Utilization review nurse jobs in Massachusetts - 585 jobs

Site: Mass General Brigham Health Plan Holding Company, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Job Summary The Medicare UM Case Manager, RN performs utilization management activities primarily for Medicare Advantage, including review of authorizations for home care, high tech radiology, outpatient, inpatient, and post-acute services. The Medicare UMCM reviews the medical necessity of authorization requests using NCD, LCD, Medicare Benefit Policy Manual, medical policies, and InterQual criteria. Qualifications Education Associate's Degree Nursing required; Bachelor's Degree Nursing preferred Licenses and Credentials Massachusetts Registered Nurse license required Basic Life Support [BLS Certification] Certification preferred Experience At least 2-3 years of utilization management strongly preferred Experience applying National Coverage Determinations (NCD), Local Coverage Determinations (LCD), and Medicare Benefit Policy Manual preferred InterQual experience preferred Knowledge, Skills, and Abilities Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times. Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems. Ability to establish strong rapport and relationships with patients and staff. Proficient in Microsoft Office and industry-related software programs. Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions. Ability to maintain client and staff confidentiality. Understanding of diagnostic criteria for dual conditions and the ability to conceptualize modalities and placement criteria within the continuum of care. Knowledge of Healthcare and Managed Care preferred. Additional Job Details (if applicable) Working Conditions This is a remote role that can be done from most US states Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $58,656.00 - $142,448.80/Annual Grade 98TEMP At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package. EEO Statement: Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

Site: Mass General Brigham Health Plan Holding Company, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Job Summary The Medicare UM Case Manager, RN performs utilization management activities primarily for Medicare Advantage, including review of authorizations for home care, high tech radiology, outpatient, inpatient, and post-acute services. The Medicare UMCM reviews the medical necessity of authorization requests using NCD, LCD, Medicare Benefit Policy Manual, medical policies, and InterQual criteria. Qualifications Education * Associate's Degree Nursing required; Bachelor's Degree Nursing preferred Licenses and Credentials * Massachusetts Registered Nurse license required * Basic Life Support [BLS Certification] Certification preferred Experience * At least 2-3 years of utilization management strongly preferred * Experience applying National Coverage Determinations (NCD), Local Coverage Determinations (LCD), and Medicare Benefit Policy Manual preferred * InterQual experience preferred Knowledge, Skills, and Abilities * Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times. * Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems. * Ability to establish strong rapport and relationships with patients and staff. * Proficient in Microsoft Office and industry-related software programs. * Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions. * Ability to maintain client and staff confidentiality. * Understanding of diagnostic criteria for dual conditions and the ability to conceptualize modalities and placement criteria within the continuum of care. * Knowledge of Healthcare and Managed Care preferred. Additional Job Details (if applicable) Working Conditions * This is a remote role that can be done from most US states Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $58,656.00 - $142,448.80/Annual Grade 98TEMP At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package. EEO Statement: Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

Benefits: Direct Deposit Weekly Pay Competitive salary Inpatient RN - Utilization Review Nurse (Behavioral Health) - Cambridge, MA Schedule: Day Shift, Monday-Friday, 8:30 AM - 5:00 PM Pay: $72/hour Job Summary: We are seeking a skilled Inpatient RN Utilization Review Nurse to join our behavioral health team in Cambridge. This role focuses on acute care review and utilization management to ensure high-quality patient care. Requirements: Must be a local candidate within 50 miles of Cambridge, MA Acute care experience required Experience with InterQual criteria EMR experience required (EPIC preferred) Strong clinical judgment and utilization review skills Responsibilities: Review and evaluate patient care for appropriateness and efficiency Collaborate with interdisciplinary teams to support patient care and discharge planning Ensure compliance with hospital policies and clinical guidelines Apply now to join a team dedicated to delivering exceptional behavioral health care. Compensation: $72.00 per hour Great jobs. Great company. Great community of caregivers. At Aura Staffing Partners, we know that partnering with you to find the right opportunity in healthcare is just the beginning. We don't leave you high and dry, instead we help you grow even brighter with quarterly reviews, continued training and plenty of communication.

The Registered Nurse (RN) will utilize the nursing process of assessment, planning, implementation, and evaluation to ensure quality-nursing care and to maximize the quality of life for the residents and patients. The RN is an integral member of the clinical support team, and collaborates with other multidisciplinary members to meet the clinical needs of the residents. The RN is an active supporter of the culture change initiatives, and serves as a role model and mentor to others. In addition, the RN will demonstrate a strong commitment to the philosophy and mission of Orchard Cove and recognize resident's dignity and choice in all aspects of daily life. They are an active participant in the activities, work, and social environment of the households, and strive to make every resident encounter into a positive and meaningful experience and opportunity, while ensuring the provision of safe and efficient quality care. Core Competencies: Demonstrates empathy and compassion with all interactions with residents and with families Articulates importance of supporting independence and resident choice when caring for residents Demonstrates strong communication skills and ability to foster teamwork Articulates commitment to excellence and high quality care Articulates the importance of accountability and personal ownership related to teamwork and resident care Demonstrates strong critical thinking skills Demonstrates ability to coach and mentor others to achieve high quality care Position Responsibilities: Ensures all care delivered is within the scope and established standards of safe professional nursing practice and HSL core competencies Collaborates with other members of the clinical support team (MD, NP, nurses, social worker, therapists, dietician) to meet the clinical needs of the resident and monitor outcomes of care Adheres to best practice recommendations and implements evidence based interventions to ensure optimum outcomes for residents Practices in a primary nursing model and maintains accountability for a set of assigned residents/patients Collaborates and participates in care planning activities and supports autonomy and individual choice wherever possible Ensures adherence to the plan of care, revises as necessary, and ensures the plan accurately reflects an individualized approach to resident's needs Documents appropriately in the electronic medical record Identifies and seeks out necessary resources as needed to ensure the provision of safe and effective care Delegates and supervises clinical care delivered by the licensed practical nurse and the nursing assistant Assumes accountability for his/her own learning needs and professional development Demonstrates critical thinking abilities in problem resolution Role models professional behavior Actively participates in shared governance, committees, etc Collaborates in the development of new work processes and systems Serves as a resource and support to the elder assistants in the households Identifies and responds to safety concerns on the household and neighborhood Maintains compliance with policies, procedures, practice and regulatory matters Participates in the collection and monitoring of quality data to ensure high standards of care Participates in performance improvement projects Participate and assists with activities (i.e. assist with serving meals) Serves as a coach and mentor to all staff, i.e. Nursing/Resident assistants and LPNs May be assigned charge nurse responsibilities. Responsibilities may include: Giving shift report to on coming staff Provide clinical/supervisory oversight to assigned unit during shift Delegate assignments to team assigned to shift Initiate necessary reports including DPH, incident reports, concern resolutions Assure completion of admission or discharges during shift Attend rounds (wound, physician etc) Provides oversight of LPN assessments (as assigned) and co-signs nursing assessments and initial care plans The above covers the most significant responsibilities of the position. It does not, however, exclude other duties, which would be in conformity with the level of the position. Completes special projects as assigned Qualifications: Graduate of approved school of nursing required; BSN preferred Current Massachusetts license as an R.N. in good standing Previous experience preferred Understand the philosophy and support the model of care at HRC required Must be professional, proactive, collaborative, conscientious and results-oriented individual. Must have an optimistic and positive demeanor, excellent oral and written communication skills, good intuition and able to adapt to changing priorities and display good, sound judgment with a sense of humor Superb organizational skills. Must have solid analytical skills. Must be creative and proactive yet disciplined, discriminating and able to streamline work volume in order to maintain bottom line efforts in midst of multi-tasking and daily re-prioritizing. Must have ability to innovate, think strategically and conceptually, manage multiple projects simultaneously and handle even difficult situations Must be motivated to learn and flexible to change Computer literacy required Excellent English language skills, written and verbal Pass Med test with 80% or greater Working Conditions and Physical Demands: Contact with residents under a wide variety of circumstances, which may include exposure to unpleasant odors, sights, and sounds Push occupied wheel chairs on flat surfaces, and up/down ramp up to 50 lbs Gloves and masks worn occasionally Standing, walking, and sitting Lifting supplies and equipment up to 50 lbs Some reaching, stooping, squatting, bending, kneeling and crouching Remote Type Salary Range: $32.13 - $48.20

Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Schedule: 9:30am-6:00pm local time, with rotating weekends. New Grads are encouraged to apply! The Nurse Reviewer I will be responsible for conducting preauthorization, out of network and appropriateness of treatment reviews for diagnostic imaging services by utilizing appropriate policies, clinical and department guidelines. * Collaborates with healthcare providers, and members to promote the most appropriate, highest quality and effective use of diagnostic imaging to ensure quality member outcomes, and to optimize member benefits. * Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. * Partners with more senior colleagues to complete non-routine reviews. * Through work experience and mentoring learns to conduct medical necessity clinical screenings of preauthorization request to assess assessing the medical necessity of diagnostic imaging procedures, out of network services, and appropriateness of treatment. How you will make an impact: * Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review. * Conducts initial medical necessity review of exception preauthorization requests for services requested outside of the client health plan network. * Notifies ordering physician or rendering service provider office of the preauthorization determination decision. * Follows-up to obtain additional clinical information. * Ensures proper documentation, provider communication, and telephone service per department standards and performance metrics. Minimum Requirements: * AS in nursing and minimum of 3 years of clinical nursing experience in an ambulatory or hospital setting or minimum of 1 year of prior utilization management, medical management and/or quality management, and/or call center experience; or any combination of education and experience, which would provide an equivalent background. * Current unrestricted RN license in applicable state(s) required. Preferred Skills, Capabilities, and Experiences: * Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed health care including HMO, PO and POS plans strongly preferred. * BA/BS degree preferred. * Previous utilization and/or quality management and/or call center experience preferred. * Knowledge in Microsoft office. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $33.12/hr - $56.77/hr Locations: New York, New Jersey, Washington, Nevada, Maryland, Massachusetts, Illinois, District of Columbia In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Job Level: Non-Management Non-Exempt Workshift: Job Family: MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

With the belief that they were there when we needed them, so we must be there now that they need us , Veterans Inc., the largest provider of supportive services to Veterans and their families in New England, is seeking to fill the Inpatient Behavioral Health Admission Review Nurse position and become a valued member of the Veterans Inc. team! WHAT YOU'LL BE DOING DAY TO DAY: Patient Assessment: Conducting initial, comprehensive assessments of patients to determine their need for inpatient care. Information Gathering: Collecting and reviewing medical histories, current medications, existing treatment plans, and diagnostic information from patients, families, and referring providers. Eligibility & Compliance: Reviewing information to ensure patients meet specific eligibility criteria for program admission that include reviewing the organization's requirements, insurance providers, and state regulations. Documentation & Coordination: Completing all required documentation and collaborating with the multidisciplinary treatment team to coordinate care and develop initial treatment plans. Crisis Intervention: Utilizing knowledge of crisis management and behavioral health protocols to manage patients in acute distress during the admissions process. Referral Management: Processing referrals from doctors, emergency departments, or other agencies and, if the patient is not a candidate for the facility, coordinating alternative referrals. WHAT YOU MUST HAVE: Minimum Associate's degree from an accredited school of Nursing required. Bachelor's degree in Nursing is highly valued. Must have a current and valid Massachusetts licensure as a Registered Nurse Current certification in CPR Minimum of one year of nursing experience preferred. Experience providing nursing care in a substance abuse treatment setting is highly valued. Time Management skills and the ability to answer medical questions before referral reaches Admissions staff Must be able to successfully pass a CORI/Background records check. Compliance with Veterans Inc. COVID-19 Vaccination Policy. Religious and Medical Exemptions are considered. For more information, or to apply now; visit our website. Please do not mail, email, or fax your cover letter/resume as we are limited to only accepting completed applications through our career page. Mailed, emailed, or faxed cover letter, resume, and applications will not be reviewed. Veterans Inc. is proud to be an equal opportunity employer. We are committed to equal employment opportunity regardless of race, color, religion, sex, national origin, sexual orientation, age, marital status, disability, gender identity or protected Veteran status. If you need assistance completing an application please contact ************************ . We do not accept unsolicited resumes from agencies. Agencies are requested not to contact Veterans Inc. with recruiting inquiries.

Why Join South Shore Medical Center? •NEW NURSING RATES! If you're interested in learning more about our new rates and the position, we currently have available, we encourage you to apply today. •Opportunity for competitive shift differentials. •Newly enhanced triaging and improved workflow processes designed to support our staff and patient experience. •Flexible schedule Monday-Friday with no weekend requirements. •Opportunities to explore or support different outpatient services across South Shore Medical Center. •The opportunity to enroll in benefits 1st day of hire with no waiting period. Job Description Learn more about South Shore Medical Center : Meet Shiv Sehra, MD Rheumatology, VP for South Shore Medical Center and Ambulatory Services Manages individualized, outcome oriented nursing care through the use of the nursing process. Provides care, treatment and services through the successful coordination and completion of a series of processes that include assessment, planning care, providing care, coordinating cross continuum care and assessing outcomes of interventions in accordance with system, departmental and ambulatory policies and procedures. This role provides clinically-based, risk reducing care and coordination that facilitates the delivery of cost-effective quality healthcare along the continuum. It directly interfaces with physicians, care managers, health care teams, patients and their caregivers to achieve desired patient outcomes. Excellent communication skills, both written and verbal, a commitment to coaching patients on health promoting behaviors, and an ability to listen and assimilate complex clinical information are required in the role. The ability to work autonomously and in teams is essential. Participation in quality improvement efforts, research and evaluation processes related to the management of patient care is integral to the role. ESSENTIAL FUNCTIONS 1 - Medication Administration a - *Demonstrates knowledge of and follows SSH policies and procedures for administering and documenting medications. b - *Completes medication reconciliation process following SSH policy and procedure. c - *Demonstrates safe procedures for the safe administration of medication and vaccines. 2 - Plan of care/Documentation/Patient Family Centered Care/Patient Experience Develops, discusses, and communicates a prioritized problem and plan of care for each patient. a - Develops, evaluates and updates individualized plan for patient and documents outcomes. b - Initiates patient outreach, identifies and documents patient/family/significant other needs and makes appropriate interventions, evaluating outcomes of interventions. c - Continues assessment/reassessment and identifies care needs within established nursing practice. d - Documents all patient care following the department of nursing policy, department-based standards, disease processes (CHF, PNA vaccines) and nurse sensitive indicators (falls, safety risk, isolation, etc.) e - Assess/reassesses and documents patient's response to each intervention both pharmacological and non-pharmacological per South Shore Health and ambulatory policies and procedures. f - Works on behalf of patient /family. Seeks help to represent patient/family when they are unable to represent themselves. g - Raises ethical questions and concerns with clinical team. Seeks available resources to help formulate and understand ethical decisions. h - Actively communicates and collaborates with health team members: primary care, specialty care, and ancillary providers and departments. i - Facilitates care across the continuum to insure patient needs are met in the right setting and at the right time. 3 - Safety/Quality - Foster's a "Culture of Safety" through personal ownership and commitment to a safe environment. a - Verifies patient identification with two identifiers prior to the start of any procedure, including "time out", administration of care, medications, labeled specimen's and documents confirming the correct patient, procedure, site, equipment and consent. b - *Complies with the current CDC hand hygiene guidelines through proper handwashing. Adheres to universal precautions, makes appropriate use of personal protective equipment at all times and appropriately disposes of hazardous materials. Maintains awareness of MSDS sheets and how to access. c - Ensures environment meets regulatory requirements at all times. d - Understands and is able to demonstrate individual roles and responsibilities in the event of ambulatory codes/emergency preparedness. 4 - Professional Development: Assumes overall responsibility for own professional development by incorporating evidenced-based practice, research, and performance improvement initiatives as a part of ongoing nursing practice. a - Obtains at least 5 contact hours per year in area of practice. b - Practices within the legal boundaries of MA Nurse Practice Act. Directs other licenses and non-licensed personnel as assigned. c - Displays the ability to accept and respond appropriately to feedback and recommendations for change. d - Demonstrates professional working relationships with colleagues from all disciplines to promote a positive/encouraging workplace. e - Critical Thinking: analyzes causes of problems, identifies and evaluates alternative solutions, and selects appropriate solution, and communicates appropriately and effectively utilizing chain of command. f - Accountable for being informed about changes in policy and procedure. 5 - Technology: Utilizes technological solutions to work processes and practices. a - Accesses Outlook, Epic, HealthStream and Workday to review email, learning management and other resources as applicable to RN role. b - Utilizes software applications required by health system, nursing and department standards. c - Accountable to understand how to operate in downtime. 6 - Compliance a - Works within legal, regulatory and ethical standards relevant to the position. b - Complies with applicable policies and procedures. c - Safeguards the privacy and security of patient information. The employee compiles will policies and procedures relating to SSH's privacy and security programs. d - Brings potential compliance issues through chain of command. e - Complies with the mandatory education requirements of the compliance, privacy and security programs. 7 - Patient and Family Centered Care a - Conveys respect for values, preferences, and expressed needs of the patient and family. b - Recognizes the patient and family according to patient preferences, as important members of the health care team. c - Collaborates with the patient and family according to patient preferences, in planning, implementing, and evaluating care. d - Welcomes the presence and participation of family members at all times according to patient preferences. 8 - Age & Culture a - Possesses and practices age and cultural knowledge and awareness. b - Considers the individual needs of each person with whom they interact. c - Interacts with sensitivity and inclusion in the delivery of care/services of diverse populations as needed. d - Effectively utilizes resources to provide care/services - such as, interpreter services and on-line sources. 9 - Technology and Learning a - Participates in continued learning and possess a willingness and ability to learn and utilize new technology and procedures that continue to develop in their role and throughout the organization. b - Embraces technological advances that allow us to communicate information effectively and efficiently based on role. UNIT / DEPARTMENT SPECIFIC JOB FUNCTIONS 1 - Demonstrates as part of daily work experience the Aspects of Caring including but not limited to accountability and respect to our patients and colleagues. 2 - Demonstrates professional working relationships with colleagues to promote a positive/encouraging workplace. 3 - Consistently advocates for, facilitates, and implements principles of positive patient experience including caring, kindness and service. 4- Communicates plan of care to patient and family. Goals are: a. Keep the patient and family informed b. Provide information to patient and family about condition / treatment c. Include the patient/family in care plan decisions d. Communicate to patients and families in terminology they can understand. JOB REQUIREMENTS Minimum Education - Preferred Graduate of an accredited School of Nursing, BSN preferred Minimum Work Experience Previous Ambulatory Care RN experience preferred Required Licenses / Registrations RN - Registered Nurse Required Classes/Skills - BLS - Basic Life Support Required additional Knowledge, and Abilities Demonstrated proficiency in ambulatory care nursing, knowledge, and skills Excellent verbal and written communication skills required. Demonstrates flexibility via an ability to adapt to changing priorities and regulations. Basic computer skills required. Demonstrated skills in the areas of: communication (verbal and written), interdisciplinary collaboration, creative problem solving, and critical thinking. Knowledge of health system and community resources preferred.

**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 *************************************************************

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

Job DescriptionBenefits: 401(k) Competitive salary Flexible schedule Training & development FootCare by Nurses is a rapidly growing company that covers all of Western Massachusetts, Northern Connecticut and Cape Cod. Due to an ongoing expansion in needs, we are currently looking for 2 exceptional nurses throughout the Cape (from Bourne to Provincetown!) to join our visiting nursing team! Ours is a holistic practice with a primary focus on taking care of the feet of older adults to prevent pain, wounds, and falls from happening. We take the time to teach you our highly specialized technique, you take that to your consumers. We believe all ships rise with a rising tide. An ideal candidate has: Homecare experience, Experience working with older adults, Strong critical thinking abilities, A genuine curiosity and love of learning, and A flexible and focused problem-solving mindset Our work can be incredibly rewarding. Can you answer yes to either of the following? Are you the kind of person who likes one-on-one care and values ongoing relationships and connection with the community? Do you have a desire for a flexible work environment that respects autonomy and a holistic approach to care? If you answered yes to any of these questions, then this just might be your dream job! Benefits: Flexibility Autonomy No nights, weekends, or on-call Mileage reimbursement Gas reimbursement 401K Education reimbursement CE credits Extensive training and support Tools and equipment Laundry stipend Health insurance premium reimbursement for a commitment of 30+ hours per week This is an ideal position for a working parent. New RN graduates with previous home care experience encouraged to apply! Requirements: Current Registered Nursing license Current driver's license Able to sit on the floor and work Familiarity and comfortable with technology; have a smartphone or tablet with a data plan. (We use apps on smartphones or tablets to communicate, schedule, and do our charting.) Comfortable using power tools (we will train!) Enjoy driving and working in a variety of settings Prior to certification, FootCare by Nurses will put you through extensive training and pay you $30 an hour during the training period. Initial training to CFCS Certification is expected to take 2 weeks (40 hours). Once certified, fully trained, and managing their own schedule consistently, RN's compensation ranges from $42 - $52, per unit completed. Nurses are expected to see 6-8 people per day, and fulfill their monthly commitment. Accurate charting is expected, day of service; FootCare by Nurses has worked to make that an enjoyable and efficient experience. Work Life Balance is important in our Culture, while also meeting our Mission. Bilingual a plus. For more information about our company and culture please visit ************************

Behavioral Health Community Partnership (BHCP) Nurse Case Manager Department: Social Services Supervisor: Director of Nursing Status/Hours Per Week: Non-exempt / 35 hours Pay Range: The expected base pay for the position is $36-$65.02 per hour and may be increased based on other factors, such as language, certifications, etc. Primary Function: The Behavioral Health Community Partnership Nurse Case Manager [BHCP RN Case Manager] functions under the supervision of the Director of Nursing and overall guidance and consultation with the Medical Director and other Primary Care Providers to conduct patient monitoring, tracking, and provide ongoing care coordination and support to patients with behavioral health issues that are enrolled in BHCP. The BHCP RN Case Manager ensures patients' adequate linkages with behavioral health counseling, all levels of substance use care, including medication assisted treatment, and chronic pain management care. Duties & Responsibilities: * Receive and maintain a log of all patients enrolled in BHCP, and ensure adequate follow up and care coordination. * Serve as Clinical Care Manager for enrollees referred to the team, participating in the assessment, care planning, and on-going BHCP service provision specified in program protocols and policies. * Review and approve Comprehensive Health Assessments for members including performing medication reconciliations. * Make patient referrals to behavioral health, and human services providers at the Health Center for needed services such as primary care and other substance use and mental health care. * Make "warm handoffs" and coordinate support to needed services at external organizations including hospitals, substance use treatment programs, etc. * Follow up with members post-discharge to ensure members are seen by a Primary Care provider in a timely manner. * Monitor and track patients including progress in their treatment plan and update PCPs and other members of the team. * Participate in multi-disciplinary team meetings, utilization review, and program planning. * Participate in consultation, sharing of resources and best practices with other Riverside Community Partner teams.

ECMO, which stands for extracorporeal membrane oxygenation, is an advanced technology that functions as a replacement for a critically ill child's heart and lungs. It's used to support a child who is awaiting surgery, or to give a child's vital organs time to recover from heart surgery or disease. Boston Children's Hospital is home to one of the largest pediatric ECMO programs in the world; we provide services to critically ill children in the New England region, and to those who are referred from other states and internationally. We serve between 50 and 60 patients with severe respiratory or cardiac problems each year. Since its establishment in 1984, the ECMO Program has supported more than 900 children. Throughout the 20-year history of the ECMO Program at Boston Children's, we have gained considerable expertise, minimized complications, and increased its success rate for survival to 60 percent, higher than the national average of around 40 percent. Key Responsibilities: * Plans and organizes daily clinical and administrative responsibilities within the designated unit/program/service. * Develops, recommends, and implements internal standards, policies, and procedures to improve quality of patient care in collaboration with ECMO clinical leadership. * Develops and provides staff education/development programs in collaboration with unit specific nursing leadership. * Performs clinical review of inpatients who are either at risk of requiring ECMO or have been exposed to ECMO. * Collects clinical data relevant to patient outcomes and adverse events associated with critical illness and/or ECMO. * Works collaboratively with a multidisciplinary health care team to optimize patient care outcomes. * 40 hours per week. Minimum Qualifications Education: * A Bachelor's degree in nursing. Experience: * 4-5 years of pediatric critical care or pediatric cardiac critical care RN experience required. * Excellent attention to detail and the ability to adhere to stringent care protocols and documentation standards. * Strong communication skills and the ability to work collaboratively in a team-oriented clinical environment with liaison with strong quality-improvement team. Licensure/ Certifications: * Current Massachusetts license as a Registered Nurse (RN) The posted pay range is Boston Children's reasonable and good-faith expectation for this pay at the time of posting. Any base pay offer provided depends on skills, experience, education, certifications, and a variety of other job-related factors. Base pay is one part of a comprehensive benefits package that includes flexible schedules, affordable health, vision and dental insurance, child care and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes. Experience the benefits of passion and teamwork.

The Guild utilizes the collaborative efforts of leading professionals, best-practice approaches, tailored curricula and unmatched care to treat the individuals we serve. Mission: The mission of The Guild for Human Services is to educate, encourage and empower individuals with intellectual disabilities so they may achieve their full potential to lead high-quality lives and participate meaningfully in the community. At The Guild you can join a workforce of creative, dedicated, and passionate employees working every day to enhance the lives of youth and adults with intellectual disabilities and other challenges. Summary: Nurse Case Manager acts as a committed member of a multi-disciplinary team to help create and maintain goals of health & wellness for an assigned group of students. Primary Job Responsibilities: * The Nurse Case Manager/ Registered Nurse acts as Nurse Consultant for assigned Group Home students. * Monitor the health and safety issues within all locations of the school and residence. * Provide staff training to ensure optimal health and safety standards. * Provide staff training pertinent to health and safety needs, medical conditions, medical diagnosis and treatment plans. * Assist in scheduling laboratory testing and medical appointments and participates in health examinations as indicated. * Maintain medical records including documentation of treatment and medication administration of students. * Communicate with outside agencies and physicians as necessary. * Complete initial and annual medical assessments for students. * Complete annual Individual Health Plans and quarterly assessments. * Monitor, plan for, and communicate with the team regarding medical appointments, medical issues and other health related matters. * Communicate with outside agencies, physicians and parents/guardians. * Participate in designated team meetings and case reviews for students. * Monitoring Medication systems in residences and school. * Ensure timely submission of Medication Error Reports. * Assess certified staff medication administration competence . * Provide medical on-call coverage at minimum one week monthly * Able to attend training as required * Other related duties as assigned Essential Job Functions * Regular attendance at work is an essential function of the job including inclement weather situations * Physical and mental capacity to work in stressful situations and de-escalate individuals who have limited cognition and complex needs * Proficiency in written and spoken English is an essential function of the job. * Excellent organization and time management skills * Pass Guild Driving test to access Guild vehicles for transportations of individuals. * Must be able to implement crisis intervention techniques as necessary, including Nonviolent Crisis Intervention (via certification through CPI) * Registered Nurses who have an associate's degree (bachelor's preferred) with 2 years Nursing experience * Preference for additional training specific to nursing practice, such as CDDN * Knowledge of Massachusetts regulatory standards is required with preferred experience in regulatory compliance with standards from Department of Developmental Services (DDS) and Department of Public Health (DPH) * Undergo a background check process * Proficiency in Microsoft Office Suite

Under direction of Head Nurse and/or Program management, plays a leadership role in the investigation and follow-up of communicable disease cases/outbreaks or other situations of public health concern. Performs and oversees communicable disease surveillance, prevention and control measures according to protocols for cases/outbreaks as assigned. In conjunction with other Division staff, identifies patterns of communicable diseases and related risk factors, and provides health education and outreach as needed for communicable disease prevention and control. This nursing leadership position ensures high quality nursing practice within the CDC Division, by overseeing clinical nursing activities and directing and evaluating the professional practice of nurses, according to established standards of care. This position is also expected to work with the nursing leadership to develop standard operating procedures and workflows for case and outbreak investigations and contact tracing efforts. Investigates and provides care and follow-up of contagious diseases including COVID-19. Vaccinates against contagious diseases including COVID-19. In conjunction with other Division staff, identifies patterns of communicable diseases and related risk factors, and provides health education and outreach as needed for communicable disease prevention and control. Assists with development of data collections tools and ensures complete and accurate collection of data. Supervises subordinates as required. Assists in orientation of new staff, program visitors and in staff development programs. Identifies or develops resources as needed for case or outbreak follow-up. Provides nursing support for CDC Division activities, including vaccine and other clinics or other projects or activities as needed. Provides nursing services at the TB Clinic, including phlebotomy, patient assessment, patient/family/significant other education, medication monitoring, and skin testing. Participates in special projects and initiatives as requested and acts as clinical back-up for special projects. Participates in staff conferences, research activities, meetings with community based or other agencies as requested. Plays a key role in communicable disease related epidemiologic activities. Plays a key role in providing education and outreach on communicable disease issues to health care providers, agencies, and community groups throughout the city. Acts as a resource on communicable disease related issues for division staff, providers, and community groups. Collaborates with others throughout the Division to ensure public health preparedness for bioterrorism and other communicable diseases. May be required to perform duties of other CD or TB nurses. Performs other duties as required. Works to help BPHC advance as an antiracist organization by meeting or exceeding the standards set by the BPHC Anti-Racism Policy.

Full-time, Part-time Description Job Title: Wellness Nurse Hours: Per Diem The Resident Care Nurse is responsible for assisting the Resident Care Director with the overall implementation, delivery and coordination of Resident Care services at the Community. Nurse will also assist in monitoring the medication management program. Duties and Responsibilities: The following essential functions are the fundamental job duties of the position to be completed with or without appropriate reasonable accommodation. • Assist in supervising the medication program and assisting the residents with self-administration of their medication. • Assist residents with Activities of Daily Living and Independent with Activities of Daily Living as needed. • Maintain positive relations with residents, families and physicians. • Report any significant incidents and/or changes in the residents needs to the Executive Director/Resident Care Director. • Assist in the completion of resident assessments and services plans. • Assist in the training of assisted living staff and participates in orientation of new staff. • Attend and participates in scheduled in-service programs, training programs and staff meetings. • Assist with scheduling and staffing of Resident Care Assistants • RN will maintain GAFC. • May perform other duties as assigned. Requirements Minimum Qualifications: • Registered Nurse/Licensed Practical Nurse/Licensed Vocational Nurse with a current license in good standing. • Certification or licensed per state guidelines. • Must successfully complete all HallKeen • Community specified training programs. • Able to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Able to deal with problems involving a few concrete variables in standardized situations. • Able to work various schedules and shifts as needed. • Required Behavior: • Appearance is neat, clean, and according to dress code. • Able to demonstrate a high level of service delivery; does what is necessary to ensure customer satisfaction; deals with service failures and prioritizes customer needs. • Able to clearly present information through the spoken word; reads and interprets complex information; talks with residents, family members and customers; listens well. • Able to communicate with others in a warm and helpful manner while simultaneously building credibility and rapport. • Able to work cooperatively with a group of people to achieve goals and objectives. • Able to be tactful; maintains confidences, and fosters an ethical work environment; prevents inappropriate behavior by coworkers; gives proper credit to others; handles all situations honestly. • Able to keep an open mind and change opinions on the basis of new information; performs a variety tasks and changes focus quickly as demands change; manages transitions effectively from task to task; adapts to varying customer needs. Physical Demands: • Physically able to move at least 50 lbs. without assistance. • Physically able to bend, reach, and work in small areas. • Physically able to push and pull equipment and furnishings. • Physically able to stand for long periods of time.

Department Child Development: Day Camp Employment Type Seasonal - Full Time Location Ponkapoag Workplace type Onsite Compensation $25.00 - $35.00 / hour Key Responsibilities Skills, Knowledge and Expertise Benefits About YMCA of Greater Boston The YMCA of Greater Boston is the largest social services provider in Massachusetts. Through our network of facilities and program sites, the YMCA provides health and wellness programming, child care, summer camp, youth sports, and teen leadership programs, as well as work-force development and community outreach. The YMCA of Greater Boston is committed to a policy of nondiscrimination and equal opportunity for all employees and qualified applicants without regard to race, color, religious creed, protected genetic information, national origin, ancestry, sex, sexual orientation, gender identity, age, disability, or veteran's status.

The Current Beverly, our senior living community in Beverly, MA is a beautiful newly renovated historic building, inviting residents for both Assisted Living and Memory Care. Apply now for consideration and/or to learn more! Each and every member of our team is committed to developing progressive yet approachable communities to support the needs of all future generations. We want to transform healthcare infrastructure so that people can not only age well but live well and THRIVE. Job Description Reporting to Director of Health and Wellness, the Wellness Nurse (LPN) provides direct nursing care to the residents, and supervises the day-to-day nursing activities performed by care staff. Schedule: The Wellness Nurse (LPN) is Full-Time: 7am - 3pm and/or 7:30am-7:pm. We also have Part-Time and Per diem available for all shifts Salary Range: $37.00 - $41.00 Hourly Responsibilities and Duties Supervise care staff in accordance with current state regulations and community policies Monitors the health, safety, and well-being of all residents Assisting in training and monitoring of medication administration Maintaining clinical quality assurance in accordance with federal, state and local standards Promote the highest degree of service to our residents while leading and demonstrating the mission of the company Conduct thorough resident assessments Qualifications Graduation form an accredited School of Nursing, with current LPN license At least 1 year of experience with long-term care, assisted living, home health or hospital setting preferred Experience working with residents with Alzheimer's or other related dementias Ability to handle multiple tasks Knowledge of federal and state regulations, and of nursing practices, techniques and methods applied to health and wellness resident Proficiency in computer skills, Microsoft Office (Windows, Outlook, Excel) with the ability to learn new applications While performing the duties of this job, the associate is often required to stand, walk, sit, use fine and gross motor skills, reach with hands and arms, balance, stoop, kneel, crouch, talk, hear, and smell. An individual in this position will be required to lift or carry weight in up to 50 lbs. Intermittent physical activity includes lifting and supporting residents. The associate must use proper body mechanics. Additional Information Benefits Offered(Full Time): Health Insurance: Medical/Rx, Dental, and Vision Ancillary Benefits: Life Insurance/AD&D, Short Term Disability and Long-Term disability Basic Life & Accidental Death & Dismemberment (AD&D) Insurance FSA (Commuter/Parking) Employee Assistance Program (EAP) 401(k) Retirement with Company Match Paid Time Off (PTO) and Holidays Tuition Reimbursement Other Compensation Programs: Employee Referral Bonus Resident Referral Bonus Benefits Offered (for Part-Time Employees): Paid Time Off (PTO) and Holidays Flexible Schedule On the job training Employee Assistance Program (EAP) Free Parking Other Compensation Programs: Employee Referral Bonus Resident Referral Bonus Benefits Offered (Per Diem Employees): Flexible Schedule On the job training Free Parking Equal Opportunity Statement: Monarch Communities and Brandywine Senior Living is an Equal Opportunity Employer. We comply with all applicable federal, state, and local laws. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Nurse Schedule: 40hrs - Flexible schedule within the hours of 7a-7p Department/Division: Adult Community Clinical Services (ACCS) (1) Intensive Medical Specialty Site Nurse FLSA Status: Non-Exempt Supervised by: Licensed Program Director General Statement of Duties: Oversee all medical and medication issues, including the Medication Administration Program (MAP). Collaborate with the Program Director to provide direct care staff supervision and ongoing education. Provide coordination of crisis intervention as needed. Provide on-call coverage through established rotation. Responsibilities: 1. Utilize recovery principals in partnership with Persons and staff members of the assigned program(s) to improve Persons' health and wellness; achieve symptom stabilization and self-management; develop and/or restore skills impacted by their mental illness; live a self-directed life; and strive to reach their full potential. 2. Provide the staff and persons served with a vision about the importance and inevitability of achieving goals through the recovery process. 3. Ensure that a culture of quality is maintained by using evidence-based and other best practices within the services being provided. 4. Increase the level of involvement and decision-making by persons served in their treatment planning and in service delivery. Document interactions provided to persons served on required service note. 5. Coordinate treatment and services with all Persons' Served Care Coordination Entities and behavioral and physical health providers. 6. Enhance efforts to encourage and provide services regarding physical and emotional wellness. Facilitate referrals as needed to all needed services. 7. Anticipate issues of medical/clinical risk and attend to crisis or emergency situations by intervening immediately with appropriate clinical/medical treatment and/or supervision. 8. Develop and implement medical protocols for Persons as needed. Train staff in the use of protocols. 9. In collaboration with assigned administrative supervisors, provide clinical supervision and ongoing education to direct care staff. 10. Provide clinical and administrative oversight to assigned programs regarding DPH Medication Administration Program (MAP) procedures, protocols, and compliance. 11. When needed, administer medications and treatments ensuring adherence to agency, funder, and DPH regulations. 12. Coordinate with assigned programs to ensure medications, medical and safety supplies are available as needed. 13. Coordinate hospital admissions and discharges using a collaborative approach. 14. Provide in-service training regarding medication administration and medical supports for direct care and management staff. 15. Ensure compliance with organizational policies, contracts, and funding source requirements as they relate to health and safety. 16. Assume rotating on-call responsibilities as assigned. 17. Ensure compliance with licensing and accreditation standards as well as local, state, and federal regulations relative to the required documentation, medical areas, and medication in assigned programs. 18. Follow funder and agency protocol for reporting significant incidents and alleged abuse and/or neglect. 19. Transport persons served as needed. 20. Perform other related work duties as needed or as assigned by supervisor. 21. Perform duties to reflect agency policies and procedures. 22. Attend all required training courses and demonstrate continued growth and competency. Obtain and maintain required training within allotted time frames. 23. Execute duties to reflect reasonable safety standards. Universal/standard precautions must be utilized, and training obtained in areas that constitute risk. Follow the person served Risk and Safety Plans as applicable. Qualifications: · Registered Nurse in the Commonwealth of Massachusetts preferred, Licensed Practical Nurse in the Commonwealth of Massachusetts required. · Competency with medical and psychiatric monitoring; and consultation and coordination for Persons. · Knowledge of the theories, methods, procedures and practices of nursing care and physical rehabilitation as applicable to community services. · Experience working with people who have been diagnosed with a serious and persistent mental illness. · Ability to speak and write English clearly and accurately to keep documentation up to date and understandable. · Basic computer literacy, including the ability to record data, use electronic medical records, use electronic time and attendance software, and receive and send electronic mail, is required. · Effective listening, critical thinking, writing, and communication skills. · Must possess a valid driver's license in state of residence and own means of transportation required. · Preference given to candidates with lived experience and fluency in languages prevalent in Southeastern MA. #BAMSI2 40hrs: Flexible schedule within the hours of 7a-7p daily 40

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