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Utilization review nurse full time jobs - 40 jobs

  • Staff RN, Interventional Radiology

    Ohiohealth 4.3company rating

    Columbus, OH

    We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more - in our careers and in our communities. Summary: This position provides individualized, goal directed general and critical care nursing, including assessment, procedure preparation, and procedure monitoring while administering sedation to patients that undergo diagnostic, interventional, emergent and therapeutic procedures. Nurses need to be familiar with caring for acutely ill intensive care patients and titrating intravenous medications. Care is delivered along the health illness continuum in diverse health care settings while collaborating with the health care team. We ensure high service standards while promoting an excellent patient experience. A high expectation to work as a team with the interventional radiologists, radiology technologists and anesthesiologists while providing personal and procedural needs and comfort for each patient. Accountable for the practice of nursing as defined by the Ohio Board of Nursing. Responsibilities And Duties: Assessment/Diagnosis - Performs initial, ongoing, and functional health status assessment as applicable to the population and or individual (30%). Outcomes Identification/Planning - Based on nursing diagnoses and collaborative problems, documents planned nursing interventions to achieve outcomes appropriate to patient needs (30%). Implementation/Evaluation - Evaluates and documents response to nursing interventions and achievement of outcomes at appropriately determined intervals; as part of a multidisciplinary team, revises plan of care based on evaluative data (20%). Leadership - Actively participates in process improvement activities to achieve targeted measures of clinical quality, customer satisfaction, and financial performance (10%). Operations (10%). As a High Reliability Organization (HRO), responsibilities require focus on safety, quality and efficiency in performing job duties. The job profile provides an overview of responsibilities and duties and is not intended to be an exhaustive list and is subject to change at any time. Minimum Qualifications: BLS - Basic Life Support - American Heart Association, RN - Registered Nurse - Ohio Board of Nursing Additional Job Description: MINIMUM QUALIFICATIONS Current Registered Nurse license from the State of Ohio and/or current Registered Nurse license in good standing with a multi-state compact state. BLS certification BSN required at 5 years of employment Work Shift: Day Scheduled Weekly Hours : 40 Department Interventional Radiology Join us! ... if your passion is to work in a caring environment ... if you believe that learning is a life-long process ... if you strive for excellence and want to be among the best in the healthcare industry Equal Employment Opportunity OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment
    $46k-75k yearly est. 5h ago
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  • Utilization Management Nurse 2

    Humana 4.8company rating

    Columbus, OH

    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The UM Nurse 2 will- + Uses clinical knowledge, communication skills, and independent critical thinking skills towards:. + Interpreting criteria, policies, and procedures related to Long Term Services and Support authorizations to provide the best and most appropriate treatment, care, or services for members. + Coordinate and communicate with providers, members, or other parties to facilitate optimal care and treatment. + Understand department and organizational strategy and operating objectives, including their linkages to related areas. + Follow established guidelines/procedures. + Make decisions regarding own work methods, occasionally in ambiguous situations, requires minimal direction and receives guidance where needed. **Use your skills to make an impact** **REQUIRED QUALIFICATIONS:** + **Must reside in Michigan or within 40 miles of the border in Indiana or Ohio** . + Active Registered Nurse (RN) in the state of Michigan with no disciplinary action. + 1-year previous experience in utilization management/LTSS service authorization. + At least 2 years prior clinical experience preferably in an acute care, skilled or rehabilitation clinical setting, or Medicaid Managed Care Organization. + Comprehensive knowledge of Microsoft Word, Outlook and Excel. + Ability to work independently under general instructions and with a team. + Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role); a minimum standard speed for optimal performance of 10x1 (10mbs download x 1mbs upload) is required. **PREFERRED QUALIFICATIONS:** + Bachelor's or Associate's Degree in Nursing or other related field. + Previous Medicare/Medicaid experience. + NCQA, CM experience. + Previous experience in discharge planning and/or home health or rehabilitation. + Bilingual preferred (Spanish, Arabic, Chaldean Neo-Aramaic or other). **ADDITIONAL INFORMATION:** + Workstyle: This is a remote position. + Travel: May need to attend onsite meetings + Workdays and Hours: Monday - Friday; 8:00am - 5:00pm Eastern Standard Time (EST). + Language Assessment Statement: Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. **WAH INTERNET STATEMENT:** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. + Satellite, cellular and microwave connection can be used only if approved by leadership. + Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. **Interview Process** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. **Assessment:** If you are selected to move forward, you will receive an email to complete the Virtual Job Experience (VJE). This is an online activity where you will learn more about Customer Care jobs at Humana, try out some of the most common job tasks, and tell us more about yourself. Most people complete the VJE in approximately 30 minutes. To complete it, you will need a smart phone, computer or tablet with internet access, and speakers/headphones. We do not make job offers to candidates that do not complete the VJE. **Video Prescreen** : If you are successful with your text screen, you will receive another communication to record a Video Prescreen. This is an online video activity using your phone, tablet, or computer; however, most candidates prefer using a computer or tablet. **Interviews** : Some candidates will be invited to interview. If so, the recruiter will reach out to schedule. **Offers** : Finalists from the interview will be contacted by a recruiter to discuss an offer for the job **Note** : Depending on the number of openings, the number of candidates who apply, and the schedules of interviewers and recruiters, this process may take several weeks or less; however, know that we are working hard to proceed as quickly as possible and to keep you informed. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $71.1k-97.8k yearly 4d ago
  • Utilization Management Nurse

    Centerwell

    Columbus, OH

    **Become a part of our caring community and help us put health first** Healthcare isn't just about health anymore. It's about caring for family, friends, finances, and personal life goals. It's about living life fully. At Conviva, a wholly-owned subsidiary of Humana, Inc., we want to help people everywhere, including our team members, lead their best lives. We support our team members to be happier, healthier, and more productive in their professional and personal lives. We encourage our people to build relationships that inspire, support, and challenge them. We promote lifelong well-being by giving our team members fresh perspective, new insights, and exciting opportunities to enhance their careers. At Conviva, we're seeking innovative people who want to make positive changes in their lives, the lives of our patients, and the healthcare industry as a whole. Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that focuses on excellent service to others. **Preferred Locations:** Daytona, FL, Louisville, KY, San Antonio, TX **Use your skills to make an impact** **Role Essentials** + Active Unrestricted RN license + Possession of or ability to obtain Compact Nursing License + A minimum of three years clinical RN experience; + Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work independently and within a team setting + Valid driver's license and/or dependable transportation necessary + Travel for offsite Orientation 2 to 8 weeks + Travel to offsite meetings up to 6 times a year as requested + Willing to work in multiple time zones + Strong written and verbal communication skills + Attention to detail, strong computer skills including Microsoft office products + Ability to work in fast paced environment + Ability to form positive working relationships with all internal and external customers + Available for On Call weekend/holiday rotation if needed **Role Desirables** + Education: BSN or bachelor's degree in a related field + Experience with Florida Medicaid + Experience with Physical Therapy, DME, Cardiac or Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare/Medicaid Experience a plus + Current nursing experience in Hospital, SNF, LTAC, DME or Home Health. + Bilingual **Additional Information** We offer tangible and intangible benefits such as medical, dental and vision benefits, 401k with company matching, tuition reimbursement, 3 weeks paid vacation time, paid holidays, work-life balance, growth, a positive and fun culture and much more. To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 02-18-2026 **About us** About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options *************************************************************
    $71.1k-97.8k yearly 4d ago
  • Nurse Case Manager - Internal (Medical Review Nurse - PN 20014026)

    Dasstateoh

    Columbus, OH

    Nurse Case Manager - Internal (Medical Review Nurse - PN 20014026) (250009CG) Organization: HealthAgency Contact Name and Information: Gayla. A will contact you if selected for interview.Unposting Date: OngoingWork Location: Health Department Building 246 North High Street 1st Floor Columbus 43215Primary Location: United States of America-OHIO-Franklin County-Columbus Compensation: $34.96Schedule: Full-time Work Hours: Monday - Friday; 8am - 5pmClassified Indicator: ClassifiedUnion: 1199 Primary Job Skill: NursingTechnical Skills: Health Administration, Nursing, Public Health, Public Relations, Medical records Professional Skills: Analyzation, Attention to Detail, Collaboration, Consultation, Verbal Communication, Written Communication Agency OverviewNurse Case Manager- Internal (Medical Review Nurse) About Us:Our mission at the Ohio Department of Health (ODH) is advancing the health and well-being of all Ohioans. Our agency is committed to building a modern, vibrant public health system that creates the conditions where all Ohioans flourish.The Bureau of Maternal, Child, and Family Health (BMCFH)/ Complex Medical Help (CMH) is organized to support families by improving birth outcomes and the health status of women, infants, children, and youth, including children and youth with complex health care needs. Using data and proven practice, the bureau's programs support the delivery of direct services, linkages and referrals, population-based supports, program evaluation, education, monitoring and quality oversight, and policy and systems development. Job DescriptionWhat You'll Do:Are you a compassionate and detail-oriented nurse looking to make meaningful impact in the lives of children with special care needs? This role offers a dynamic blend of clinical decision-making, case management, community engagement, and administrative support-ideal for nurses who thrive in both independent and collaborative environments. Duties Include: Clinical and Case Management: Independently assess medical applications and determine eligibility for CMH services. Authorize or deny diagnostic, treatment, and service coordination based on medical data and program guidelines. Interpret medical plans for treatment and develop appropriate care strategies. Monitor ongoing service needs and effectiveness, ensuring compliance with HIPAA and CMH policies. Coordinate complex treatment plants with other state and federal programs. Evaluate diagnoses and determine appropriate services, including medical equipment, orthotics, prosthetics, and orthodontia. Manage case data and service authorizations.Community Engagement & Education: Maintain contact with families, providers, and community partners through phone, written communication and site visits across Ohio. Provide technical assistance and orientation to providers on CMH policies, procedures and billing. Plan and participate in educational workshops, seminars, and nursing care conferences. Resolve service delivery issues and respond to sensitive inquiries professionally and confidentially. Collaborate with nurse case managers and other stakeholders to ensure timely and effective case processing Administrative and Liaison Support: Maintain accurate and confidential client records in accordance with national, state and CMH guidelines.Perform administrative tasks such as answering phone, managing documents and operating office equipment.Serve as a liaison to government agencies, private sector partners and other state programs UNUSUAL WORKING CONDITIONS: May require travel Why Work for the State of OhioAt the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees*. For a list of all the State of Ohio Benefits, visit our Total Rewards website! Our benefits package includes: Medical Coverage Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period Paid time off, including vacation, personal, sick leave and 11 paid holidays per year Childbirth, Adoption, and Foster Care leave Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more) Public Retirement Systems (such as OPERS, STRS, SERS, and HPRS) & Optional Deferred Compensation (Ohio Deferred Compensation) *Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position.QualificationsPosition Qualifications: Current and valid license to practice professional nursing as Registered Nurse (i.e., R.N.) in Ohio as issued by Board of Nursing pursuant to Section 4723.03 of Revised Code and all of the following bulleted criteria: 24 mos. exp. in pediatric nursing, which included care of children with special health care needs (i.e., CSHCN) &/or case management of children with multiple health care needs completion of undergraduate core program in nursing to include 1 course in community health nursing or public health nursing & 1 course in research methodologies or equivalent.1 course or 3 mos. exp. in operation of personal computer. Or Current and valid license to practice professional nursing as Registered Nurse (i.e., R.N.) in Ohio as issued by Board of Nursing pursuant to Section 4723.03 of Revised Code and all of the following bulleted criteria: 24 mos. exp. in pediatric nursing, which included care of children with special health care needs (i.e., CSHCN) &/or case management of children with multiple health care needs. 24 mos. exp. in nursing, which included 3 mos. trg. or 3 mos. exp, in community health or public health nursing & 3 mos. trg. or 3 mos. exp. in data collection & analysis.1 course or 3 mos. exp. in operation of personal computer. Or Equivalent of Minimum Class Qualifications for Employment noted above may be substituted for the experience required, but not for the mandated licensure. Additional Qualifications: Applications of those who meet the minimum qualifications will be further evaluated against the following criteria:Graduate or advanced degree in nursing Experience in pediatric nursing and case management of children/ young adults with special health care needs Experience providing technical assistance/consultation services to a local health department or other provider of child /young adults health services (e.g., hospitals, pediatric clinics, physician's offices, other health care related professionals) Experience in public/community and/or home health nursing Experience reviewing and authorizing medical plans of treatment/requests for services (e.g., may include durable medical equipment/orthotics/prosthetics/orthodontic services/therapies) Certified Nurse Case Manager/ Discharge Planner or Certified Pediatric NurseExperience in analyzing health related data to prepare reports (e.g., quality assurance/technical reports, medical reports) Experience providing education or training to various groups (e.g., medical groups, nursing staff, parents, young adults) Experience with computer software (e.g., Microsoft Office: Word, PowerPoint) All eligible applications shall be reviewed considering the following criteria: qualifications, experience, education, active disciplinary record, and work record Job Skills: NursingTechnical Skills: Health Administration, Medical Records, Nursing, Public Health, Public RelationsProfessional Skills: Analyzations, Attention to Detail, Collaboration, Consultation, Verbal Communication, Written CommunicationsEducational Transcript Requirements: Official educational transcripts are required for all post-high school educational accomplishments, coursework or degrees claimed on the application. Applicants will be required to submit an official transcript prior to receiving a formal offer of employment. Failure to provide transcripts within five (5) working days of being requested will cause the applicant to be eliminated from further consideration. Please note that a transcript is considered "official" only if it is an original copy from the educational institution and includes an institutional watermark, ink stamp or embossed stamp. Transcripts printed from the institution's website will not be accepted. ODH reserves the right to assess the academic credibility of an educational entity's award of a putative degree.If you are using education or coursework to meet the minimum qualifications for this position, an official transcript must be attached prior to submitting your application. Supplemental InformationSupplemental Information:ALL ANSWERS TO THE SUPPLEMENTAL QUESTIONS MUST BE SUPPORTED BY THE WORK EXPERIENCE/EDUCATION PROVIDED ON YOUR CIVIL SERVICE APPLICATION.Unless required by legislation, the selected candidate will begin at Pay Grade 13, Step 1 of the SEIU/1199 union Pay Range Schedule ($34.96 per hour), with an opportunity for pay increase after six months ($36.65 per hour) of satisfactory performance and then a yearly raise thereafter. APPLICATION PROCEDURES: All applicants must submit a completed Ohio Civil Service Application using the TALEO System. Paper applications will not be considered. Applicants must clearly indicate how they meet the minimum qualifications and/or position specific minimum qualifications. Applicants are also encouraged to document any experience, education and/or training related to the job duties above. An assessment of these criteria may be conducted to determine the applicants who are interviewed.STATUS OF POSTED POSITION:You can check the status of your application online by signing into your profile. Jobs you applied for will be listed. The application status is shown to the right of the position title and application submission details.BACKGROUND CHECK NOTICE:The final candidate selected for this position will be required to undergo a criminal background check. Criminal convictions do not necessarily preclude an applicant from consideration for a position. An individual assessment of an applicant's prior criminal convictions will be made before excluding an applicant from consideration.All final applicants tentatively selected for this class will be required to submit to urinalysis to test for illegal drug use prior to appointments. An applicant with a positive test shall not be offered employment.ADA StatementOhio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.Drug-Free WorkplaceThe State of Ohio is a drug-free workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note, this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39), and as outlined in the posting.
    $35-36.7 hourly Auto-Apply 17h ago
  • QM Nurse Consultant

    CVS Health 4.6company rating

    Delaware, OH

    At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. Responsible for the review and evaluation of clinical information and documentation. Reviews documentation and interprets data obtained from clinical records or systems to apply appropriate clinical criteria and policies in line with clinical editing, policy and coding standards. Fundamental Components:Reviews documentation and evaluates potential correct coding issues based on multiple clinical policies. Considers all documented system information as well as any additional records/data presented to develop a determination or recommendation. Data gathering requires navigation through multiple system applications. Staff may be required to contact internal Aetna departments to obtain additional information. Evaluates documentation/information to determine compliance with clinical policy, regulatory, and accreditation guidelines. Accurately applies review requirements to assure case is reviewed by a practitioner with clinical expertise for the issue at hand. Commands a comprehensive knowledge of complex delegation arrangements, contracts (member and provider), clinical criteria, benefit plan structure, regulatory requirements, company policy and other processes which are required to support the review of the clinical documentation/information. Pro-actively and consistently applies the regulatory and accreditation standards to assure that activities are reviewed and processed within guidelines. Condenses complex information into a clear and precise clinical picture while working independently. Reports audit or clinical findings to appropriate staff or others in order to ensure appropriate outcome and/or follow-up for improvement as indicated. Required Qualifications3-5 years of direct care clinical experience as an RN required. Active and unrestricted RN licensure required in candidate's state of residence. 2 years' experience with MS Office suite applications including Excel. Strong computer skills utilizing multiple systems and applications at the same time. Must have critical thinking skills. Preferred QualificationsExperience with ICD-10, CPT coding Experience with QNXTExperience with QuickBase. Experience with Cotiviti Editing/CXTEducationRegistered Nurse with compact license Associates Degree required, Bachelors preferred Anticipated Weekly Hours40Time TypeFull time Pay RangeThe typical pay range for this role is:$54,095. 00 - $155,538. 00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ************* cvshealth. com/us/en/benefits We anticipate the application window for this opening will close on: 01/30/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
    $54.1k-155.5k yearly 5d ago
  • Nurse Case Manager

    Battelle 4.7company rating

    Columbus, OH

    Battelle delivers when others can't. We conduct research and development, manage national laboratories, design and manufacture products and deliver critical services for our clients-whether they are a multi-national corporation, a small start-up or a government agency. We recognize and appreciate the value and contributions of individuals from a wide range of backgrounds and experiences and welcome all qualified individuals to apply. Job Summary The Health Research and Analytics (HRA) business line is seeking a highly motivated, full-time Nurse Case Manager to join our team in support of our government customer, U.S. Special Operations Command. This position will play a critical role in advancing the Preservation of the Forces and Family (POTFF) program, which is dedicated to optimizing and sustaining the mission readiness, longevity, and performance of Special Operations Forces (SOF). Through integrated and holistic human performance initiatives, POTFF strengthens both the Forces and their families, ensuring comprehensive support for those who serve. As a Nurse Case Manager, you will contribute to impactful research and analytics that drive evidence-based decision-making and enhance the effectiveness of these vital programs. This is an exciting opportunity to make a meaningful difference in the lives of SOF personnel and their families while working in a dynamic, mission-driven environment. This position applies professional health nursing principles and clinical expertise to analyze and address complex patient needs, ensuring appropriate and cost-effective treatment. This role involves collecting and communicating detailed health data, developing time-sensitive treatment plans, assessing patient care via telephone, and coordinating discharge planning to optimize care delivery and outcomes. Additionally, the Nurse Case Manager facilitates referrals, collaborates with healthcare providers, and manages service agreements to support efficient, effective, and compliant patient care. Responsibilities Provide a full range of professional health nursing principles, practices, and procedures in clinical settings to analyze the full scope of problems associated with providing appropriate, cost-effective care to Department of Defense (DOD) beneficiaries Collect, organize, record, and communicate data relevant to primary health assessments including a detailed medical history to develop time sensitive treatment plans which delineate the expected process of care delivery for selected case managed patients or populations Assess patient care via the telephone, using established protocols to provide appropriate and cost-effective care Establish priorities for patient care monitors and evaluate progress toward the stated goals to provide coordinated, efficient, effective health care to its beneficiaries Oversee discharge-planning activities to ensure ideal timing and sequencing of patient care Provides professional assistance to health care finders to identify patient's needs for referrals to appropriate health care providers or facilities Negotiate, write, finalize, and administer product/service agreements to ensure mutual compliance in meeting care goals Key Qualifications Certified as a case manager by a recognized certifying organization, i.e., Commission for Case Management Certification or American Nurse Credentialing Center At least two years' nursing experience Current, full, active, and unrestricted license as a Registered Nurse in any U.S. State, the District of Columbia, Guam, Puerto Rico or U.S. Virgin Islands Ability to seek feedback from peers, professional colleagues, clients, and outcomes research, to expand clinical knowledge, enhance role performance, and increase knowledge of professional issues. Experience effectively consulting with health care providers at all levels and negotiating with outside providers for services and products to obtain client services and support Experience understanding diagnoses to assist patients to optimize their level of function and self-care Possess knowledge of patient education principles and management of complex medical, psychosocial, and financial problems to enhance patient adherence to individualized treatment plans and train peers and staff Maintain credentialing requirements in good standing at a local MTF Possess oral and written communication skills to meaningfully interact with peers, outside agencies, vendors, providers, and Military Health System (MHS) stakeholders to exchange information, provide briefings, presentations, research, and metrics to demonstrate or advance effective, efficient case management practice, outcomes, and organizational/MHS value. Experience in team coordination, facilitation, and communication to facilitate the exchange of information/education, enhance goal achievement, augment abilities of client support network, and effect change in system or policy at any level Knowledge of local, state, and federal laws and regulations, professional code of ethics, and practice standards to ensure adherence within legal and professional parameters Knowledge and skill in using pre-established utilization review criteria to recognize and report actual or potential quality and risk management issues to improve practice and ensure compliance Knowledge and skills in the use of VA/DOD Clinical Practice Guidelines to ensure an evidence-based standardized process of care to military beneficiaries Knowledge of the healthcare financial environment and the fiscal dimension of population health to ensure optimal stewardship of resources Experience using research tools to critically evaluate existing practices, opportunities, and outcomes Experience in management of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to involved stakeholders Knowledge of computers and software applications to conduct data collection, tracking, rending, and analysis Ability to design and present computer-generated outcome analysis information to provide timely, effective peer and higher-level educational programs or project briefings Knowledge of pharmaceuticals, their desired effects, side effects, and complications of their use to gauge their effect on patients and their recovery Knowledge of community resources, patient entitlement/benefit eligibility, and ability to access these resources to assist patients/families in optimizing their level of function and self-care Knowledge of current third-party regulations and policies, with special emphasis on TRICARE and Medicare benefits and services, to identify alternative financing sources to which DOD beneficiaries may be entitled Additional Qualifications May be required to receive and maintain clinical practice privileges Current certification in Basic Cardiac Life Support (BCLS) from the American Heart Association, with documentation provided Ability to obtain and maintain a U.S. government security clearance Benefits: Live an Extraordinary Life We care about your well-being, not just on the job. Battelle offers comprehensive and competitive benefits to help you live your best life. Balance life through a compressed work schedule: Most of our team follows a flexible, compressed work schedule that allows for every other Friday off-giving you a dedicated day to accomplish things in your personal life without using vacation time. Enjoy enhanced work flexibility, including a hybrid arrangement: You have options for where and when you work. Our Together with Flexibility model allows you to work 60% in-office and 40% remote, with Monday and Tuesday as common in-office days, dependent on team and position needs. Take time to recharge: You get paid time off to support work-life balance and keep motivated. Prioritize wellness: Stay healthy with medical, dental, and vision coverage with wellness incentives and benefits plus a variety of optional supplemental benefits. Better together: Coverage for partners, gender-affirming care and health support, and family formation support. Build your financial future: Build financial stability with an industry-leading 401(k) retirement savings plan. For most employees, we put in 5 percent whether you contribute or not, and match your contributions on top of that. Advance your education: Tuition assistance is available to pursue higher education. A Work Environment Where You Succeed For brilliant minds in science, technology, engineering and business operations, Battelle is the place to do the greatest good by solving humanity's most pressing challenges and creating a safer, healthier and more secure world. You will have the opportunity to thrive in a culture that inspires you to: Apply your talent to challenging and meaningful projects Receive select funding to pursue ideas in scientific and technological discovery Partner with world-class experts in a collaborative environment Nurture and develop the next generation of scientific leaders Give back to and improve our communities Vaccinations & Safety Protocols Battelle may require employees, based on job duties, work location, and/or its clients' requirements to follow certain safety protocols and to be vaccinated against a variety of viruses, bacteria, and diseases as a condition of employment and continued employment and to provide documentation that they are fully vaccinated. If applicable, Battelle will provide reasonable accommodations based on a qualified disability or medical condition through the Americans with Disabilities Act or the Rehabilitation Act or for a sincerely held religious belief under Title VII of the Civil Rights Act of 1964 (and related state laws). Battelle is an equal opportunity employer. We provide employment and opportunities for advancement, compensation, training, and growth according to individual merit, without regard to race, color, religion, sex (including pregnancy), national origin, sexual orientation, gender identity or expression, marital status, age, genetic information, disability, veteran-status veteran or military status, or any other characteristic protected under applicable Federal, state, or local law. Our goal is for each staff member to have the opportunity to grow to the limits of their abilities and to achieve personal and organizational objectives. We will support positive programs for equal treatment of all staff and full utilization of all qualified employees at all levels within Battelle. The above statements are intended to describe the nature and level of work being performed by people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, activities and skills required of staff members. No statement herein is intended to imply any authorities to commit Battelle unless special written permission is granted by Battelle's Legal Department. For more information about our other openings, please visit ************************
    $69k-94k yearly est. 60d+ ago
  • Field Nurse Case Manager (1099) - Columbus, OH

    The Ima Group 4.4company rating

    Columbus, OH

    Description Company Overview: For over 30 years, The IMA Group has been dedicated to enhancing the livelihood and productivity of individuals and organizations navigating challenging periods of health, work and disability while actively contributing to the development of new medical treatments and clinical advancements. At IMA, we are not just a company; we are a community committed to making a difference. About Us: We are seeking an Experienced Field Case Manager to oversee medical treatment for individuals with workplace injuries. Collaborating with insurance carriers, medical providers, attorneys, employers, and employees, you will closely monitor each case, providing regular updates to employers and insurance carriers. Your role will focus on ensuring optimal medical care and facilitating a safe and timely return to work. We offer the flexibility to take on a caseload that aligns with both your preferences and our needs-whether that's a few cases or a full 40-hour week. We'd love to partner with you! This position operates on a contract basis as a 1099 independent contractor. Responsibilities: Manage comprehensive medical case management, coordinating with patients, physicians, healthcare providers, employers, and referral sources. Assess treatment plans for appropriateness, medical necessity, and cost-effectiveness. Coordinate Independent Medical Evaluations and/or conduct job site evaluations to support case management. Monitor patient progress, engage in discussions with physicians, and provide medical recommendations to all involved parties. Develop cost-effective strategies for medical care management and efficiently prioritize workload. Prepare detailed reports within specified timeframes, attend injured worker appointments, and fulfill additional duties as assigned. Qualifications: Possession of Malpractice Liability Insurance (or ability to obtain). Must have experience in Workers' Compensation Case Management. Proficient in PC and technology skills. Registered Nurse (RN) qualification with flexibility for contract work (1099). Preferred bilingual proficiency; access to personal computer, phone, and reliable transportation for in-person appointments. The IMA Group is an Affirmative Action/Equal Opportunity Employer Our Government Services Division supports local, state, and federal agencies and delivers professional and objective medical and psychological examinations as well as ancillary services. Our Payer Services Division meets the evaluation and screening needs of Carriers, TPAs, Public Entities and Employers and includes behavioral health and physical medicine specialty services, working with a wide range of organizations within the workers' compensation, disability, liability, and auto markets. Our Clinical Research Division performs all types of Phase II-IV clinical trials in multiple therapeutic areas through a flexible nationwide network of site locations and virtual capabilities. #LI-HYBRID #LI-AR1
    $56k-69k yearly est. Auto-Apply 60d+ ago
  • Field Nurse Case Manager

    Unitedhealth Group 4.6company rating

    Columbus, OH

    Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere. As a team member of our Optum At Home product, together with an interdisciplinary care team we help patients navigate the health care system, and connect them to key support services. This preventive care can help patients stay well at home. We're connecting care to create a seamless health journey for patients across care settings. Join us to start **Caring. Connecting. Growing together.** Registered Nurses in the Optum at Home program work with patients primarily in their home setting. They perform as part of a care team including a Nurse Practitioner, Behavioral Health Advocate, Care Navigator and other supporting team members. They deliver role appropriate patient care through in-home visits, telephonic outreach and consultations, and interdisciplinary team activities. The Field Case Manager RN may perform care and counsel of the ill, injured, or infirm, in the promotion and maintenance of health with individuals, groups, or both throughout the life span. They help to manage health problems and coordinate health care for the Optum at Home patients in accordance with State and Federal rules and regulations and the nursing standards of care. This includes (but is not limited to) assessment of health status, development and implementation of plan of care, and ongoing evaluation of patient status and response to the plan of care. Clinical management is conducted in collaboration with other care team members. **Primary Responsibilities:** + Reports to RN Manager + Assess the health status of members as within the scope of licensure and with the frequency established in the model of care + Establish goals to meet identified health care needs + Plan, implement and evaluate responses to the plan of care + Work collaboratively the multidisciplinary team to engage resources and strategies to address medical, functional, and social barriers to care + Works closely with mental health clinicians to help bridge the gap between mental and physical health + Consult with the patient's PCP, specialists, or other health care professionals as appropriate + Assess patient needs for community resources and make appropriate referrals for service + Facilitate the patient's transition within and between health care settings in collaboration with the primary care physician and other treating physicians + Completely and accurately document in patient's electronic medical record + Provide patients and family members with counseling and education regarding health maintenance, disease prevention, condition trajectory and need for follow up as appropriate during each patient visit + Verify and document patient and/or family understanding of condition, plan of care and follow up recommendations + Actively participate in organizational quality initiatives + Participate in collaborative multidisciplinary team meetings to optimize clinical integration, efficiency, and effectiveness of care delivery + Maintain credentials essential for practice, to include licensure, certification (if applicable) and CEUs + Demonstrate a commitment to the mission, core values and goals of UnitedHealthcare and its healthcare delivery including the ability to integrate values of compassion, integrity, performance, innovation and relationships in the care provided to our member You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Years of post-high school education can be substituted/is equivalent to years of experience. **Required Qualifications:** + Current unrestricted licensure as RN in Ohio + 2+ years of relevant experience + Experience in assessing the medical needs of patients with complex behavioral, social and/or functional needs + Demonstrated ability to work with diverse care teams in a variety of settings including non-clinical settings (primarily patient homes) + Proven solid computer skills, including use of electronic medical records + Ability to travel 100% of the time for field-based work within 60 miles of residence + Valid driver's license + Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area **Preferred Qualification:** + Field based experience + Case management experience + Proven effective time management and communication skills Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. _OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
    $58.8k-105k yearly 11d ago
  • Immunization Nurse Consultant - 20013627

    State of Ohio 4.5company rating

    Columbus, OH

    Immunization Nurse Consultant - 20013627 (250007Y4) Organization: HealthAgency Contact Name and Information: Ryan F. Candidates chosen for an interview will be contacted directly.Unposting Date: OngoingWork Location: Health Department Building 246 North High Street 1st Floor Columbus 43215Primary Location: United States of America-OHIO-Franklin County-Columbus Compensation: $31.74Schedule: Full-time Work Hours: M-F, 8a-5pClassified Indicator: ClassifiedUnion: 1199 Primary Job Skill: NursingTechnical Skills: Learning and Development, Public Relations, TrainingProfessional Skills: Adaptability, Managing Meetings, Verbal Communication Agency OverviewImmunization Nurse Consultant (Public Health Nurse Specialist) About Us: Our mission at the Ohio Department of Health (ODH) is advancing the health and well-being of all Ohioans. Our agency is committed to building a modern, vibrant public health system that creates the conditions where all Ohioans flourish.The goal of the Bureau of Infectious Diseases (BID) is to prevent and control the spread of infectious diseases (e.g., foodborne outbreaks, general infectious diseases, healthcare-associated infections, influenza, meningitis, tuberculosis, vaccine-preventable diseases, waterborne outbreaks, zoonotic diseases and vector-borne diseases).The bureau works closely with local health departments (LHDs), healthcare providers and laboratories to ensure that infectious disease reports are reviewed and investigated timely; the program provides technical expertise and coordination to LHDs, healthcare providers, laboratories and where appropriate, the general public.Job DescriptionWhat You'll Do:The Bureau of Infectious Diseases is seeking an Immunization Nurse Consultant to serve as the statewide expert on immunizations & vaccine-preventable diseases. This position will monitor & evaluate implementation of Get Vaccinated subgrants including review of local grant applications. Additional job duties may include:Write & assure accomplishment of CDC grant objectives related to immunization education interventions.Participate in immunization program phone duty responding to calls from providers & general public on immunizations, vaccine-preventable diseases, Vaccine for Children (VFC) issues & storage & handling guidelines.Ensure adherence to all applicable state & federal rules, regulations, laws, agency policies, procedures & protocols for immunization & vaccine preventable disease control educational program.Collaborate with other state &/or local agencies, educational institutions & advocacy organizations to develop & present coordinated educational activities, programs for health professionals & the general public.Research & identify ODH resources (e.g., ODH publications, employees with expertise on vaccine- preventable disease prevention & control) available to assist agencies in dealing with vaccine- preventable diseases.Training and development required to remain in the classification after employment: Biennial renewal of license to practice as registered nurse.Unusual working conditions: Travels overnight; exposed to unpredictable patient behavior.Normal working hours are Monday through Friday, 8:00am to 5:00pm. This is an hourly position, with a pay range of 12 on the Ohio Health Care SEIU/1199 Pay Range Schedule.Why Work for the State of OhioAt the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees*. For a list of all the State of Ohio Benefits, visit our Total Rewards website! Our benefits package includes: Medical Coverage Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period Paid time off, including vacation, personal, sick leave and 11 paid holidays per year Childbirth, Adoption, and Foster Care leave Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more) Public Retirement Systems (such as OPERS, STRS, SERS, and HPRS) & Optional Deferred Compensation (Ohio Deferred Compensation) *Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position.QualificationsCurrent & valid license to practice professional nursing as Registered Nurse (i.e., R.N.) in Ohio as issued by Board of Nursing pursuant to Section 4723.03 of Revised Code AND 6 mos. trg. or 6 mos. exp. in nursing; must be able to provide own transportation. OREquivalent of Minimum Class Qualifications for Employment noted above may be substituted for the education & experience required, but not for the mandated licensure. Job Skills: NursingTechnical Skills: Learning and Development, Public Relations, TrainingProfessional Skills: Adaptability, Managing Meetings, Verbal Communication*Applications of those who meet the minimum qualifications will be further evaluated against the following criteria:Bachelor's or advanced degree in nursing.12 months experience working as a nurse in a clinical setting, public health or community health setting.Experience working with vaccinations or in the vaccine field. Experience with computer software (e.g., Word, Excel, PowerPoint, TEAMS). Experience presenting, training, and/or public speaking.Experience in writing and implementing grants.Experience working on a committee or facilitating a group.Experience in analyzing health related data to produce reports.Experience working with healthcare providers and local health departments. Experience collecting health related data and information from studies, investigations, or reports.All eligible applications shall be reviewed considering the following criteria: qualifications, experience, education, active disciplinary record, and work record. Supplemental InformationSupplemental InformationAll answers to the supplemental questions must be supported by the work experience/education provided on your civil service application.Application Procedures:All applicants must submit a completed Ohio Civil Service Application using the TALEO System. Paper applications will not be considered. Applicants must clearly indicate how they meet the minimum qualifications and/or position specific minimum qualifications. Applicants are also encouraged to document any experience, education and/or training related to the job duties above. An assessment of these criteria may be conducted to determine the applicants who are interviewed.Status of Posted Position:You can check the status of your application online by signing into your profile. Jobs you applied for will be listed. The application status is shown to the right of the position title and application submission details.Background Check Information:The final candidate selected for this position will be required to undergo a criminal background check. Criminal convictions do not necessarily preclude an applicant from consideration for a position. An individual assessment of an applicant's prior criminal convictions will be made before excluding an applicant from consideration. ADA StatementOhio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.Drug-Free WorkplaceThe State of Ohio is a drug-free workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note, this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39), and as outlined in the posting.
    $31.7 hourly Auto-Apply 1d ago
  • Wound Nurse - Riverview

    Optalis Healthcare

    Columbus, OH

    Wound Care Nurse - LPN or RN Riverview Full-Time Flexible hours Competitive Wages. plus Attendance Bonus We offer paid holidays, generous PTO, excellent benefit package as well as employer retirement match. Be a part of the success at a leading healthcare company in Central Ohio where our employees Make a Difference with the Residents each day. We are looking for caring and compassionate nurses that are looking to join our team and help us fulfill our mission of caring for our residents. Qualifications: Current Licensed Practical Nurse or Registered Nurse License from the State of Ohio that is in good standing CPR certification 2 years in long term care and in the management of resident care preferred Previous experience with PointClickCare is a plus. Position includes every other weekend Come join our team and Make A Difference for our residents! #RVCC
    $41k-67k yearly est. 60d+ ago
  • RN Travel Nurse

    Trilogy Health Services 4.6company rating

    Columbus, OH

    JOIN TEAM TRILOGY What You will be Doing: * Create a warm, friendly environment where your residents are comfortable from admission through discharge. * You'll advocate for your residents at every stage of care, making sure that we go above and beyond for them every single day. * Develop personalized care plans for each resident based on observation and expertise. * When emergency situations happen, you'll act quickly and calmly to initiate life-saving measures. This could happen with or without a physician present, and you have the confidence to act with your residents' well-being in mind. * Handle medication for your residents and keep meticulous records of every aspect of the care you administer. Where You will be Going: * Regional Travel * Defined as travel for work assignment up to two (2) hours from home address, where license or certification is applicable. * or- * Full Travel * Defined as travel for work assignment across the Company's footprint. (IN, OH, MI, WI, AND KY) where license or certification is applicable. * Full-time, 12-hour shifts with block scheduling for overnight stays! * Mileage and meal reimbursement provided! (if applicable) * Lodging accommodations provided by the Company! (if applicable) What You Can Expect: At Trilogy, we are serious about caring for residents, and caring for one another. And we are serious about having fun while we do it. Join our close-knit community, united in service to our residents and in pursuit of a shared vision to be the best healthcare company in the Midwest. Our Registered Nurses are the staffing support system for Trilogy campuses throughout IN, OH, MI, WI and KY. Make a difference with Trilogy, a growing company that invests in their employees. Trilogy's Promise to You: As an employee of Trilogy, we promise to support you, both personally and professionally. We strive to create a work environment that's as fun as it is fulfilling, and we are proud to offer programs that will help you learn new skills and grow your career. Join our growing company that is Great Place to Work certified and recognized as Best Places to Work on Glassdoor! We would love to welcome you to the Trilogy family! POSITION OVERVIEW * Active and in good-standing RN license. * Every other weekend and holiday work availability. * At least one year's experience as a Nurse preferred. * At least 18 years of age with a valid driver's license and reliable transportation. LOCATION US-OH-Columbus Trilogy Health Services - Travel Columbus OH BENEFITS * Competitive base wages * Additional hourly pay premiums for all hours worked! * Pay premiums vary based on Regional Travel or Full Travel designation. * Quarterly Wage Increases (QWI) equivalent to 3% annually! * Eligible for additional shift differentials and weekend differentials! * Weekly Pay * Paid Time Off (PTO) * Referral Bonus Program * Multiple options to further develop your career and education. * 401(k) with company match * Student loan repayment and tuition reimbursement * Deals on Meals: receive one free meal per shift! * Health, dental, vision, and life Insurance with Health Savings (HSA) or Flexible Spending (FSA) Account * Susan's Savings home buying program * And so much more! LIFE AT TRILOGY Careers close to home and your heart. Since our founding in 1997, we've been making long-term care better for our residents and more rewarding for our team members. We're a Fortune Best Places to Work in Aging Services, a certified Great Place to Work, and one of Glassdoor's Top 100 Best Companies to Work. If you're looking for a place that embraces you for who you are, helps you achieve your full potential, and makes working hard feel less like hard work, then look no further than Trilogy. ABOUT TRILOGY HEALTH SERVICES FOR THIS TYPE OF EMPLOYMENT STATE LAW REQUIRES A CRIMINAL RECORD CHECK AS A CONDITION OF EMPLOYMENT. * Active and in good-standing RN license. * Every other weekend and holiday work availability. * At least one year's experience as a Nurse preferred. * At least 18 years of age with a valid driver's license and reliable transportation. What You will be Doing: * Create a warm, friendly environment where your residents are comfortable from admission through discharge. * You'll advocate for your residents at every stage of care, making sure that we go above and beyond for them every single day. * Develop personalized care plans for each resident based on observation and expertise. * When emergency situations happen, you'll act quickly and calmly to initiate life-saving measures. This could happen with or without a physician present, and you have the confidence to act with your residents' well-being in mind. * Handle medication for your residents and keep meticulous records of every aspect of the care you administer. Where You will be Going: * Regional Travel * Defined as travel for work assignment up to two (2) hours from home address, where license or certification is applicable. * or- * Full Travel * Defined as travel for work assignment across the Company's footprint. (IN, OH, MI, WI, AND KY) where license or certification is applicable. * Full-time, 12-hour shifts with block scheduling for overnight stays! * Mileage and meal reimbursement provided! (if applicable) * Lodging accommodations provided by the Company! (if applicable) What You Can Expect: At Trilogy, we are serious about caring for residents, and caring for one another. And we are serious about having fun while we do it. Join our close-knit community, united in service to our residents and in pursuit of a shared vision to be the best healthcare company in the Midwest. Our Registered Nurses are the staffing support system for Trilogy campuses throughout IN, OH, MI, WI and KY. Make a difference with Trilogy, a growing company that invests in their employees. Trilogy's Promise to You: As an employee of Trilogy, we promise to support you, both personally and professionally. We strive to create a work environment that's as fun as it is fulfilling, and we are proud to offer programs that will help you learn new skills and grow your career. Join our growing company that is Great Place to Work certified and recognized as Best Places to Work on Glassdoor! We would love to welcome you to the Trilogy family!
    $54k-69k yearly est. Auto-Apply 60d+ ago
  • Staff - Director Registered Nurse (RN) - Home Health - $95K-110K per year

    Core Medical-Perm

    Columbus, OH

    Staff - Director Registered Nurse (RN) - Home Health - $95K-110K per year at Core Medical-Perm summary: The Staff Director Registered Nurse (RN) for Home Health oversees patient care and manages home health nursing staff to ensure quality healthcare delivery. This permanent, full-time position in Columbus, Ohio involves leadership, coordination, and administration of nursing services in a home health setting. CoreMedical Group supports this role with recruitment, career development, and unique benefits like an all-inclusive annual retreat for healthcare professionals. Core Medical-Perm is seeking a Registered Nurse (RN) Home Health Director for a nursing job in Columbus, Ohio. Job Description & Requirements • Specialty: Home Health • Discipline: RN • Start Date: ASAP • Duration: Ongoing • 40 hours per week • Shift: 8 hours • Employment Type: Staff HOME HEALTH DIRECTOR Pay-$90,000 Shift-8 hour days We are looking for a healthcare professional who is ready to provide exceptional patient care in this permanent position. This is an excellent opportunity to expand your healthcare career and take the next step in your professional journey. CoreMedical Group is a nationally recognized leader in the medical recruitment and employment industry. Core will provide you with dedicated, personalized support from a recruiter who understands your needs and healthcare industry trends. Our services will connect you with open positions like this one nationwide. Working with a CoreMedical Group recruiter is free and confidential. You'll get access to: • Extensive healthcare industry expertise that will help you map out your career • Resume edits and formatting to make sure you put your best foot forward when applying • Interview scheduling and coaching to help you win the job • Support during difficult conversations, including help with pay negotiations • Streamlined communication and feedback from the hiring manager • Advice and support for relocation requirements CoreMedical Group also offers you the opportunity to earn a free, all-inclusive vacation each year as our way of saying "thank you" for your hard work. Join other healthcare professionals on the annual Club Coremed retreat and you'll see why candidates choose to work with us to expand their careers. Your career is too valuable to tackle on your own. Let CoreMedical Group help you with your healthcare journey! Core Medical Direct Job ID #. Posted job title: RN About Core Medical-Perm CoreMedical Group is one of the largest healthcare staffing agencies in the country. We have jobs nationwide in travel nursing, travel allied health, interim, locum tenens, and permanent placements! Join the staffing agency with Club CoreMed, the best perk in the industry - an all inclusive paid trip to a tropical resort! Keywords: Registered Nurse, Home Health, Nursing Director, Patient Care, Healthcare Management, Medical Recruitment, Healthcare Staffing, Nursing Leadership, Care Coordination, Healthcare Career Development
    $90k yearly 4d ago
  • Staff RN-Homecare Private Duty

    Nationwide Children's Hospital 4.6company rating

    Columbus, OH

    Starting pay $36.90, will be more pending experience Sign on Bonus of $3,500, half paid on first check, half after 18 months (External Applicants Only) Offering both Full time and Part Time roles Flexible schedule, we match what you can work Minimum of 1 (8) hour shift per week, with the ability to work in the following zip codes: Columbus (43205, 43228, 43231) Grove City Galloway Granville Hilliard Powell Reynoldsburg Upper Arlington Summary: Provides the direct continuous skilled nursing care of acute, chronically ill, and terminally ill patients in the home setting as prescribed by NCH and community physicians in compliance with regulatory bodies. Provides developmentally appropriate care that reflects the highest standards of nursing practice and in a manner which promotes quality, continuity, and safe patient care. Practices professional nursing and promotes patient advocacy in accordance with the ANA Code of Ethics for Nurses and maintains a current Ohio Nursing License. Job Description: Essential Functions: Provides nursing care using a Family Centered approach. Assesses individualized patient needs, communicates patient care needs, priorities, updates, and changes in condition to the assigned Home Health Nurse Supervisor or Manager and as needed, to the Staffing Specialists per the policies and guidelines. Utilizes Therapeutic Communication while monitoring the physical, psychological, and social needs of patients and families. Engages in the workplace community by staying aware of changes, participating in data collection or auditing, understanding Quality Improvement. Collaborates to develop an individualized care plan using standards, protocols, and current nursing literature and research. Implements and follows the individualized plan of care for each patient, which states the patient outcomes, goals, and means by which these goals will be achieved. Education Requirement: ADN, required. BSN required within 5 years from date of hire. Licensure Requirement: Ohio RN license, required. Certifications: CPR, required. Skills: Position specific skills assessed at orientation and annual skill days. RN I skills are contingent upon experience and basic infusion care. RN II skills are contingent upon experience and complex infusion care. Experience: One year of nursing experience, required. Physical Requirements: OCCASIONALLY: Bend/twist, Biohazard waste, Blood and/or Bodily Fluids, Chemicals/Medications, Climb stairs/ladder, Communicable Diseases and/or Pathogens, Depth perception, Driving motor vehicles (work required) *additional testing may be required, Electricity, Lifting / Carrying: 0-10 lbs, Lifting / Carrying: 11-20 lbs, Machinery, Patient Equipment, Pushing / Pulling: 0-25 lbs, Reaching above shoulder, Repetitive hand/arm use, Sitting, Squat/kneel FREQUENTLY: Audible speech, Color vision, Hearing acuity, Peripheral vision, Standing, Walking CONTINUOUSLY: Decision Making, Interpreting Data, Problem solving, Seeing - Far/near "The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"
    $36.9 hourly Auto-Apply 60d ago
  • Metro Travel Nurse Practitioner

    Milan Laser Hair Removal 3.9company rating

    Upper Arlington, OH

    Milan Laser Hair Removal is one of the nations premier laser hair removal providers. Thats because we only use top of the line lasers, and all our treatments are performed by licensed medical professionals. Additionally, we guarantee our clients results for life with our exclusive Unlimited Package. With 400+ locations throughout 38+ states and plans to expand into a national brand, this is a very exciting time to join the Milan Team! Position Summary: With our continued growth and success, we are excited to hire a full-time, Metro Traveling Nurse Practitioner to join our dynamic treatment team. Our company is medically-based, so as the Metro Traveling Nurse Practitioner, you will provide exceptional patient care to clients, helping them achieve their desired aesthetic results. Deliver laser hair removal treatments according to established medical protocols. Travel to various clinics within a designated geography and reasonable distance to provide necessary coverage and operational support. Status: Full-time, Exempt Travel Requirements: Ability to travel up to a 60 mile radius of the assigned metro area and requires flexibility for travel. Based out of: Columbus (Upper Arlington), OH; Candidates must live within close proximity to a Milan Laser clinic. Travel Requirements: * Ability to travel up to a 60-mile radius of the assigned metro area * Flexibility for business needs which may require same day assignments Some things our Metro Traveling NPs love about working at Milan: * No Overnights - sleep in the comfort of your own home * No Weekend coverage required * Mileage Reimbursement - IRS Mileage Rate * Monthly Cell Phone Reimbursement * Closed on 7 Major Holidays * Free Laser Hair Removal for you and a spouse * 2 weeks Paid Training * Certified on Milan's state of the art Laser Responsibilities: * Provide laser hair removal treatments: Perform all laser hair removal treatments within established medical treatment protocols. Educate patients on laser hair removal pre/post treatment care recommendations. Record clear and accurate medical documentation in patient charts. Handle client information privately and respectfully in compliance with HIPAA. Ensure a professional, clean work environment to include prepping the treatment room in between clients. Provide world class customer service to clients. * Drive Sales: Encourage clients to complete online reviews. Engage with clients to discuss laser hair removal results and suggest additional areas to get treated, per the Milan Upsell Best Practices. * Operational Duties: Clean and perform minor maintenance on the laser to ensure proper functionality. Schedule and confirm appointments, communicate with clients and maintain and update client records, field incoming calls, and support medical staff with treatment room upkeep, perform opening and closing duties and process client financial transactions. * Travel & Coverage Support: Demonstrate flexibility and dependability with regard to travel, which may be required with as little as 24 hours notice. Provide coverage as directed by Regional Sales Managers to ensure continuity of care and operational support across clinic locations. * Other Duties: Performs additional tasks, duties, and responsibilities as needed or assigned by leadership to support departmental and organizational objectives Requirements: * Current applicable Nurse Practitioner (NP) license in good standing, along with active national certification as a Certified Family Nurse Practitioner (FNP-C or FNP-BC) is required * Possess phenomenal customer service skills and a passion for providing excellent patient care required * Exhibit exceptional communication skills, both verbal and written required * Ability to maintain highly confidential information required * Ability to display a passion for the aesthetics industry required * A valid drivers license required Benefits Include: * Medical, dental, vision, disability, and life insurance within 30 days * 401k retirement plan with vested employer match * Paid time off starting immediately * Employee and spouse or legal partner receive free laser hair removal services * Professional liability insurance provided * CEU reimbursement * Annual allowance for scrubs * Career advancement opportunities To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other duties may be assigned. We are deeply committed to attracting talented team members in the US from all backgrounds regardless of race, age, gender, ethnicity, religion, sexual orientation, disability status, or nationality. However, at this time, we are not sponsoring any Visas. Equal Opportunity Employer
    $14k-43k yearly est. 7d ago
  • Travel Nurse - Surgical ICU Stepdown in Washington Court House, Ohio - $8933/month

    Vetted Health

    Washington Court House, OH

    Travel Nurse - Surgical ICU Stepdown in Washington Court House, Ohio - $8933/month at Vetted Health summary: This position is a temporary Travel Nurse role specializing in Surgical ICU Stepdown care in Washington Court House, Ohio, offering a 13-week contract with competitive monthly compensation. The nurse will coordinate patient care, provide leadership within the clinical team, and maintain professional nursing standards for adult-geriatric patients. Candidates must have at least 2 years of relevant experience, an Ohio RN license, BLS certification, and reliable transportation for travel assignments. Job Opportunity: RN - Surgical ICU Stepdown Position Details Specialty: RN - Surgical ICU Stepdown Location: Washington Court House, Ohio Facility: AHS Staffing Employment Type: Temporary Contract Length: 13 weeks Job Description Coordinates total nursing care for patients. Participates in patient and family teaching. Provides leadership by working cooperatively with ancillary nursing and other patient team personnel. Maintains standards for professional nursing practice in the clinical setting. Patient Population: Adult-Geriatric Requirements Experience: 2+ years of RN - Surgical ICU Stepdown experience required. Travel healthcare experience preferred. Strong clinical skills and patient care abilities. Licensing: Ohio state license required. Current BLS certification required. Additional certifications may be required based on specialty. Transportation: Candidate must have reliable transportation for travel assignments. Additional Information Scheduling: Work 40 hours per week with 8-hour shifts. Contract start date: November 03, 2025. Competitive monthly compensation: $8933. Benefits: Travel and housing provided. Health insurance and 401(k) matching. Professional development opportunities. Flexible scheduling options. Compliance: All medical/occupational health compliance items must be completed within 5 days of offer acceptance. Background check and drug screening required. Apply now to join our team of travel healthcare professionals! Keywords: Travel Nurse, Surgical ICU, Stepdown Unit, Registered Nurse, RN, Patient Care, Temporary Nursing Job, Adult-Geriatric Care, BLS Certification, Ohio Nurse License
    $8.9k monthly 4d ago
  • University Nurse

    Wilberforce University 4.1company rating

    Wilberforce, OH

    Return to Careers Division/Department Student Engagement Reports to Vice President for Student Engagement Type Full-time Wilberforce University is seeking a compassionate and skilled Nurse to join our Health Center team. As the nation's oldest private historically Black university, Wilberforce University offers a unique opportunity to make a meaningful impact in a vibrant academic community. Join us in shaping a healthier future for our students. This role is essential in supporting the health and well-being of our diverse student population. The Nurse will provide direct care, health education, and support campus-wide wellness initiatives. Essential Duties & Responsibilities * Provide treatment for minor injuries and illnesses. * Triage student health concerns and refer to appropriate medical or counseling services. * Support students managing chronic health conditions. * Develop and maintain health crisis management policies and train staff accordingly. * Serve as a liaison/health advisor among students, parents, and others connected to the student. * Review and follow up on student health history forms. * Maintain accurate and confidential health records. * Manage clinical supply inventory and ordering in compliance with nursing/medical guidelines. * Ensure compliance with HIPAA, FERPA, and all relevant regulations. * Contribute to the curriculum planning and development of healthy programs to promote positive health within the campus community. Required Knowledge, Skills and Abilities * Requires strong organizational skills and the ability to manage multiple priorities under pressure. * Collaborate with allied professionals and other individuals and/or groups such as: students and their parents, caregivers and advocates, university staff, other professionals working with the students, and Community Services including Clinical Commissioning Groups. Minimum Qualifications Education: Completion of an accredited Nursing program. Licensure: Current Nursing certification in good standing with the Ohio Board of Nursing (or equivalent). Experience: Prior experience in a clinical or college health setting preferred. Wilberforce University Founded in 1856, Wilberforce University is America's first private, coeducational University established to educated men and women of African descent; and is closely affiliated with the African Methodist Episcopal Church. Today, Wilberforce is a well-respected private, residential liberal arts university with a clear mission, core values and vision for the future and is a noted pioneer in the Co-Operative Education Movement. Wilberforce awards the Bachelor of Arts and Bachelor of Science degrees in the areas of business, engineering and computing science, humanities, natural sciences, and social sciences; as well as the Master of Rehabilitation Counseling degree. The University is located in Wilberforce, Ohio, a community readily accessible to the Dayton, Cincinnati and Columbus metropolitan centers' social, professional and cultural amenities and airports. Wilberforce University is an Equal Opportunity Employer How to Apply: To apply for the University Nurse position, use the "Quick Apply/Submit Resume" button below to submit your information, cover letter and resume to the Wilberforce University Department of Administration and Human Resources.
    $52k-62k yearly est. 2d ago
  • Staff RN - Surgical Unit 1, nights, Doctors

    Ohiohealth 4.3company rating

    Columbus, OH

    We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more - in our careers and in our communities. Summary: This position is full time, night shift. Provides general nursing care to patients and families throughout the continuum of care in diverse, acute health care settings. (Department has scheduled staff to operate 24/7/365). The RN accountable for the practice of nursing as defined by the Ohio Board of Nursing. The RN delegates nursing tasks to licensed practical nurses (LPNs) and unlicensed assistive personnel (UAPs) using the criteria written in the Ohio Nurse Practice Act. According to department policies and nursing care standards, provides professional nursing care services to patients. Responsible for assessing, planning, implementing, and evaluating nursing care provided to assigned patients. Responsibilities And Duties: Assessment/Diagnosis - Performs initial, ongoing, and functional health status assessment as applicable to the population and or individual (30%). Outcomes Identification/Planning - Based on nursing diagnoses and collaborative problems, documents planned nursing interventions to achieve outcomes appropriate to patient needs (30%). Implementation/Evaluation - Evaluates and documents response to nursing interventions and achievement of outcomes at appropriately determined intervals; as part of a multidisciplinary team, revises plan of care based on evaluative data (20%). Leadership - Actively participates in process improvement activities to achieve targeted measures of clinical quality, customer satisfaction, and financial performance (10%). Operations (10%). As a High Reliability Organization (HRO), responsibilities require focus on safety, quality and efficiency in performing job duties. The job profile provides an overview of responsibilities and duties and is not intended to be an exhaustive list and is subject to change at any time. Minimum Qualifications: BLS - Basic Life Support - American Heart Association, RN - Registered Nurse - Ohio Board of Nursing Additional Job Description: MINIMUM QUALIFICATIONS Current Registered Nurse license from the State of Ohio and/or current Registered Nurse license in good standing with a multi-state compact state. BLS certification BSN required at 5 years of employment Work Shift: Night Scheduled Weekly Hours : 36 Department Surgical Unit 1 Join us! ... if your passion is to work in a caring environment ... if you believe that learning is a life-long process ... if you strive for excellence and want to be among the best in the healthcare industry Equal Employment Opportunity OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment
    $46k-75k yearly est. 5h ago
  • Utilization Management Appeals Nurse

    Humana 4.8company rating

    Columbus, OH

    **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Humana is seeking a Part C Grievance & Appeals (G&A) Nurse who will assist in preparation of cases prior to review by the Humana G&A Medicare Medical Directors. The Nurse reviews the medical documentation, researching claims, benefits, as well as prior determinations pertinent to the appeal and provides a written summary of findings using a template for each case. The associate will be working and collaborating with Humana CIT teams, Vendors, G&A specialists, and Humana Medical Directors on submitted G&A cases. The G&A Nurse will participate in initiatives which result in improved member outcomes, operational efficiencies, and process improvement opportunities. + Case preparation of Medicare and/or Duals line of businessinvolving expedited, pre-service and post serviceappeals + Apply and implement Medicare, Medicaid,MCG, claims policy and evidence of coverage guidelines for reviews + Perform outreach to providers and/or members + Utilize multiple systems such as MHK, CGX, MRM, SRO **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action + 3 or more years of clinical experience preferably in an acute care, skilled or rehabilitation clinical setting or broad clinical nursing experience + Comprehensive knowledge of Microsoft Word, Outlook and Excel + Strong organizational and effective time management skills + Ability to work independently under general instructions and with a team **Preferred Qualifications** + Bachelor's degree (BSN) + Appeal Review Experience + Knowledge of MHK + Previous Medicare/Medicaid Experience + Previous experience in utilization management + Previous claims experience **Work-At-Home Requirements** To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested + Satellite, cellular and microwave connection can be used only if approved by leadership + Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense + Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information **Additional Information** + Hours are Monday-Friday 9am-6pm EST with a weekend rotation (Your 8-hour shift will fall within this timeframe) + Candidate's must also commit to working on the holidays as needed + This is a remote position, but all candidates must work in the Eastern Standard Time Zone (EST) Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-21-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************
    $71.1k-97.8k yearly 3d ago
  • Immunization Nurse Consultant - 20013627

    Dasstateoh

    Columbus, OH

    Immunization Nurse Consultant - 20013627 (250007Y4) Organization: HealthAgency Contact Name and Information: Ryan F. Candidates chosen for an interview will be contacted directly.Unposting Date: OngoingWork Location: Health Department Building 246 North High Street 1st Floor Columbus 43215Primary Location: United States of America-OHIO-Franklin County-Columbus Compensation: $31.74Schedule: Full-time Work Hours: M-F, 8a-5pClassified Indicator: ClassifiedUnion: 1199 Primary Job Skill: NursingTechnical Skills: Learning and Development, Public Relations, TrainingProfessional Skills: Adaptability, Managing Meetings, Verbal Communication Agency OverviewImmunization Nurse Consultant (Public Health Nurse Specialist) About Us: Our mission at the Ohio Department of Health (ODH) is advancing the health and well-being of all Ohioans. Our agency is committed to building a modern, vibrant public health system that creates the conditions where all Ohioans flourish.The goal of the Bureau of Infectious Diseases (BID) is to prevent and control the spread of infectious diseases (e.g., foodborne outbreaks, general infectious diseases, healthcare-associated infections, influenza, meningitis, tuberculosis, vaccine-preventable diseases, waterborne outbreaks, zoonotic diseases and vector-borne diseases).The bureau works closely with local health departments (LHDs), healthcare providers and laboratories to ensure that infectious disease reports are reviewed and investigated timely; the program provides technical expertise and coordination to LHDs, healthcare providers, laboratories and where appropriate, the general public.Job DescriptionWhat You'll Do:The Bureau of Infectious Diseases is seeking an Immunization Nurse Consultant to serve as the statewide expert on immunizations & vaccine-preventable diseases. This position will monitor & evaluate implementation of Get Vaccinated subgrants including review of local grant applications. Additional job duties may include:Write & assure accomplishment of CDC grant objectives related to immunization education interventions.Participate in immunization program phone duty responding to calls from providers & general public on immunizations, vaccine-preventable diseases, Vaccine for Children (VFC) issues & storage & handling guidelines.Ensure adherence to all applicable state & federal rules, regulations, laws, agency policies, procedures & protocols for immunization & vaccine preventable disease control educational program.Collaborate with other state &/or local agencies, educational institutions & advocacy organizations to develop & present coordinated educational activities, programs for health professionals & the general public.Research & identify ODH resources (e.g., ODH publications, employees with expertise on vaccine- preventable disease prevention & control) available to assist agencies in dealing with vaccine- preventable diseases.Training and development required to remain in the classification after employment: Biennial renewal of license to practice as registered nurse.Unusual working conditions: Travels overnight; exposed to unpredictable patient behavior.Normal working hours are Monday through Friday, 8:00am to 5:00pm. This is an hourly position, with a pay range of 12 on the Ohio Health Care SEIU/1199 Pay Range Schedule.Why Work for the State of OhioAt the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees*. For a list of all the State of Ohio Benefits, visit our Total Rewards website! Our benefits package includes: Medical Coverage Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period Paid time off, including vacation, personal, sick leave and 11 paid holidays per year Childbirth, Adoption, and Foster Care leave Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more) Public Retirement Systems (such as OPERS, STRS, SERS, and HPRS) & Optional Deferred Compensation (Ohio Deferred Compensation) *Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position.QualificationsCurrent & valid license to practice professional nursing as Registered Nurse (i.e., R.N.) in Ohio as issued by Board of Nursing pursuant to Section 4723.03 of Revised Code AND 6 mos. trg. or 6 mos. exp. in nursing; must be able to provide own transportation. OREquivalent of Minimum Class Qualifications for Employment noted above may be substituted for the education & experience required, but not for the mandated licensure. Job Skills: NursingTechnical Skills: Learning and Development, Public Relations, TrainingProfessional Skills: Adaptability, Managing Meetings, Verbal Communication*Applications of those who meet the minimum qualifications will be further evaluated against the following criteria:Bachelor's or advanced degree in nursing.12 months experience working as a nurse in a clinical setting, public health or community health setting.Experience working with vaccinations or in the vaccine field. Experience with computer software (e.g., Word, Excel, PowerPoint, TEAMS). Experience presenting, training, and/or public speaking.Experience in writing and implementing grants.Experience working on a committee or facilitating a group.Experience in analyzing health related data to produce reports.Experience working with healthcare providers and local health departments. Experience collecting health related data and information from studies, investigations, or reports.All eligible applications shall be reviewed considering the following criteria: qualifications, experience, education, active disciplinary record, and work record. Supplemental InformationSupplemental InformationAll answers to the supplemental questions must be supported by the work experience/education provided on your civil service application.Application Procedures:All applicants must submit a completed Ohio Civil Service Application using the TALEO System. Paper applications will not be considered. Applicants must clearly indicate how they meet the minimum qualifications and/or position specific minimum qualifications. Applicants are also encouraged to document any experience, education and/or training related to the job duties above. An assessment of these criteria may be conducted to determine the applicants who are interviewed.Status of Posted Position:You can check the status of your application online by signing into your profile. Jobs you applied for will be listed. The application status is shown to the right of the position title and application submission details.Background Check Information:The final candidate selected for this position will be required to undergo a criminal background check. Criminal convictions do not necessarily preclude an applicant from consideration for a position. An individual assessment of an applicant's prior criminal convictions will be made before excluding an applicant from consideration. ADA StatementOhio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.Drug-Free WorkplaceThe State of Ohio is a drug-free workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note, this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39), and as outlined in the posting.
    $31.7 hourly Auto-Apply 17h ago
  • Field Nurse Case Manager

    Unitedhealth Group 4.6company rating

    Grove City, OH

    Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere. As a team member of our Optum At Home product, together with an interdisciplinary care team we help patients navigate the health care system, and connect them to key support services. This preventive care can help patients stay well at home. We're connecting care to create a seamless health journey for patients across care settings. Join us to start **Caring. Connecting. Growing together.** Registered Nurses in the Optum at Home program work with patients primarily in their home setting. They perform as part of a care team including a Nurse Practitioner, Behavioral Health Advocate, Care Navigator and other supporting team members. They deliver role appropriate patient care through in-home visits, telephonic outreach and consultations, and interdisciplinary team activities. The Field Case Manager RN may perform care and counsel of the ill, injured, or infirm, in the promotion and maintenance of health with individuals, groups, or both throughout the life span. They help to manage health problems and coordinate health care for the Optum at Home patients in accordance with State and Federal rules and regulations and the nursing standards of care. This includes (but is not limited to) assessment of health status, development and implementation of plan of care, and ongoing evaluation of patient status and response to the plan of care. Clinical management is conducted in collaboration with other care team members. **Primary Responsibilities:** + Reports to RN Manager + Assess the health status of members as within the scope of licensure and with the frequency established in the model of care + Establish goals to meet identified health care needs + Plan, implement and evaluate responses to the plan of care + Work collaboratively the multidisciplinary team to engage resources and strategies to address medical, functional, and social barriers to care + Works closely with mental health clinicians to help bridge the gap between mental and physical health + Consult with the patient's PCP, specialists, or other health care professionals as appropriate + Assess patient needs for community resources and make appropriate referrals for service + Facilitate the patient's transition within and between health care settings in collaboration with the primary care physician and other treating physicians + Completely and accurately document in patient's electronic medical record + Provide patients and family members with counseling and education regarding health maintenance, disease prevention, condition trajectory and need for follow up as appropriate during each patient visit + Verify and document patient and/or family understanding of condition, plan of care and follow up recommendations + Actively participate in organizational quality initiatives + Participate in collaborative multidisciplinary team meetings to optimize clinical integration, efficiency, and effectiveness of care delivery + Maintain credentials essential for practice, to include licensure, certification (if applicable) and CEUs + Demonstrate a commitment to the mission, core values and goals of UnitedHealthcare and its healthcare delivery including the ability to integrate values of compassion, integrity, performance, innovation and relationships in the care provided to our member You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Years of post-high school education can be substituted/is equivalent to years of experience. **Required Qualifications:** + Current unrestricted licensure as RN in Ohio + 2+ years of relevant experience + Experience in assessing the medical needs of patients with complex behavioral, social and/or functional needs + Demonstrated ability to work with diverse care teams in a variety of settings including non-clinical settings (primarily patient homes) + Proven solid computer skills, including use of electronic medical records + Ability to travel 100% of the time for field-based work within 60 miles of residence + Valid driver's license + Access to reliable transportation that will enable you to travel to client and/or patient sites within a designated area **Preferred Qualification:** + Field based experience + Case management experience + Proven effective time management and communication skills Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $58,800 to $105,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. _OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
    $58.8k-105k yearly 42d ago

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