Utilization review nurse jobs in Readington, NJ - 185 jobs

Job Description Interventional Radiology RN - $76/hr | Day Shift | 13-Week Contract If you would like to know a bit more about this opportunity, or are considering applying, then please read the following job information. Start Date: May 19, 2025 Shift: 4x10s (8:00 AM-6:30 PM) Pay: $76/hr Contract Length: 13 Weeks About the Role: Support IR procedures at the Morris Cancer Center and Main Hospital Campus Deliver conscious sedation recovery care Float between campuses 2-3 days/week on-call (PICC procedures) Work with specialty equipment: EKOS+, A-line, procedural wedge pressures, portable midlines Requirements: 2+ years in a stroke center (Level I or II) ED or ICU background strongly preferred Confident using specialty equipment & serving as Primary RN Certs: BLS, ACLS, xevrcyc NIHSS License: NJ or compact license at time of submission Ready to make an impact with a team that values your skill and commitment? Apply today and work with a staffing agency that treats you like family - ATC Healthcare of NJ.

Job Description Kent Place School is seeking nurses to serve as daily substitutes in our Jr. Are you ready to apply Make sure you understand all the responsibilities and tasks associated with this role before proceeding. pre-K - 12th grade school. All interested candidates should send a resume and cover letter to with "Nurse Substitute" in the subject line. Must have current NJ nursing license and experience in an educational setting is preferred. Kent Place School is an equal opportunity employer. xevrcyc We seek candidates who support the development of a school community that is culturally competent, a working environment that is affirming and inclusive, where each member feels safe and valued, as described in our Diversity statement.

This position is for a registered nurse specializing in interventional radiology on a 13-week travel assignment in New Brunswick, New Jersey. The role requires working 40 hours per week in 10-hour day shifts and offers competitive pay along with extensive benefits such as medical coverage, housing support, and 401k matching. The position is facilitated by Host Healthcare, which provides support and resources for travel nurses across the United States. Host Healthcare is seeking a travel nurse RN Interventional Radiology for a travel nursing job in New Brunswick, New Jersey. Job Description & Requirements Specialty: Interventional Radiology Discipline: RN Start Date: Duration: 13 weeks 40 hours per week Shift: 10 hours, days Employment Type: Travel Host Healthcare Job ID #a1fVJ000007UJHJYA4. Pay package is based on 10 hour shifts and 40 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: RN - Interventional Radiology About Host Healthcare At Host Healthcare, we provide a truly comfortable experience as you explore your travel nursing, therapy, or allied career. We make your travel healthcare journey easy by taking care of all the details, so you don't have to. We are on a mission to help others live better and we do this by helping the healers of the world be as comfortable as possible. With access to tens of thousands of travel nursing, therapy, and allied jobs in all 50 states, our responsive and friendly recruiters find your dream position based on what's important to you. During your assignment, get access to premium benefits, including Day 1 medical that continues up to 30 days between assignments, 401K matching, travel reimbursements, dedicated housing support, and more. We also offer 24/7 support from our team and access to our on-staff clinicians so you can feel comfortable and confident throughout your entire assignment. Travel comfortably with Host Healthcare. Benefits Referral bonus School loan reimbursement Vision benefits Wellness and fitness programs Company provided housing options License and certification reimbursement Life insurance Medical benefits Mileage reimbursement Pet insurance Discount program Employee assistance programs Guaranteed Hours Health savings account Holiday Pay 401k retirement plan Continuing Education Dental benefits Keywords: Travel Nurse, Interventional Radiology, Registered Nurse, RN Travel Jobs, Healthcare Travel Nursing, Medical Benefits, Nursing Assignment, Travel Nursing Benefits, Host Healthcare, Healthcare Staffing

Job DescriptionBenefits: Do not wait to apply after reading this description a high application volume is expected for this opportunity. Competitive salary Employee discounts Training & development Wellness resources Benefits/Perks A competitive salary Flexible Schedules Casual Dress-code Fun, wellness-focused work environment Company Overview Restore Hyper Wellness is the leading retail provider of alternative health and wellness modalities in the United States. Our goal is to make Hyper Wellness widely accessible, affordable, and fun. This means helping people from all walks of life feel better and perform at a higher level so they can do more of what they love in life. Inc. 5000 ranked Restore as the #113 Fastest Growing Company in America, the #17 Fastest Growing Company in Texas, and the #1 Hottest Franchise in America. Job Summary Do you have a passion for nursing but are tired of the hectic, high-stress environment of a clinic or ER? This is your chance to take your career in an exciting, new direction. Restore is seeking an outgoing, experienced Nurse to join our team of wellness professionals on a mission to help people feel better so they can do more of what they love. Were the antithesis of a traditional medical office or clinic, offering innovative wellness services in a fun, comfortable environment. Our nurses have described working for Restore as the most fun you can have at a nursing job while still helping people in a meaningful way. This is your opportunity to take an active role in assisting individuals on their health and wellness journey and leading a team of nurses to support the Restore mission. Responsibilities Medical Operations & Clinical Duties Administer IV Drip Therapy and Intramuscular (IM) Shots to deliver our menu of vitamins, minerals, and antioxidants. Educate clients on the qualities and benefits of our IV Drip and Intramuscular (IM) Shot ingredients. Administer Hyperbaric Oxygen Therapy sessions. Utilize blood test offerings to help clients optimize their wellness. Promote memberships and medical services based on client needs. Document client visits via electronic medical records. Address and answer client questions using the Restore Nursing Reference Guide under the supervision of the Medical Director and network of licensed Advanced Practice Providers. Communicate to the medical compliance team any issues or adverse effects clients experience. Provide therapeutic communication along with exceptional customer service Assist staff with store services. Assist with off-site nursing events and special projects. This position reports to the Lead Nurse. Maintain a safe and clean working environment. Qualifications Youre a licensed Registered Nurse (RN). You have at least two years of experience as a nurse in an acute care setting (ER, ICU, Med-Surg, or similar). You are BLS (Basic Life Support) certified You have at least one year of experience administering injections. Youre comfortable using electronic medical records to document client details. You maintain a non-judgemental outlook and have a demonstrated ability to work with a diverse clientele. Your verbal and written communication skills are on point. You value ethics and integrity. You embrace a team environment and also excel at working independently. xevrcyc Youre willing to adhere to all policies and procedures and understand the importance of maintaining medical compliance.

Job Description Add Flexible RN Visits to Your Week - Hunterdon CountyAlready working as an RN and looking to add a few skilled nursing visits to your schedule? If you want to feel appreciated without changing your primary job, come to BAYADA. Have you got the right qualifications and skills for this job Find out below, and hit apply to be considered. BAYADA Home Health Care is seeking a compassionate Registered Nurse (RN) to join our North Jersey West Skilled Nursing team servicing Hunterdon County. This role is ideal for nurses who want to supplement their current schedule, pick up daytime visits, and enjoy 1:1 patient care-all on their own terms. 0-4 Hours per week. Whether you're hospital-based, school-based, or working another nursing role, BAYADA offers the flexibility to add meaningful visits that fit seamlessly into your week. Why this role works as a schedule add-on: Per-case model - pick up only the cases you want Perfect for filling open days or adding extra income True 1:1 care with each patient Flexible scheduling based on your availability Weekly pay Supportive clinical team-no pressure, no minimums What you'll need: Ability to travel throughout Hunterdon County Minimum 1 year RN experience Daytime availability for multiple visits per week Med-Surg or equivalent experience Current, valid U.S. RN license Graduation from an accredited nursing program What BAYADA offers our RNs: One-on-one patient visits (no patient ratios) Flexible scheduling that works around your main job Preventive Care Coverage for ALL employees (PRN included) PTO Company-paid life insurance Employee Assistance Program (EAP) 401(k) Career growth, skill development, and paid training How we support your success: Paid training from day one (office, in-home, and online) Award-winning adult and pediatric simulation labs 24/7 clinical support-even for PRN nurses Simple, efficient electronic charting We care for clients of all ages, diagnoses, and acuity levels and provide paid training to ensure you feel confident and supported from your very first visit. Compensation: $68 per visit Looking to add flexibility, income, and meaningful 1:1 care to your existing RN role? Apply today and make BAYADA part of your balanced nursing schedule. NER-NJ-RX As an accredited, regulated, certified, and licensed home health care provider, BAYADA complies with all state/local mandates. BAYADA is celebrating 50 years of compassion, excellence, and reliability. Learn more about our 50th anniversary celebration and how you can join in here. BAYADA Home Health Care, Inc., and its associated entities and joint venture partners, are Equal Opportunity Employers. All employment decisions are made on a non-discriminatory basis without regard to sex, race, color, age, disability, pregnancy or maternity, sexual orientation, gender identity, citizenship status, military status, or any other similarly protected status in accordance with federal, state and local laws. xevrcyc Hence, we strongly encourage applications from people with these identities or who are members of other marginalized communities.

Job Description Now Hiring: On Call Hospice Visit Registered Nurse Middlesex, Union, & Somerset Counties Please read the information in this job post thoroughly to understand exactly what is expected of potential candidates. Positions: On-Call Visit Nurse Registered Nurse Employment Type: Full-Time Monday - Friday 5pm - 8am Are you a compassionate and dedicated nursing professional with a passion for providing exceptional hospice care? Do you thrive in a supportive, team-oriented environment where your clinical expertise is valued and your heart for service shines? If so, we invite you to join our team as an On Call Visit Nurse and make a meaningful impact every day. Why You'll Love These Roles: Patient-Centered Care: Be a critical part of a dynamic team that identifies and addresses the physical, psychological, social, and spiritual needs of patients and their families. Collaborative Environment: Work closely with our RN Case Manager and Interdisciplinary Team (IDT) to ensure a seamless and responsive plan of care. Autonomy & Support: Enjoy the perfect blend of independence in your role, backed by strong leadership and a culture of collaboration. Purpose & Fulfillment: Experience the profound reward of guiding families through some of life's most challenging moments with compassion and dignity. What You'll Do: Provide compassionate, on-call care to hospice patients, addressing urgent needs with empathy and professionalism. Collaborate closely with the RN Case Manager to implement tailored interventions that support patients and their families. Maintain accurate and thorough documentation to ensure high-quality care. Act as a vital member of the Interdisciplinary Team (IDT), contributing to a comprehensive and responsive plan of care. Work under the supervision of a Registered Nurse to assess and meet the multifaceted needs of patients and their families. Provide continuous, compassionate care, ensuring adherence to hospice care standards and protocols. What We're Looking For: Active and unrestricted RN license. Experience in hospice, palliative care, or acute care settings is highly valued. Exceptional communication and organizational skills. Ability to thrive in a fast-paced and emotionally rewarding environment. A heart for service and a commitment to delivering the highest standard of care. Perks & Benefits: Competitive Pay & Benefits Package Flexible Scheduling Options Opportunities for Professional Development & Growth Supportive & Mission-Driven Work Culture Wellness Programs & Resources Ready to Make a Difference? xevrcyc If you're ready to bring your skills, compassion, and dedication to our team, we'd love to hear from you! Apply today and become a part of a community that values healing, hope, and heart.

Job DescriptionCertified Infusion Trained Nurse for giving Simple infusions in a physician clinic setting. If the following job requirements and experience match your skills, please ensure you apply promptly. Should have experience in using infusion pumps. This is part time position for a few hours a week either on Wednesday or Thursday. xevrcyc Please apply with a resume.

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. We're making a solid connection between exceptional patient care and outstanding career opportunities. The result is a culture of performance that's driving the health care industry forward. As a Telephone Case Manager RN, you'll support a diverse member population with education, advocacy and connections to the resources they need to feel better and get well. Instead of seeing a handful of patients each day, your work may affect millions for years to come. Ready for a new path? Apply today! If you are located within Northern New Jersey territory and willing to travel up to 20% of your time to assigned territory, you will have the flexibility to work remotely as you take on some tough challenges. Primary Responsibilities: Comprehensive Assessment & Care Planning Conduct thorough health assessments, including medical history, chronic conditions, behavioral health, and social determinants of health Develop individualized care plans that address medical, rehabilitation, behavioral health, and social needs Create personalized interventions that integrate medical treatment, support services, and community resources Member Engagement, Education & Self-Management Build and maintain relationships with an established caseload of high-risk members Provide education to members and caregivers on disease processes, treatment adherence, and lifestyle changes Encourage self-management strategies that support long-term wellness and reduce complications Maintain consistent outreach to support adherence to care plans and monitor evolving needs Intensive Care Coordination Coordinate services across providers, including PCPs, specialists, hospitals, LTSS, behavioral health, and pharmacy. Facilitate referrals for home health, hospice, palliative care, and DME Collaborate with Medical Directors during interdisciplinary rounds to review and align care for complex cases Discharge Planning & Transitional Care Support members through transitions of care such as hospitalization, skilled nursing, and rehabilitation Conduct "welcome home" and follow-up calls to ensure post-discharge services, medications, and follow-up appointments are in place Deliver intensive outreach during the 30-day post-discharge period to reduce avoidable readmissions and ED utilization Advocate for safe, coordinated, and timely transitions of care that align with the member's individualized care plan Field-Based Care Management (20% of Time) Conduct home and hospital visits in North Jersey as required by program guidelines Perform in-person assessments and provide care coordination to address high-risk needs and ensure continuity of care Collaborate directly with providers, facilities, and families during field visits to close care gaps and reinforce the care plan Monitoring & Clinical Oversight Monitor members' clinical conditions, care plan progress, and treatment adherence Reassess care plans regularly and adjust interventions based on changing needs or barriers Identify red-flag conditions and escalate urgent or complex cases for higher-level review and intervention Documentation, Compliance & Quality Outcomes Document all assessments, care plans, interventions, and communications per NCQA, CMS, and state regulatory requirements Ensure care management services align with DSNP/NCQA standards and contract requirements Track outcomes tied to quality metrics (HEDIS, STARs), utilization management, and member satisfaction Maintain audit readiness through timely, accurate, and comprehensive documentation 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. Required Qualifications: Current, unrestricted RN license in New Jersey 2+ years of Case Management Experience serving complex, elderly and disabled Experience with government health programs (Medicaid/Medicare) Proficient in Microsoft Office Suite; tech-savvy with ability to navigate multiple systems simultaneously Demonstrated ability to talk and type proficiently at the same time Access to reliable transportation and the ability to travel up to 20% within assigned territory. Available for occasional in-person meetings as needed Preferred Qualifications: Certified Case Manager (CCM) Experience working with populations with special needs (DSNP) Experience with Managed Care Population Bilingual - English/Spanish *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy 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 hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group 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. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

This travel nurse RN position specializes in Interventional Radiology, providing care to patients undergoing image-guided procedures. The role involves patient assessment, sedation administration, and monitoring during and after procedures, requiring collaboration with multidisciplinary teams. Candidates must hold an active RN license, BLS and ACLS certifications, and have relevant clinical experience in IR or related fields. Prime Staffing is seeking a travel nurse RN Interventional Radiology for a travel nursing job in New Brunswick, New Jersey. Job Description & Requirements Specialty: Interventional Radiology Discipline: RN Start Date: Duration: 13 weeks 40 hours per week Shift: 8 hours Employment Type: Travel About the Position Specialty: RN - Interventional Radiology Experience: 2+ years of experience in IR, ICU, ED, or procedural areas preferred License: Active State or Compact RN License Certifications: BLS & ACLS - AHA Must-Have: IV sedation management, pre- and post-procedure care experience Description: The Interventional Radiology RN supports patients undergoing image-guided procedures. Responsibilities include patient assessment, administering sedation, monitoring during procedures, and ensuring safe recovery. Collaboration with radiologists, technologists, and other departments is essential to provide optimal care throughout diagnostic and therapeutic interventions. Requirements Required for Onboarding: Active RN License BLS ACLS Prime Staffing Job ID #. Pay package is based on 8 hour shifts and 40.0 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: RN:Interventional Radiology,08:00:00-16:00:00 About Prime Staffing At Prime Staffing, we understand the importance of finding the perfect fit for both our clients and candidates. Prime Staffing utilizes a unique matchmaking approach, providing the most qualified contingent staffing to our clients, and the most competitive contracts to our workforce. Our experienced team takes the time to get to know both our clients and candidates, their needs, and preferences, to ensure that each placement is a success. We offer a wide range of staffing services including temporary, temp-to-perm, and direct hire placements. Our extensive network of qualified candidates includes nurses, allied healthcare professionals, corporate support professionals and executives. Keywords: travel nurse, interventional radiology, registered nurse, RN license, BLS certification, ACLS certification, patient care, sedation management, image-guided procedures, critical care nursing

Description: Nurse - Lake in the Woods (Overnight, Monday to Friday) Make sure to apply quickly in order to maximise your chances of being considered for an interview Read the complete job description below. Join our dedicated healthcare team at Lake in the Woods as a Nurse, where your expertise will make a meaningful difference in patient care. This full-time overnight position offers a rewarding opportunity to work in a supportive environment committed to excellence and compassion. Key Responsibilities: - Provide comprehensive nursing care to patients in accordance with physician orders and established protocols - Monitor patient conditions, vital signs, and responses to treatments during overnight shifts - Administer medications and treatments accurately and safely - Document patient information thoroughly and maintain accurate medical records - Collaborate with interdisciplinary team members to develop and implement individualized care plans - Educate patients and their families about health management and post-discharge care - Ensure compliance with healthcare regulations, safety standards, and infection control policies Skills and Qualifications: - Valid Registered Nurse (RN) license in the state of practice - Proven experience in a clinical or hospital setting preferred - Strong assessment, critical thinking, and problem-solving skills - Excellent communication and interpersonal skills - Ability to work independently and as part of a team during overnight hours - Flexibility to work Monday through Friday overnight shifts - Knowledge of healthcare regulations and safety procedures At Lake in the Woods, we foster a culture of growth, teamwork, and compassion. We offer competitive compensation, ongoing professional development, and a supportive environment where your skills can thrive. xevrcyc Join us in delivering exceptional care to our community. Requirements:

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

**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. 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.

Clinical Document-Coding Mgmt Saint Peter's is among the few hospitals in the world to have earned its 7th consecutive Magnet designation and its first Magnet with Distinction designation. The Magnet with Distinction designation is an elite level of this recognition, awarded to organizations that demonstrate exceptional performance in nursing practices and patient outcomes. Our team of award-winning nurses is growing, and we are looking for talented, compassionate RNs to join our team. The Utilization Review RN Per Diem will: * Identify appropriate medical information necessary to certify and/or refer cases on admission and on continued stay reviews. * The review of the medical record includes all pertinent information required by insurance payers including the reason for admission, current symptoms, abnormal lab values, abnormal diagnostics, outpatient condition prior to an admission and response or lack of response to such treatment. Review medication administration record to identify antibiotics administered, dose and frequency, respiratory treatments, medical/surgical and social history. Documentation if discharged from a hospital within 30 days, as well as any pertinent clinical information. * Performs assigned admission reviews within established time frame in accordance with payer requirements as well as daily reviews for Medicare, Medicaid and managed care companies per their requirements. * Ensures timely provision of clinical review information to payer as evidenced by no denials for lack of clinical information. Collaborates with patient registration /resource services for issues related to insurance coverage (i.e., correct insurance is not in patient record. * Whenever possible, manages requests for concurrent reconsiderations as evidenced by the "overturn" of the initial denial decision. * Initiates collaboration with the Medical Staff or Clinical Documentation Specialists by identifying additional clinical information required for obtaining payer determination for approval of the admission. * Identifies hospital stays at risk for admission downgrades or denials and involves the Physician Advisor in a timely fashion when assistance is needed. * Refers cases to the Physician Advisor when a change in level of care or termination of benefits seems applicable based upon criteria for Medicare/Medicaid patients (i.e., certification of acute days versus custodial or SNF). * Utilizes case management software including utilization criteria guidelines, to capture essential admission clinical review documentation. Requirements: * Registered nurse currently licensed to practice in the State of New Jersey. * Required to have three (3) to five (5) years-nursing experience working in an acute care hospital setting, preferably medical/surgical or critical care. * Experience should include assessment of a patient's diagnosis, prognosis, care needs responsible for a patient admission. * The ability to clinically assess the patient condition for establishing medical necessity justifying an inpatient admission by analyzing medical records, interpreting clinical and laboratory data. * Must have excellent interpersonal, communication, organizational and computer skills. * Flexible and able to work independently and part of a team. Salary Range: 51.00 - 51.00 USD We offer competitive base rates that are determined by many factors, including job-related work experience, internal equity, and industry-specific market data. In addition to base salary, some positions may be eligible for clinical certification pay and shift differentials. The salary range listed for exempt positions reflects full-time compensation and will be prorated based on employment status. Saint Peter's offers a robust benefits program to eligible employees that will support you and your family in working toward achieving and maintaining secure, healthy lives now and into the future. Benefits include medical, dental, and vision insurance; savings accounts, voluntary benefits, wellness programs and discounts, paid life insurance, generous 401(k) match, adoption assistance, back-up daycare, free onsite parking, and recognition rewards. You can take your career to the next level by participating in either a fully paid tuition program or our generous tuition assistance program. Learn more about our benefits by visiting our site at Saint Peter's.

**his position is responsible for performing RN duties using established guidelines to ensure appropriate level of care as well as planning for the transition to the continuum of care. Performs duties and types of care management as assigned by management.** **Responsibilities:** 1. Assesses patient's clinical need against established guidelines and/or standards to ensure that the level of care and length of stay of the patient are medically appropriate for inpatient stay. 2. Evaluates the necessity, appropriateness and efficiency of medical services and procedures provided. 3. Coordinates and assists in implementation of plan for members. 4. Monitors and coordinates services rendered outside of the network, as well as outside the local area, and negotiate fees for such services as appropriate. Coordinates with patient, family, physician, hospital and other external customers with respect to the appropriateness of care from diagnosis to outcome. 5. Coordinates the delivery of high quality, cost-effective care supported by clinical practice guidelines established by the plan addressing the entire continuum of care. 6. Monitors patient's medical care activities, regardless of the site of service, and outcomes for appropriateness and effectiveness. 7. Advocates for the member/family among various sites to coordinate resource utilization and evaluation of services provided. 8. Encourages member participation and compliance in the case/disease management program efforts. 9. Documents accurately and comprehensively based on the standards of practice and current organization policies. 10. Interacts and communicates with multidisciplinary teams either telephonically and/or in person striving for continuity and efficiency as the member is managed along the continuum of care. 11. Understands fiscal accountability and its impact on the utilization of resources, proceeding to self-care outcomes. 12. Evaluates care by problem solving, analyzing variances and participating in the quality improvement program to enhance member outcomes. 13. Completes other assigned functions as requested by management. Core Individual Contributor Competencies. Personal and professional attributes that are critical to successful performance for Individual Contributors: Customer Focus, Accountable, Learn, Communicate. **Qualifications:** **Education/Experience** 1. Requires an associate's or bachelor's degree (or higher) in nursing and/or a health related field OR accredited diploma nursing school. 2. Requires a minimum of two (2) years clinical experience. **Additional licensing, certifications, registrations:** 1. Requires an active New Jersey Registered Nurse License. **Knowledge:** - Prefers proficiency in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint) and Lotus Notes; prefers knowledge in the use of intranet and internet applications. - Prefers working knowledge of case/care management principles. - Prefers working knowledge of principles of utilization management. - Prefers basic knowledge of health care contracts and benefit eligibility requirements. - Prefers knowledge of hospital structures and payment systems. **Skills and Abilities:** - Analytical - Compassion - Interpersonal & Client Relationship Skills - Judgment - Listening - Planning/Priority Setting - Problem Solving - Team Player - Time Management - Written/Oral Communication & Organizational Skills **About US Tech Solutions:** US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit *********************** (********************************** . US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

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

Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Hours: Monday - Friday 9:00am to 5:30pm EST and 1 late evening 11:30am to 8:00pm EST. * This position will service members in different states; therefore, Multi-State Licensure will be required. This position requires an on-line pre-employment skills assessment. The assessment is free of charge and can be taken from any PC with Internet access. Candidates who meet the minimum requirements will be contacted via email with instructions. In order to move forward in the process, you must complete the assessment within 48 hours of receipt and meet the criteria. The Telephonic Nurse Case Manager II is responsible for care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically. How you will make an impact: * Ensures member access to services appropriate to their health needs. * Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment. * Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements. * Coordinates internal and external resources to meet identified needs. * Monitors and evaluates effectiveness of the care management plan and modifies as necessary. * Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans. * Negotiates rates of reimbursement, as applicable. * Assists in problem solving with providers, claims or service issues. * Assists with development of utilization/care management policies and procedures. Minimum Requirements: * Requires BA/BS in a health-related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. * Current, unrestricted RN license in applicable state required. * Multi-state licensure is required if this individual is providing services in multiple states. Preferred Capabilities, Skills and Experiences: * Case Management experience. * Certification as a Case Manager. * Minimum 2 years' experience in acute care setting. * Managed Care experience. * Ability to talk and type at the same time. * Demonstrate critical thinking skills when interacting with members. * Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly. * Ability to manage, review and respond to emails/instant messages in a timely fashion. For candidates working in person or virtually in the below locations, the salary* range for this specific position is $76,944 to $126.408. Locations: Colorado; New York; New Jersey 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. 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.

Monarch/Brandywine Senior Living Company Culture and Values: At Monarch Communities, we value compassion, innovation, and community. Our team is committed to making a meaningful impact on the lives of our residents and fostering a collaborative and supportive work environment. Job Description LPN - Brandywine Living - Livingston, NJ Salary Range: $32/hr to $36/hr Led by the community's Health and Wellness Director (RN), our Wellness Nurse is a Licensed Practical Nurse (LPN) who provides direct nursing care to the Residents with an emphasis on holistic wellness. They also help supervise the day-to-day nursing activities performed by care staff of Certified Nursing Assistants. Schedule: The Wellness Nurse (LPN) is Part-Time Responsibilities and Duties Monitors the health, safety, and well-being of all residents Assisting in training and monitoring of medication administration Supervise care staff in accordance with current state regulations and community policies Maintaining clinical quality assurance in accordance with federal, state and local standards Promote the highest degree of service to our residents while leading and demonstrating the mission of the company Conduct thorough resident assessments Qualifications Graduation from an accredited School of Nursing, with current LPN license At least 2 years' experience with long-term care, assisted living, home health or hospital setting preferred Experience working with residents with Alzheimer's or other related dementias Ability to handle multiple tasks Knowledge of federal and state regulations, and of nursing practices, techniques and methods applied to health and wellness resident Proficiency in computer skills, Microsoft Office (Windows, Outlook, Excel) with the ability to learn new applications While performing the duties of this job, the associate is often required to stand, walk, sit, use fine and gross motor skills, reach with hands and arms, balance, stoop, kneel, crouch, talk, hear, and smell. An individual in this position will be required to lift or carry weight in up to 50 lbs. Intermittent physical activity includes lifting and supporting residents. The associate must use proper body mechanics. Additional Information Benefits Offered (for Part-Time Employees): · Paid Time Off (PTO) and Holidays · Flexible Schedule · On the job training · Employee Assistance Program (EAP) · Free Parking Other Compensation Programs: · Employee Referral Bonus · Resident Referral Bonus Equal Opportunity Statement: Monarch Communities and Brandywine Senior Living is an Equal Opportunity Employer. We comply with all applicable federal, state, and local laws. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Job DescriptionDescription: Reporting to the Director of Nursing, the Registered Nurse (RN) is a licensed professional that utilizes specialized knowledge, judgment, and nursing skills in the care of patients and maintains standards of professional nursing practice in a clinical setting. The RN works in collaboration with the patient, family, physician/nurse practitioner and office staff within the team structure to ensure that patient-centered, cost effective, high quality care is provided. The incumbent has interest and experience in Community Health and plays an integral role in the care coordination and management of patients, supervises the clinical support staff at the site, and is a key member of the Care Team. This is a full-time professional position encompassing all nursing aspects of primary care services including services both in the clinic setting, in the mobile health van, and in the community Scroll down to find an indepth overview of this job, and what is expected of candidates Make an application by clicking on the Apply button. Essential Functions, Duties and Responsibilities Assist in the care of patients in collaboration with the Care Teams, providers, outreach team, and the clinical support staff. Engender communication and coordination of activities amongst all team members to achieve optimal patient care services and outcomes. When working in the clinic setting, perform triage in person or by telephone. Triage medical related calls during clinic sessions (i.e. inquiries from clients, pharmacies, etc.) according to policies and ambulatory care regulations. Assist with triage, translation, and determination of acute issues, transition of care processes, and other duties in the clinical setting. Document interventions and plans in electronic medical record. Triage patients who present for same-day care as needed. Responsible for implementation of policies and procedures with respect to all clinical conditions as per Zufall Health Center Policies and Procedures. Identify processes and assist in the development of new policies and procedures as needed. Oversee and assist in the implementation and documentation of laboratory services as per CLIA/CLIS regulations and procedures, including point of care and HIV testing. Act as NJIIS/VFC liaison for the site, mobile health van or outreach event and ensure that MA staff are entering and reconciling vaccines appropriately. Identify the need for and organize trainings as needed. Assist in the review of laboratory and diagnostic studies, flagging those that need immediate attention and working with the care team/provider to inform patients. Provide education and counseling for all aspects of primary care services, including vaccine information, procedure review, women's health and primary care counseling to clients according to medical standing orders and ZHC educational protocols. Assess and assist in coordination a response to community needs such as outbreak of illness, need for immunization, need for community education. Attend health fairs and other outreach events. Educate patients about what, why and how tests are being done. Instruct and assist patients with preparation for all procedures. Obtain informed consent for patients as needed. Assist providers with procedures as needed. Provide patient education as per grants and programs including but not limited to, VFC/317 vaccination program, Title X and Ending the Epidemic and according to established guidelines and protocols, and document in the EMR Conduct inventories and replenishments of medical and clinical supplies on Highland Health Van as needed and in a timely manner. Conduct periodic inventory of all medications on Highland's Health Van including refrigerated items. Conduct inventory and replenishment of educational materials and other clinical items on a regular basis. Facilitate patient appointments with appropriate providers, subspecialists, programs, services or organizations for the provision of initial and follow-up appointments as needed. Coordinate and document care among different providers and organizations. Provide Nurse Visits while following established standing orders and guidelines. Exercise good nursing judgment and knowledge per licensed scope of practice. Apply and maintain current knowledge of principles/protocols specific Zufall Health Center. Collect patient history and gather information pertinent to visit; document for communication to provider and to assist with evaluation. Give treatments/procedures, medications and injections as ordered. Following established protocols, assists providers in medication administration and refills. Assist providers with contacting patients to discuss results and additional procedures. Enter interventions and follow up plans in electronic medical record via telephone encounters. Assist patients with completion of medical and prescription forms and requests to other providers and agencies. Assist patients with applications for Charity Care at local hospitals, Medicaid, NJ Family Care and other benefits or insurances as appropriate. Act as advocate for patients and their families with community organizations and governmental agencies. Prepare reports for analysis and reporting as per grants and requirements of the center. Bring any barriers or process issues identified that are interfering with optimal patient care to the attention of the QA PI Team and the Director of Nursing. Participate in collaborative and performance improvement initiatives as directed by Director of Nursing and Chief Medical Officer. Maintain patient confidentiality at all times and as per regulations and health center policies. Perform other duties as assigned. Assume duties of Director of Nursing as assigned in the absence of the Director of Nursing. Requirements: Knowledge of nursing principles and practices Knowledge of primary care and women's health issues in an ambulatory care setting and reproductive health/family planning, contraceptives and other medications. Excellent knowledge of available community services and resources. Excellent communication, orally and written, and excellent team and interpersonal skills. Bilingual Spanish/English preferred. Ability to sensitively communicate well with patients regardless of education and cultural background Ability to interact and communicate well with outside providers and agencies. Ability to work independently with minimal supervision. Ability to follow up with all tasks efficiently, accurately and in a timely manner. Maintain high level of confidentially. Working knowledge of ZHC policies and procedures, and adoption of mission and values of ZHC. Efficient organizational skills. Education, Training and Experience Successful completion of an accredited nursing program, and a passing grade in the National Council Licensure Examination for Registered Nurses Have current and valid RN license from the state of New Jersey. Have current BLS certification. Minimum of one experience in an ambulatory care/community health center setting. Experience working with community services agencies. xevrcyc Knowledge of Microsoft Office, keyboarding, and experience in the use of electronic medical records.

**Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.** **_Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law._** **Hours: Monday - Friday 9:00am to 5:30pm EST and 1 late evening 11:30am to 8:00pm EST.** *******This position will service members in different states; therefore, Multi-State Licensure will be required.** **_This position requires an on-line pre-employment skills assessment. The assessment is free of charge and can be taken from any PC with Internet access. Candidates who meet the minimum requirements will be contacted via email with instructions. In order to move forward in the process, you must complete the assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically. **How you will make an impact:** + Ensures member access to services appropriate to their health needs. + Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment. + Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements. + Coordinates internal and external resources to meet identified needs. + Monitors and evaluates effectiveness of the care management plan and modifies as necessary. + Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans. + Negotiates rates of reimbursement, as applicable. + Assists in problem solving with providers, claims or service issues. + Assists with development of utilization/care management policies and procedures. **Minimum Requirements:** + Requires BA/BS in a health-related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. + Current, unrestricted RN license in applicable state required. + Multi-state licensure is required if this individual is providing services in multiple states. **Preferred Capabilities, Skills and Experiences:** + Case Management experience. + Certification as a Case Manager. + Minimum 2 years' experience in acute care setting. + Managed Care experience. + Ability to talk and type at the same time. + Demonstrate critical thinking skills when interacting with members. + Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly. + Ability to manage, review and respond to emails/instant messages in a timely fashion. For candidates working in person or virtually in the below locations, the salary* range for this specific position is $76,944 to $126,408. Locations: Colorado; New York; New Jersey 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. 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.