qualifications: * RNs hired prior to 2/2012 (10/1/2017 at Bethesda or 7/1/2019 at BRRH) with an Associates Degree in Nursing are not required to have a BSN to continue their non-leadership role as an RN; however, required to complete the BSN within 5 years of hire. * 3 years of hospital clinical experience preferred. * Excellent written, interpersonal communication and negotiation skills. * Strong critical thinking skills and the ability to perform clinical chart review abstract information efficiently. * Strong analytical, data management and computer skills. * Strong organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components. * Current working knowledge of payer and managed care reimbursement preferred. * Ability to work independently and exercise sound judgment in interactions with the health care team and patients/families. * Knowledgeable in local, state, and federal legislation and regulations, and ability to tolerate high volume production standards. Minimum Required Experience: 3 Years of Utilization Review experience in an acute care setting required

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 Are you an experienced Registered Nurse with Utilization Review or Concurrent Review experience looking for a new opportunity with a prestigious Managed Care Company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions - this is the position for you! Daily Responsibilities: Conducts pre-admission, concurrent and retrospective acute care, sub-acute, hospice, qualification of transitional care and long-term care needs for medical necessity Perform case reviews and complete all required documentation in appropriate database Collaborate with primary or attending physician, case managers, patient and/or family to provide continuity and quality of care in the most cost-effective manner. Timely completion of admission reviews (within 48-hours for weekday, 72-hours for weekend) Provide outpatient or pharmacy services utilization review Hours for this Position: M-F 8:00am to 5:00pm Requirements: Current Florida RN License 2+ years in recent medical/surgical or critical care experience 3+ years of Utilization Review / Case Management experience Strong reasoning ability: define problems, collect data, establish facts, and draw conclusions Advantages of this Opportunity: Competitive salary ($30/hr. to $32/hr.) Permanent position Benefits offered, Medical, Dental, and Vision Fun and positive work environment Interested in being considered? If you are interested in being considered for this position, PLEASE click the APPLY NOW button! Additional Information

Pool Utilization Review Registered Nurse, Case Management, Per Diem, Shift Varies (Rotating Weekends)-155669Description The purpose of this position is to conduct initial, concurrent, retrospective chart review for clinical, financial and resource utilization. Coordinates with healthcare Team for optimal efficient patient outcomes, while decreasing length of stay and avoid delays and denied days. They are accountable for a designated patient caseload and provides intervention and coordination to decrease avoidable delays denial of reimbursement. Specific functions within this role include: Screens pre-admission, admission process using established criteria for all points of entry, Facilitates communication between payers, review agencies and healthcare team, Identify delays in treatment or inappropriate utilization and serves as a resource, Coordinates communication with physicians, Identify opportunities for expedited appeals and collaborates resolve payer issues and ensures, maintains effective communication with Revenue Cycle Departments.Qualifications Degrees:Associates.Licenses & Certifications:Registered Nurse.Additional Qualifications:RNs hired prior to 2/2012 (10/1/2017 at Bethesda or 7/1/2019 at BRRH) with an Associates Degree in Nursing are not required to have a BSN to continue their non-leadership role as an RN; however, required to complete the BSN within 3 years of hire.3 years of hospital clinical experience preferred.Excellent written, interpersonal communication and negotiation skills.Strong critical thinking skills and the ability to perform clinical chart review abstract information efficiently.Strong analytical, data management and computer skills.Strong organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components.Current working knowledge of payer and managed care reimbursement preferred.Ability to work independently and exercise sound judgment in interactions with the health care team and patients/families.Knowledgeable in local, state, and federal legislation and regulations, and ability to tolerate high volume production standards.Minimum Required Experience: 3 YearsJob Case Management/Home HealthPrimary Location Boca RatonOrganization Boca Raton Regional HospitalSchedule Per DiemJob Posting Jan 7, 2026, 5:00:00 AMUnposting Date Ongoing Pay Grade Z44EOE, including disability/vets

About us: Solis Health Plans is a new kind of Medicare Advantage Company. We provide solutions that are more transparent, connected and effective for both our members and providers. Solis was born out of a desire to provide a more personal experience throughout all levels of the healthcare journey. Our team consists of expert individuals that take pride in delivering quality service. We believe in a culture that collaborates and supports one another, and where success is interlinked and each employee is valued. Please check out our company website at ************************ to learn more about us! **Bilingual in English and Spanish is required** Full benefits package offered on the first on the month following date of hire including: Medical, Dental, Vision, 401K plan with a 100% company match! Our company has doubled size and we have experienced exponential growth in membership from 2,000 members to over 10,000 members! Join our winning Solis Team! Position is fully onsite Monday-Friday. Location: 9250 NW 36th St, Miami, FL 33178. Position Summary: Under the supervision of the Health Services Director, the Utilization Management Nurse (LPN or RN) uses a multidisciplinary approach to organize, coordinate, monitor, evaluate, create and manage organization determinations and authorizations. These service requests will focus on selected complex medical and psychosocial needs of Solis Health Plans members. The UM Nurse is responsible for assuring the receipt of high quality, cost efficient medical outcomes for enrollees. This role works with Medical Directors, Authorization Coordinators and Service Coordinators to perform first level review to pre-certify elective services, procedures and tests utilizing established Care Coordination polices and protocols, Solis Health Plans benefit criteria, applicable regulatory review criteria and nationally accepted criteria for medical necessity determination. Main Key Responsibilities: Conduct concurrent and retrospective utilization review for inpatient, observation or SNF services. Conducts clinical reviews of proposed services against appropriate criteria/guidelines to determine medical necessity, benefit eligibility, and network contract status. Work with Medical Directors, Program Leadership and Solis Health Plans Provider Relations Teams to identify and mitigate facility barriers associated with the ability to make timely decisions. Identify, align and utilize health plan and community resources that impact high-risk/high cost care. Act as liaison between assigned facilities, members/families, and Solis Health Plans. Clarify policies/procedures and member benefits as needed. Authorizes services, coordinates care, and ensures timeliness and coordination of healthcare services, in compliance with department and regulatory standards, seeking supplemental services when appropriate or when needed. Assess enrollee needs and monitor progress toward goals at all times, communicating findings and status with members of the enrollee's primary care team. Ensure optimal delivery of safe quality health care to members, while maximizing resources and containing costs, and facilitate continual patient-centered and outcome-driven health performance improvement activities. Review enrollees with the Medical Directors and Primary Care Teams and advocates for Administration Exception considerations as appropriate. Facilitate communications between the facility, providers, and the PCT in order to effect and influence a safe and effective discharge plan and care plan for the enrollee. Qualifications: Graduate from an accredited school of nursing, or Bachelors (or advanced) degree in nursing. Active and unrestricted licensure as a Registered Nurse in Florida. A minimum of three to five years clinical experience as a Registered Nurse in a clinical setting required. 2 years' experience as a Utilization Management nurse in a managed care payer preferred. One year experience as a case manager in a payer or facility setting highly preferred. Discharge planning experience highly preferred. What Sets Us Apart: Join Solis Health Plans as a Utilization Management Nurse and become a catalyst for positive change in the lives of our members. At Solis, you will be part of a locally rooted organization deeply committed to understanding and serving our communities. If you are eager to embark on a purpose-driven career that promises growth and the chance to make a significant impact, we encourage you to explore the opportunities available at Solis Health Plans. Join us and be the difference!

Job Description We are seeking an Utilization Management Coordinator to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. About the Role: The Utilization Management Coordinator plays a critical role in ensuring that healthcare services are delivered efficiently and effectively by overseeing the review and authorization of medical treatments and procedures. This position is responsible for coordinating utilization management activities to optimize member care while controlling costs and adhering to regulatory requirements. The role involves collaborating with healthcare providers, insurance companies, and internal teams to evaluate the necessity and appropriateness of medical services. The Coordinator will analyze clinical data and documentation to support decision-making processes and ensure compliance with organizational policies and healthcare standards. Ultimately, this position contributes to improving member outcomes by facilitating timely access to necessary care and preventing unnecessary or redundant services. Minimum Qualifications: Associate degree in Health Administration, or a related healthcare field Minimum of 2 years of experience in utilization management, case management, or a related healthcare coordination role. Strong knowledge of healthcare regulations, insurance processes, and medical terminology. Proficiency in electronic health records (EHR) systems and utilization management software. Relevant experience may substitute for the educational requirement on a year-for-year basis. Preferred Qualifications: Bachelor's degree in Nursing, Health Administration, or a related healthcare field. Certification in Utilization Review (e.g., Certified Professional in Utilization Review - CPUR) or Case Management (e.g., CCM). Experience working within managed care organizations or health insurance companies. Advanced knowledge of clinical guidelines and healthcare quality improvement methodologies. Familiarity with regulatory requirements such as HIPAA, URAC, and NCQA standards. Demonstrated ability to lead or participate in cross-functional teams focused on utilization management initiatives. Responsibilities: Conduct thorough reviews of medical records and treatment plans to determine the medical necessity and appropriateness of requested services. Coordinate communication between healthcare providers, insurance representatives, and internal departments to facilitate timely authorization and appeals processes. Maintain accurate documentation of utilization management activities and decisions in compliance with regulatory and organizational standards. Monitor and analyze utilization data to identify trends, potential issues, and opportunities for process improvement. Assist in developing and implementing utilization management policies and procedures to enhance operational efficiency and member care quality.

Cherishing Our Children Since 1977 Helping children and families help themselves to live a better life and build a stronger community. The Center for Family and Child Enrichment (CFCE) is dedicated to help children and their families by providing the right services and solutions based on individual needs. CFCE is constantly evolving to better support our community. CFCE expanded in early 2012 to include a health care center, The Pediatric & Family Health and Wellness Center. The Pediatric & Family Health and Wellness Center, a Federally Qualified Health Center (FQHC), offers an array of preventative health services including but not limited to: general and sick care for adults and children, OB/GYN, dental services, nutrition programs and mental health and substance abuse treatment for children and adults. As a Nurse Case Manager (NCM), you will provide expertise as an educator, consultant, and facilitator. The NCM provides quality patient care via the development, implementation and evaluation of individual patient care plans and patient education sessions. Why join CFCE: Great benefits package, including a Zero (0) cost out of pocket medical plan, 13 Paid Holidays and a competitive Paid Time Off Package Making an invaluable impact in your community Growth and professional development opportunities available Qualify for Public Service Loan Forgiveness We are a tax-exempt organization under section 501(c)(3) of the Internal Revenue Code Some of the Functions Include: Establish communication and collaborative relationships with multidisciplinary healthcare team members. Serve as a liaison between behavioral health and the medical (adult and pediatric) teams to facilitate integration and coordination of care between the two entities. Participate in daily patient care team meetings, training as scheduled, and health team coordination activities. Facilitate the work of the physician -Triage, patient phone calls, and subspecialty appointments. Ensure tracking and follow-up of referrals for laboratory, imaging, and subspecialty services within established timelines. Coordinate subspecialty referrals from appointment scheduling to result follow-up for pediatric and adult care. Complete hospital and emergency room referral and follow-up. Coordinate communication/needs with other entities to assist patients to access resources to address barriers to self-care, such as WIC. Provide health promotion and illness prevention case management for pediatric and adult patient populations (examples include but are not limited to asthma action plans, diet and exercise counseling, ADHD management, transition from pediatric to adult care, diabetes education and hypertension education). Provide patient education, monitoring of health needs, and coordination of community resources. Represent the Agency in health fairs. Plans, prepares and maintains materials for use in educational programs for accuracy and relevance to the target audience. Develop educational materials consistent with evidence-based approaches to improve health literacy and promote self-care. Minimum Education Current State of Florida Licensed Practical Nurse. Certification in BLS and ACLS. Minimum Experience 3 Years of applied clinical experience as a LPN in a health related field or as a Clinical Case Manager or Educator. Skills Needed Proficiency in the use of Microsoft Word, Windows, Microsoft Outlook, Excel and spread sheet applications. Knowledge of audiovisual equipment setup is an advantage. CFCE is a Drug Free Workplace and an Equal Opportunity Employer.

This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Founded in 2005, HealthSun is a local Medicare Managed Care Organization with administrative offices located in Coconut Grove, Florida. Serving more than 50,000 members, HealthSun is one of the fastest growing health plans in South Florida. As a local plan, we recognize the healthcare needs of our community and strive to provide our members with only the best service and experience possible. The Nurse Case Manager I is responsible for performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically or on-site such as at hospitals for discharge planning. How You Will Make an Impact: Primary duties may include, but are not limited to: Ensures member access to services appropriate to their health needs Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment. Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements. Coordinates internal and external resources to meet identified needs. Monitors and evaluates effectiveness of the care management plan and modifies as necessary. Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans. Assists in problem solving with providers, claims or service issues. Minimum Requirements: Requires BA/BS in a health related field and minimum of 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. Current, unrestricted RN license in applicable state(s) required. Multi-state licensure is required if this individual is providing services in multiple states. Preferred Skills, Capabilities & Experiences: Certification as a Case Manager is preferred. Bilingual English/Spanish highly preferred. MS Office Suite good working knowledge preferred. For URAC accredited areas the following applies: Requires BA/BS and 3 years of clinical care experience; or any combination of education and experience, which would provide an equivalent background. Current and active RN license required in applicable state(s). Multi-state licensure is required if this individual is providing services in multiple states. Certification as a Case Manager and a BS in a health or human services related field preferred. Job Level: Non-Management Exempt Workshift: 1st Shift (United States of America) Job Family: MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Founded in 2005, **HealthSun** is a local Medicare Managed Care Organization with administrative offices located in Coconut Grove, Florida. Serving more than 50,000 members, HealthSun is one of the fastest growing health plans in South Florida. As a local plan, we recognize the healthcare needs of our community and strive to provide our members with only the best service and experience possible. The **Nurse Case Manager I** is responsible for performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically or on-site such as at hospitals for discharge planning. **How You Will Make an Impact:** Primary duties may include, but are not limited to: + Ensures member access to services appropriate to their health needs + Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment. + Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements. + Coordinates internal and external resources to meet identified needs. + Monitors and evaluates effectiveness of the care management plan and modifies as necessary. + Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans. + Assists in problem solving with providers, claims or service issues. **Minimum Requirements:** + Requires BA/BS in a health related field and minimum of 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. + Current, unrestricted RN license in applicable state(s) required. Multi-state licensure is required if this individual is providing services in multiple states. **Preferred Skills, Capabilities & Experiences:** + Certification as a Case Manager is preferred. + Bilingual English/Spanish highly preferred. + MS Office Suite good working knowledge preferred. For URAC accredited areas the following applies: Requires BA/BS and 3 years of clinical care experience; or any combination of education and experience, which would provide an equivalent background. Current and active RN license required in applicable state(s). Multi-state licensure is required if this individual is providing services in multiple states. Certification as a Case Manager and a BS in a health or human services related field preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

ChenMed is seeking a Registered Nurse (RN) Educator for a nursing job in Miami, Florida. Job Description & Requirements Specialty: Educator Discipline: RN Duration: Ongoing Employment Type: Staff Salary will be competitive and based on equitable consideration of qualifications and experience. We're unique. You should be, too. We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy? We're different than most primary care providers. We're rapidly expanding and we need great people to join our team. The Patient Educator, Specialty (RN) collaborates with medical practitioners and leaders to incorporate chronic disease education into the plan of care for a specialized group of patients. The incumbent in this role is responsible for helping to improve patient health outcomes by promoting and facilitating disease education with the patient and/or family member(s) thereby ensuring their active involvement in care and care decisions. He/She performs direct specialty nursing services to patients as required, ensuring adherence to regulatory standards and all related policies, procedures, and guidelines. The Patient Educator, Specialty (RN), is also accountable for the development and delivery of clinical education to patients that increases their knowledge of disease processes, improves patient engagement in care, and reduces hospital and ER admissions. ESSENTIAL JOB DUTIES/RESPONSIBILITIES: Provides chronic disease education relative to quality care for a specific patient population. Coordinates care between their primary care physicians, community specialists and vendor services including hospitals. Monitors chronic disease program performance across multiple medical centers. Identifies gaps and implements improvements in patient and quality outcomes. Assists with the development of strategies for quality improvement and management related to disease education. Collaborates with medical center leaders and PCPs to evaluate, develop and implement patient education programs through needs assessment analysis. Educates patients and/or family member(s) by gaining an understanding of their cultural and religious practices, emotional barriers, desire and motivation to learn, physical and/or cognitive limitations, language barriers and readiness to learn. Identifies opportunities to minimize fragmentation of health care for patients. Encourages decision-making about health care options by ensuring the patient and/or family member(s) understand the patient's health status. Maximizes care skills by observing the patient and/or family member(s) ability to cope with patient's health status/prognosis/outcome and pivoting communication as necessary. Enriches the patient's overall health by promoting and encouraging healthy lifestyles. Selects, adapts and individualizes patient education information by analyzing available brochures, printed materials, videos and other resources that align with the age, culture, religious practices, language, etc. of the patient. Documents patient care services in patients' chart and department records as determined by internal policies and procedures and external laws, rules and regulations. Improves quality results by studying, evaluating and re-designing processes; implements changes as needed. Coordinates care activities with transitional care team and case management to decrease hospitalizations and lengths of stay. Develops trusting relationships with internal and external stakeholders to determine areas of opportunity supplemented with remediation strategies. Performs other duties as assigned and modified at manager's discretion. KNOWLEDGE, SKILLS AND ABILITIES: Strong business acumen and acuity Excellent knowledge and understanding of general nursing and nursing education functions, practices, processes, procedures, techniques and methods Excellent communication and interpersonal skills Skilled in gathering, analyzing, and interpreting information Strong customer service orientation required Ability to work across multiple centers of expertise with a range of stakeholders at different levels Ability to identify problems and recommend solutions Ability to establish priorities and coordinate work activities Must be detail oriented Ability to work effectively, both independently and as part of a team Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, database, and presentation software Ability and willingness to travel locally, regionally and nationwide up to 40% of the time Spoken and written fluency in English This job requires use and exercise of independent judgment EDUCATION AND EXPERIENCE CRITERIA: BS in Nursing (BSN) degree required A minimum of 2 years' specialty care nursing experience required A valid, active RN license required; Nursing Compact license preferred Teaching/training experience required (clinical or patient education preferred) Experience working with geriatric patients highly desirable Basic Life Support (BLS) certification required Certified Nurse Educator (CNE) or similar nursing certification a plus 2 years of dialyiss experience PAY RANGE: $76,732 - $109,617 Salary The posted pay range represents the base hourly rate or base annual full-time salary for this position. Final compensation will depend on a variety of factors including but not limited to experience, education, geographic location, and other relevant factors. This position may also be eligible for a bonuses or commissions. EMPLOYEE BENEFITS ChenMed and we're transforming healthcare for seniors and changing America's healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We're growing rapidly as we seek to rescue more and more seniors from inadequate health care. ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people's lives every single day. Current Employee apply HERE Current Contingent Worker please see job aid HERE to apply #LI-Hybrid ChenMed Job ID #R0046209. Posted job title: Nephrology Nurse RN Educator-Coordinator kidney care preferred About ChenMed At ChenMed, we're shaping the future of value-based care. Our patient-centered, preventive care approach is aimed at improving health outcomes for seniors. We serve our communities in over 100 medical centers across 12 states and prioritize our team members with competitive compensation and benefits and with our purpose-driven culture. Working at ChenMed is more than just your next opportunity, you will feel rewarded from day one as your contribution will truly make an impact in both the health and lives of seniors. Benefits Employee assistance programs Medical benefits Holiday Pay Dental benefits Benefits start day 1 Life insurance Guaranteed Hours Sick pay Vision benefits 401k retirement plan Wellness and fitness programs Mileage reimbursement Discount program

University of Miami is seeking a Registered Nurse (RN) PCU - Progressive Care Unit Level I for a nursing job in Miami, Florida. Job Description & Requirements Specialty: PCU - Progressive Care Unit Discipline: RN Duration: Ongoing 36 hours per week Shift: 12 hours Employment Type: Staff Registered Nurse - Neurosurgery Stepdown Up to $10,000 Sign-on Bonus Work Location : UHealth Tower The University of Miami/UHealth, department of Medical Surgical Telemetry at UTower has an exciting opportunity for a full time Registered Nurse. The Registered Nurse delivers patient-family centered care in a culturally competent manner utilizing evidence-based standards of quality, safety, and service while ensuring population-specific patient care. The Registered Nurse oversees nurses and allied health staff in their daily practice. Assesses assigned patients and evaluates plans to include documentation of nursing care. Reports symptoms and changes in patients' condition and vital signs. Modifies patient treatment plans as indicated by patients' responses, conditions and physician orders. Reviews, evaluates and reports diagnostic tests to assess patient's condition. Consults with physicians and other healthcare professionals related to assigned patients to assess, plan, implement and evaluate patient care plans. Prepares patients for, and assists with examinations, procedures and treatments. Considers patient age and culture during patient treatments and provides any needed information regarding treatment plan. Nurtures a compassionate environment by providing psychological support. Performs appropriate patient tests and safely administers medications within the scope of practice. Administers and maintains accurate records related to medications and treatments as per regulatory bodies, policies, procedures and physician orders. Communicates plan of care in a timely manner to patient and family, as well as the appropriate team members, ensuring compliance with all regulatory guidelines (i.e. HIPAA). Uses best practices for transition of patient care. Uses available resources to assist in discharge planning. Plans, prioritizes, and adjusts assignments to accomplish goals and render superior patient care; seeks assistance when needed. Adapts to changing work demands and environment. Safely operates medical equipment. Serves as a preceptor and assists new staff in the provision of care in order to help them acclimate to the healthcare environment, and a direct patient care role. Provides concise and constructive feedback when needed. Adheres to University and unit-level policies and procedures and safeguards University assets. This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary. MINIMUM QUALIFICATIONS Education: Graduate from an accredited school of nursing, Bachelor's degree (BSN) preferred. RNs hired with an Associates (ASN) degree have 2 years to complete the BSN degree. Certification and Licensing: Valid Florida Registered Nurse License, ACLS, BLS certification from the American Heart Association required. Experience: Minimum one year of nursing experience. Knowledge, Skills and Attitudes: Knowledge of medical terminology Knowledge of nursing care methods and procedures In-depth knowledge of health and safety guidelines and procedures (i.e. sanitation, decontamination etc.) Excellent patient experience skills Ability to recognize, analyze, and solve a variety of problems. Ability to maintain effective interpersonal relationships Ability to communicate effectively in both oral and written form The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more. University of Miami Job ID #R100092910. About University of Miami The University of Miami is considered among the top tier institutions of higher education in the U.S. for its academic excellence, superior medical care, and cutting-edge research. At the U, we are committed to attracting a talented workforce to support our common mission of transforming lives through teaching, research, and service. Through our values of Diversity, Integrity, Responsibility, Excellence, Compassion, Creativity and Teamwork (DIRECCT) we strive to create an environment where everyone contributes in making the University a great place to work. We are one of the largest private employers in Miami-Dade County; home to more than 16,000 faculty and staff from all over the world. Benefits Holiday Pay 403b retirement plan Sick pay Wellness and fitness programs Employee assistance programs Medical benefits Dental benefits Vision benefits Benefits start day 1 Continuing Education Sign-On bonus

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 Are you an experienced Registered Nurse with Utilization Review or Concurrent Review experience looking for a new opportunity with a prestigious Managed Care Company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions - this is the position for you! Daily Responsibilities: Conducts pre-admission, concurrent and retrospective acute care, sub-acute, hospice, qualification of transitional care and long-term care needs for medical necessity Perform case reviews and complete all required documentation in appropriate database Collaborate with primary or attending physician, case managers, patient and/or family to provide continuity and quality of care in the most cost-effective manner. Timely completion of admission reviews (within 48-hours for weekday, 72-hours for weekend) Provide outpatient or pharmacy services utilization review Hours for this Position: M-F 8:00am to 5:00pm Requirements: Current Florida RN License 2+ years in recent medical/surgical or critical care experience 3+ years of Utilization Review / Case Management experience Strong reasoning ability: define problems, collect data, establish facts, and draw conclusions Advantages of this Opportunity: Competitive salary ($30/hr. to $32/hr.) Permanent position Benefits offered, Medical, Dental, and Vision Fun and positive work environment Interested in being considered? If you are interested in being considered for this position, PLEASE click the APPLY NOW button! Additional Information

Job DescriptionAbout us: Solis Health Plans is a new kind of Medicare Advantage Company. We provide solutions that are more transparent, connected and effective for both our members and providers. Solis was born out of a desire to provide a more personal experience throughout all levels of the healthcare journey. Our team consists of expert individuals that take pride in delivering quality service. We believe in a culture that collaborates and supports one another, and where success is interlinked and each employee is valued. Please check out our company website at ************************ to learn more about us! **Bilingual in English and Spanish is required** Full benefits package offered on the first on the month following date of hire including: Medical, Dental, Vision, 401K plan with a 100% company match! Our company has doubled size and we have experienced exponential growth in membership from 2,000 members to over 10,000 members! Join our winning Solis Team! Position is fully onsite Monday-Friday. Location: 9250 NW 36th St, Miami, FL 33178. Position Summary: Under the supervision of the Health Services Director, the Utilization Management Nurse (LPN or RN) uses a multidisciplinary approach to organize, coordinate, monitor, evaluate, create and manage organization determinations and authorizations. These service requests will focus on selected complex medical and psychosocial needs of Solis Health Plans members. The UM Nurse is responsible for assuring the receipt of high quality, cost efficient medical outcomes for enrollees. This role works with Medical Directors, Authorization Coordinators and Service Coordinators to perform first level review to pre-certify elective services, procedures and tests utilizing established Care Coordination polices and protocols, Solis Health Plans benefit criteria, applicable regulatory review criteria and nationally accepted criteria for medical necessity determination. Main Key Responsibilities: Conduct concurrent and retrospective utilization review for inpatient, observation or SNF services. Conducts clinical reviews of proposed services against appropriate criteria/guidelines to determine medical necessity, benefit eligibility, and network contract status. Work with Medical Directors, Program Leadership and Solis Health Plans Provider Relations Teams to identify and mitigate facility barriers associated with the ability to make timely decisions. Identify, align and utilize health plan and community resources that impact high-risk/high cost care. Act as liaison between assigned facilities, members/families, and Solis Health Plans. Clarify policies/procedures and member benefits as needed. Authorizes services, coordinates care, and ensures timeliness and coordination of healthcare services, in compliance with department and regulatory standards, seeking supplemental services when appropriate or when needed. Assess enrollee needs and monitor progress toward goals at all times, communicating findings and status with members of the enrollee's primary care team. Ensure optimal delivery of safe quality health care to members, while maximizing resources and containing costs, and facilitate continual patient-centered and outcome-driven health performance improvement activities. Review enrollees with the Medical Directors and Primary Care Teams and advocates for Administration Exception considerations as appropriate. Facilitate communications between the facility, providers, and the PCT in order to effect and influence a safe and effective discharge plan and care plan for the enrollee. Qualifications: Graduate from an accredited school of nursing, or Bachelors (or advanced) degree in nursing. Active and unrestricted licensure as a Registered Nurse in Florida. A minimum of three to five years clinical experience as a Registered Nurse in a clinical setting required. 2 years' experience as a Utilization Management nurse in a managed care payer preferred. One year experience as a case manager in a payer or facility setting highly preferred. Discharge planning experience highly preferred. What Sets Us Apart: Join Solis Health Plans as a Utilization Management Nurse and become a catalyst for positive change in the lives of our members. At Solis, you will be part of a locally rooted organization deeply committed to understanding and serving our communities. If you are eager to embark on a purpose-driven career that promises growth and the chance to make a significant impact, we encourage you to explore the opportunities available at Solis Health Plans. Join us and be the difference!

We are seeking an Utilization Management Coordinator to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations. About the Role: The Utilization Management Coordinator plays a critical role in ensuring that healthcare services are delivered efficiently and effectively by overseeing the review and authorization of medical treatments and procedures. This position is responsible for coordinating utilization management activities to optimize member care while controlling costs and adhering to regulatory requirements. The role involves collaborating with healthcare providers, insurance companies, and internal teams to evaluate the necessity and appropriateness of medical services. The Coordinator will analyze clinical data and documentation to support decision-making processes and ensure compliance with organizational policies and healthcare standards. Ultimately, this position contributes to improving member outcomes by facilitating timely access to necessary care and preventing unnecessary or redundant services. Minimum Qualifications: Associate degree in Health Administration, or a related healthcare field Minimum of 2 years of experience in utilization management, case management, or a related healthcare coordination role. Strong knowledge of healthcare regulations, insurance processes, and medical terminology. Proficiency in electronic health records (EHR) systems and utilization management software. Relevant experience may substitute for the educational requirement on a year-for-year basis. Preferred Qualifications: Bachelor's degree in Nursing, Health Administration, or a related healthcare field. Certification in Utilization Review (e.g., Certified Professional in Utilization Review - CPUR) or Case Management (e.g., CCM). Experience working within managed care organizations or health insurance companies. Advanced knowledge of clinical guidelines and healthcare quality improvement methodologies. Familiarity with regulatory requirements such as HIPAA, URAC, and NCQA standards. Demonstrated ability to lead or participate in cross-functional teams focused on utilization management initiatives. Responsibilities: Conduct thorough reviews of medical records and treatment plans to determine the medical necessity and appropriateness of requested services. Coordinate communication between healthcare providers, insurance representatives, and internal departments to facilitate timely authorization and appeals processes. Maintain accurate documentation of utilization management activities and decisions in compliance with regulatory and organizational standards. Monitor and analyze utilization data to identify trends, potential issues, and opportunities for process improvement. Assist in developing and implementing utilization management policies and procedures to enhance operational efficiency and member care quality.

This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Founded in 2005, HealthSun is a local Medicare Managed Care Organization with administrative offices located in Coconut Grove, Florida. Serving more than 50,000 members, HealthSun is one of the fastest growing health plans in South Florida. As a local plan, we recognize the healthcare needs of our community and strive to provide our members with only the best service and experience possible. The Nurse Case Manager I is responsible for performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically or on-site such as at hospitals for discharge planning. How You Will Make an Impact: Primary duties may include, but are not limited to: * Ensures member access to services appropriate to their health needs * Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment. * Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements. * Coordinates internal and external resources to meet identified needs. * Monitors and evaluates effectiveness of the care management plan and modifies as necessary. * Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans. * Assists in problem solving with providers, claims or service issues. Minimum Requirements: * Requires BA/BS in a health related field and minimum of 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. * Current, unrestricted RN license in applicable state(s) required. Multi-state licensure is required if this individual is providing services in multiple states. Preferred Skills, Capabilities & Experiences: * Certification as a Case Manager is preferred. * Bilingual English/Spanish highly preferred. * MS Office Suite good working knowledge preferred. For URAC accredited areas the following applies: Requires BA/BS and 3 years of clinical care experience; or any combination of education and experience, which would provide an equivalent background. Current and active RN license required in applicable state(s). Multi-state licensure is required if this individual is providing services in multiple states. Certification as a Case Manager and a BS in a health or human services related field preferred. Job Level: Non-Management Exempt Workshift: 1st Shift (United States of America) Job Family: MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Job Description Cherishing Our Children Since 1977 Helping children and families help themselves to live a better life and build a stronger community. The Center for Family and Child Enrichment (CFCE) is dedicated to help children and their families by providing the right services and solutions based on individual needs. CFCE is constantly evolving to better support our community. CFCE expanded in early 2012 to include a health care center, The Pediatric & Family Health and Wellness Center. The Pediatric & Family Health and Wellness Center, a Federally Qualified Health Center (FQHC), offers an array of preventative health services including but not limited to: general and sick care for adults and children, OB/GYN, dental services, nutrition programs and mental health and substance abuse treatment for children and adults. As a Nurse Case Manager (NCM), you will provide expertise as an educator, consultant, and facilitator. The NCM provides quality patient care via the development, implementation and evaluation of individual patient care plans and patient education sessions. Why join CFCE: Great benefits package, including a Zero (0) cost out of pocket medical plan, 13 Paid Holidays and a competitive Paid Time Off Package Making an invaluable impact in your community Growth and professional development opportunities available Qualify for Public Service Loan Forgiveness We are a tax-exempt organization under section 501(c)(3) of the Internal Revenue Code Some of the Functions Include: Establish communication and collaborative relationships with multidisciplinary healthcare team members. Serve as a liaison between behavioral health and the medical (adult and pediatric) teams to facilitate integration and coordination of care between the two entities. Participate in daily patient care team meetings, training as scheduled, and health team coordination activities. Facilitate the work of the physician -Triage, patient phone calls, and subspecialty appointments. Ensure tracking and follow-up of referrals for laboratory, imaging, and subspecialty services within established timelines. Coordinate subspecialty referrals from appointment scheduling to result follow-up for pediatric and adult care. Complete hospital and emergency room referral and follow-up. Coordinate communication/needs with other entities to assist patients to access resources to address barriers to self-care, such as WIC. Provide health promotion and illness prevention case management for pediatric and adult patient populations (examples include but are not limited to asthma action plans, diet and exercise counseling, ADHD management, transition from pediatric to adult care, diabetes education and hypertension education). Provide patient education, monitoring of health needs, and coordination of community resources. Represent the Agency in health fairs. Plans, prepares and maintains materials for use in educational programs for accuracy and relevance to the target audience. Develop educational materials consistent with evidence-based approaches to improve health literacy and promote self-care. Minimum Education Current State of Florida Licensed Practical Nurse. Certification in BLS and ACLS. Minimum Experience 3 Years of applied clinical experience as a LPN in a health related field or as a Clinical Case Manager or Educator. Skills Needed Proficiency in the use of Microsoft Word, Windows, Microsoft Outlook, Excel and spread sheet applications. Knowledge of audiovisual equipment setup is an advantage. CFCE is a Drug Free Workplace and an Equal Opportunity Employer. Powered by JazzHR PDfOJHyNB2

University of Miami is seeking a Registered Nurse (RN) Cardiac Stepdown Level I for a nursing job in Miami, Florida. Job Description & Requirements Specialty: Cardiac Stepdown Discipline: RN Duration: Ongoing 36 hours per week Shift: 12 hours Employment Type: Staff Registered Nurse - Cardiothoracic Stepdown Up to $25,000 Sign-on Bonus Work Location : UHealth Tower The Registered Nurse delivers patient-family centered care in a culturally competent manner utilizing evidence-based standards of quality, safety, and service while ensuring population-specific patient care. Assesses assigned patients and evaluates plans to include documentation of nursing care. Reports symptoms and changes in patients' condition and vital signs. Modifies patient treatment plans as indicated by patients' responses and conditions, and physician orders. Reviews, evaluates and reports diagnostic tests to assess patient's condition. Consults with physicians and other healthcare professionals related to assigned patients to assess, plan, implement and evaluate patient care plans. Prepares patients for, and assists with examinations, procedures and treatments. Considers patient age and culture during patient treatments and provides any needed information regarding treatment plan. Nurtures a compassionate environment by providing psychological support. Performs appropriate patient tests and safely administers medications within the scope of practice. Administers and maintains accurate records related to medications and treatments as per regulatory bodies, policies, procedures and physician orders. Communicates plan of care in a timely manner to patient and family, as well as the appropriate team members, ensuring compliance with all regulatory guidelines (i.e. HIPAA). Uses best practices for transition of patient care. Uses available resources to assist in discharge planning. Plans, prioritizes, and adjusts assignments to accomplish goals and render superior patient care; seeks assistance when needed. Adapts to changing work demands and environment. Operates the appropriate medical equipment. Adheres to University and unit-level policies and procedures and safeguards University assets. This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary. MININUM QUALIFICATIONS: Education: Graduate from an accredited school of nursing, Bachelor's degree (BSN) preferred. RNs hired with an Associates (ASN) degree have 2 years to complete the BSN degree. Certification and Licensing: Valid Florida Registered Nurse License, ACLS, BLS certification from the American Heart Association required. Experience: One year of Nursing experience. Knowledge, Skills and Attitudes: Knowledge of medical terminology Knowledge of nursing care methods and procedures In-depth knowledge of health and safety guidelines and procedures (i.e. sanitation, decontamination etc.) Excellent patient experience skills Ability to recognize, analyze, and solve a variety of problems Ability to maintain effective interpersonal relationships Ability to communicate effectively in both oral and written form The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more. University of Miami Job ID #R100091428. About University of Miami The University of Miami is considered among the top tier institutions of higher education in the U.S. for its academic excellence, superior medical care, and cutting-edge research. At the U, we are committed to attracting a talented workforce to support our common mission of transforming lives through teaching, research, and service. Through our values of Diversity, Integrity, Responsibility, Excellence, Compassion, Creativity and Teamwork (DIRECCT) we strive to create an environment where everyone contributes in making the University a great place to work. We are one of the largest private employers in Miami-Dade County; home to more than 16,000 faculty and staff from all over the world. Benefits Holiday Pay 403b retirement plan Sick pay Wellness and fitness programs Employee assistance programs Medical benefits Dental benefits Vision benefits Benefits start day 1 Continuing Education Sign-On bonus

ChenMed is seeking a Registered Nurse (RN) Educator for a nursing job in Hallandale Beach, Florida. Job Description & Requirements Specialty: Educator Discipline: RN Duration: Ongoing Employment Type: Staff Salary will be competitive and based on equitable consideration of qualifications and experience. We're unique. You should be, too. We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy? We're different than most primary care providers. We're rapidly expanding and we need great people to join our team. The Patient Educator, Specialty (RN) collaborates with medical practitioners and leaders to incorporate chronic disease education into the plan of care for a specialized group of patients. The incumbent in this role is responsible for helping to improve patient health outcomes by promoting and facilitating disease education with the patient and/or family member(s) thereby ensuring their active involvement in care and care decisions. He/She performs direct specialty nursing services to patients as required, ensuring adherence to regulatory standards and all related policies, procedures, and guidelines. The Patient Educator, Specialty (RN), is also accountable for the development and delivery of clinical education to patients that increases their knowledge of disease processes, improves patient engagement in care, and reduces hospital and ER admissions. ESSENTIAL JOB DUTIES/RESPONSIBILITIES: Provides chronic disease education relative to quality care for a specific patient population. Coordinates care between their primary care physicians, community specialists and vendor services including hospitals. Monitors chronic disease program performance across multiple medical centers. Identifies gaps and implements improvements in patient and quality outcomes. Assists with the development of strategies for quality improvement and management related to disease education. Collaborates with medical center leaders and PCPs to evaluate, develop and implement patient education programs through needs assessment analysis. Educates patients and/or family member(s) by gaining an understanding of their cultural and religious practices, emotional barriers, desire and motivation to learn, physical and/or cognitive limitations, language barriers and readiness to learn. Identifies opportunities to minimize fragmentation of health care for patients. Encourages decision-making about health care options by ensuring the patient and/or family member(s) understand the patient's health status. Maximizes care skills by observing the patient and/or family member(s) ability to cope with patient's health status/prognosis/outcome and pivoting communication as necessary. Enriches the patient's overall health by promoting and encouraging healthy lifestyles. Selects, adapts and individualizes patient education information by analyzing available brochures, printed materials, videos and other resources that align with the age, culture, religious practices, language, etc. of the patient. Documents patient care services in patients' chart and department records as determined by internal policies and procedures and external laws, rules and regulations. Improves quality results by studying, evaluating and re-designing processes; implements changes as needed. Coordinates care activities with transitional care team and case management to decrease hospitalizations and lengths of stay. Develops trusting relationships with internal and external stakeholders to determine areas of opportunity supplemented with remediation strategies. Performs other duties as assigned and modified at manager's discretion. KNOWLEDGE, SKILLS AND ABILITIES: Strong business acumen and acuity Excellent knowledge and understanding of general nursing and nursing education functions, practices, processes, procedures, techniques and methods Excellent communication and interpersonal skills Skilled in gathering, analyzing, and interpreting information Strong customer service orientation required Ability to work across multiple centers of expertise with a range of stakeholders at different levels Ability to identify problems and recommend solutions Ability to establish priorities and coordinate work activities Must be detail oriented Ability to work effectively, both independently and as part of a team Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, database, and presentation software Ability and willingness to travel locally, regionally and nationwide up to 40% of the time Spoken and written fluency in English This job requires use and exercise of independent judgment EDUCATION AND EXPERIENCE CRITERIA: BS in Nursing (BSN) degree required A minimum of 2 years' specialty care nursing experience required A valid, active RN license required; Nursing Compact license preferred Teaching/training experience required (clinical or patient education preferred) Experience working with geriatric patients highly desirable Basic Life Support (BLS) certification required Certified Nurse Educator (CNE) or similar nursing certification a plus PAY RANGE: $76,732 - $109,617 Salary The posted pay range represents the base hourly rate or base annual full-time salary for this position. Final compensation will depend on a variety of factors including but not limited to experience, education, geographic location, and other relevant factors. This position may also be eligible for a bonuses or commissions. EMPLOYEE BENEFITS ChenMed and we're transforming healthcare for seniors and changing America's healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We're growing rapidly as we seek to rescue more and more seniors from inadequate health care. ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people's lives every single day. Current Employee apply HERE Current Contingent Worker please see job aid HERE to apply #LI-Hybrid ChenMed Job ID #R0046571. Posted job title: Kidney Care Nurse Educator About ChenMed At ChenMed, we're shaping the future of value-based care. Our patient-centered, preventive care approach is aimed at improving health outcomes for seniors. We serve our communities in over 100 medical centers across 12 states and prioritize our team members with competitive compensation and benefits and with our purpose-driven culture. Working at ChenMed is more than just your next opportunity, you will feel rewarded from day one as your contribution will truly make an impact in both the health and lives of seniors. Benefits Employee assistance programs Medical benefits Holiday Pay Dental benefits Benefits start day 1 Life insurance Guaranteed Hours Sick pay Vision benefits 401k retirement plan Wellness and fitness programs Mileage reimbursement Discount program

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 Conducts pre-admission, concurrent and retrospective acute care, sub-acute, hospice, qualification of transitional care and long-term care needs for medical necessity Perform case reviews and complete all required documentation in appropriate database Collaborate with primary or attending physician, case managers, patient and/or family to provide continuity and quality of care in the most cost-effective manner. Timely completion of admission reviews (within 48-hours for weekday, 72-hours for weekend) Provide outpatient or pharmacy services utilization review Qualifications Current Florida RN License 3+ years in recent medical/surgical or critical care experience 3+ years of Utilization Review / Case Management experience Strong reasoning ability: define problems, collect data, establish facts, and draw conclusions Additional Information Hours for this Position: M-F 8-5 Advantages of this Opportunity: Competitive salary $28.85/hr - $31.25/hr pending experience Excellent Medical benefits Offered, Medical, Dental, Vision, 401k, and PTO Growth potential Fun and positive work environment