Utilization review nurse jobs in Tallahassee, FL - 37 jobs

GHR Healthcare is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Tallahassee, Florida. Job Description & Requirements Specialty: Labor and Delivery Discipline: RN 36 hours per week Shift: 12 hours Employment Type: Travel GHR Healthcare Job ID #. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. About GHR Healthcare For over 30 years, GHR Healthcare has been the bridge between healthcare professionals and the facilities that need them nationwide. We're committed to uncovering your ideal fit, supported by GHR's dedication to competitive compensation, transparent communication, and a devoted team that genuinely cares about your career journey. You can trust us to stand by your side as your advocate, confidante, and partner in advancing your career. At GHR, care and consideration are at the heart of everything we do. Visit ghrhealthcare.com to learn more.

MedPro Healthcare Staffing is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Tallahassee, Florida. Job Description & Requirements Specialty: Labor and Delivery Discipline: RN 36 hours per week Shift: 12 hours, days Employment Type: Travel MedPro Healthcare Staffing, a Joint Commission-certified staffing agency, is seeking a quality Labor & Delivery Registered Nurse for a travel assignment with one of our top healthcare clients. Requirements Active RN License Degree from accredited nursing program BLS, ACLS, NRP, PALS AWHONN Certifications Eighteen months of recent experience in an Acute Care Labor and Delivery (L&D) setting Other requirements to be determined by our client facility Benefits Weekly pay and direct deposit Full coverage of all credentialing fees Private housing or housing allowance Group Health insurance for you and your family Company-paid life and disability insurance Travel reimbursement 401(k) matching Unlimited Referral Bonuses up to $1,000 Duties Responsibilities Labor and Delivery Nurses (RN), also called perinatal nurses, provide care and support for women before, during and after delivery of the baby. They are responsible for making sure that the medical as well as the emotional needs of the patient are adequately met throughout the entire birthing process. Labor and Delivery (LD) nurses provide care to women and their newborns during the antepartum, intrapartum, postpartum and neonatal stages. Monitor vital signs of the mother and baby during birth. Monitor patients for potential high risk problems. Educate and support mothers and their families after giving birth. About Agency MedPro Healthcare Staffing is a Joint Commission certified provider of contract staffing services. Since 1983, we have placed nursing and allied travelers in top healthcare facilities nationwide. Join us today for your very own MedPro Experience. If qualified and interested, please call for immediate consideration. MedPro Staffing is an Equal Opportunity Employer. All applicants will be considered for employment without attention to race, color, religion, national origin, age, sex, disability, marital status or veteran status. Key Words: Registered Nurse, RN, Labor & Delivery, Contract Nurse, Travel Nurse, Agency RN, Travel RN, Nursing, Contract, L&D, Labor and Delivery, LD *Weekly payment estimates are intended for informational purposes only and include a gross estimate of hourly wages and reimbursements for meal, incidental, and housing expenses. Your recruiter will confirm your eligibility and provide additional details. MedPro Job ID #a0Fcx000008EkUbEAK. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Labor & Delivery Registered Nurse Nursing: Labor and Delivery. About MedPro Healthcare Staffing No One Cares More for Caregivers Than MedPro. Focus on your patients, we'll take care of the rest. MedPro Healthcare Staffing is a Joint Commission certified provider of temporary and contract staffing services. Since 1983, we have placed happy nursing and allied travelers in top healthcare facilities nationwide. You deserve a travel experience that's rewarding and memorable. One that allows you to DREAM big. EXPLORE often. And ACHIEVE greatness. The MedPro Experience delivers it! Access to nationwide travel assignments Weekly pay and direct deposit Full coverage of all credentialing fees Private housing or housing allowance Group Health insurance for you and your family Tax Free Per Diems, Housing Stipends and Travel Reimbursements Company-paid life and disability insurance Travel reimbursement Access to our Clinical Nurse Liaison Team 401(k) matching Unlimited Referral Bonuses starting at $500 Benefits Weekly pay Referral bonus Employee assistance programs

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

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Utilization Review Coordinator **PRIMARY PURPOSE** : To assign utilization review requests; to verify and enter data in appropriate system(s); and to provide general support to clinical staff in a team environment. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Accesses, triages and assigns cases for utilization review (UR). + Responds to telephone inquiries proving accurate information and triage as necessary. + Enters demographics and UR information into claims or clinical management system; maintains data integrity. + Obtains all necessary information required for UR processing from internal and external sources per policies and procedures. + Distributes incoming and outgoing correspondence, faxes and mail; uploads review documents into paperless system as necessary. + Supports other units as needed. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). **QUALIFICATIONS** **Education & Licensing** High School diploma or GED required. **Experience** Two (2) years of administrative experience or equivalent combination of experience and education required. Customer service in medical field preferred. Workers compensation, disability and/or liability claims processing experience preferred. **Skills & Knowledge** + Knowledge of medical and insurance terminology + Knowledge of ICD9 and CPT coding + Excellent oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Analytical and interpretive skills + Strong organizational skills + Detail Oriented + Good interpersonal skills + Ability to work in a team environment + Ability to meet or exceed Performance Competencies **WORK ENVIRONMENT** When applicable and appropriate, consideration will be given to reasonable accommodations. **Mental:** Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines **Physical:** Computer keyboarding, travel as required **Auditory/Visual:** Hearing, vision and talking The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

**Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed within the **RN/LVN/LPN** scope of practice, under the Medical Director's direction, using independent nursing judgement and decision-making, physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care across the continuum and working in concert with the health care delivery team to maintain high-quality, cost-effective care delivery. + Perform pre-certification utilization reviews of **Oncology treatment requests** + Determines medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all review rationales and determinations. + Appropriately identifies and refers cases that do not meet established clinical criteria to the Medical Director. + Appropriately identifies and refers quality issues to UM Leadership. + Collaborates with physicians and other providers to facilitate the provision of services throughout the health care continuum. + Performs accurate data entry. + Communicates appropriate information to other staff members as necessary/required. + Participates in continuing education initiatives. + Availability on some weekends and holidays may be required. + Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, unrestricted license. + High School Diploma or equivalent required + Minimum of three years of direct clinical patient care (acute, inpatient, or critical care setting); strongly prefer direct Oncology experience. + Strong computer skills, including MS Office Suite + Strong interpersonal, oral, and written communication skills. + Availability for weekend holiday rotation. **Finishing Touches (Preferred):** + Experience with clinical decision-making criteria sets (i.e., Milliman, InterQual) + Minimum of one year of experience with medical management activities in a managed care environment + UM/UR experience + Clinical experience in Oncology, ICU, ED, or other critical care environment + Remote work experience To ensure a secure hiring process we have implemented several identity verification steps, including submission of a government issued photo ID. We conduct identity verification during interviews, and final interviews may require onsite attendance. All candidates must complete a comprehensive background check, in-person I-9 verification, and may be subject to drug screening prior to employment. The use of artificial intelligence tools during interviews is prohibited and monitored. Misrepresentation will result in immediate disqualification from consideration. **Technical Requirements:** We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations. **Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.** **If you need reasonable accommodation to access the information provided on this website, please contact** ************************** **for further assistance.** The expected base salary/wage range for this position is $32-$37 /hr. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts. Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!

**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.

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

Job Description Job Title: Nurse Case Manager II - Transition OD Care Registered Nurse Candidate must reside in Orlando area and will service Orange, Osceola, Brevard, & Seminole Counties and be able to travel to facilities within the regions/neighboring counties. Hours required are M - F 8am - 5 pm EST with some flexibility for start/ stop times. Local travel up to 75%. Applies critical thinking, evidence-based clinical criteria to support contractual rebalancing goals. Complete at least 10 NF member assessments weekly Support the Health Plan Rebalancing Initiative goal of successful transitions: Assess, identify, screen and transition NH members into the community Follow up on CM referrals and visit current NH members in-person at least twice a week to complete the rebalancing events and screening assessments. Complete telephonic or in-person contact to assess the home prior to discharge and identify any environmental supports needed to support transition (i.e. ramp, DME installation etc.). Conduct an in-person Significant Change Visit with member and Rep if applicable, within 5 days of transition. Coordinate provision of services as needed, establish Plan of Care, and document all actions taken. Contact facilitys Business Office once a week to follow-up on mbrs census and will coordinate with Social Services and CM to facilitate discharge. Work collaboratively with case managers to identify high risk community members and implement appropriate interventions to prevent lapse or coordinate safe transition (Upon receiving referral) Drive enhanced value of health care to increase member satisfaction and retention, and drive new membership growth. Be involved in at least two community relations event per year Engage in building strong relationships that contribute towards member satisfaction and retention Experience Experience Needed: Candidate must reside in FL and area of coverage.- Minimum 2 years of clinical experience- Bi-Lingual Spanish/ English required.-Willing and able to travel 75% of their time to meet members face to face _______ and surrounding counties/areas. Preferred Skills: Managed Care experience-Discharge coordination experience-Transition of care experience-Home Health experience- Case Management experience-- Position requires proficiency with computer skills which includes navigating multiple systems- Ability to work in a fast-paced environment Experience Level: Specify the level of experience required mid-level Position Summary The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individuals benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. Requires an RN with unrestricted active license Education Education/Licensure: Active, unrestricted and good standing RN license in the state of Florida. Education: Associate Degree Required and BSN preferred. What days & hours will the person work in this position List training hours, if different. M-F 8-5

Corrections professionals who foster a humane and secure environment and ensure public safety by preparing individuals for successful reentry into our communities. Corrections professionals who foster a humane and secure environment and ensure public safety by preparing individuals for successful reentry into our communities. Overview Help Accepting applications Open & closing dates 10/01/2025 to 09/30/2026 Salary $50,241 to - $114,573 per year Pay scale & grade GL 05 - 10 Locations Many vacancies in the following locations: Aliceville, AL Maxwell AFB, AL Talladega, AL Forrest City, AR Show morefewer locations (90) Phoenix, AZ Safford, AZ Tucson, AZ Atwater, CA Herlong Sierra Ordnance Depot, CA Lompoc, CA Los Angeles, CA Mendota, CA San Diego, CA Victorville, CA Florence, CO Littleton, CO Danbury, CT Coleman, FL Marianna, FL Miami, FL Miami-Dade County, FL Tallahassee, FL Atlanta, GA Jesup, GA Honolulu, HI Chicago, IL Greenville, IL Marion, IL Pekin, IL Thomson, IL Terre Haute, IN Leavenworth, KS Ashland, KY Inez, KY Lexington, KY Manchester, KY Pine Knot, KY Oakdale, LA Pollock, LA Fort Devens, MA Cumberland, MD Milan, MI Duluth, MN Rochester, MN Sandstone, MN Waseca, MN Springfield, MO Yazoo City, MS Butner Federal Correctional Complex, NC Berlin, NH Fairton, NJ Fort Dix, NJ Kings, NY Otisville, NY Ray Brook, NY Elkton, OH El Reno, OK Oklahoma City, OK Sheridan, OR Gregg Township, PA Kelly Township, PA Lewis Run, PA Loretto, PA Minersville, PA Philadelphia, PA Waymart, PA Guaynabo, PR Bennettsville, SC Edgefield, SC Estill, SC Salters, SC Yankton, SD Memphis, TN Bastrop, TX Beaumont, TX Big Spring, TX Bryan, TX Federal Medical Center Carswell, TX Fort Worth, TX Houston, TX La Tuna, TX Seagoville, TX Texarkana, TX Three Rivers, TX Jonesville, VA Prince George, VA Seatac, WA Grand Marsh, WI Alderson, WV Beaver, WV Bruceton Mills, WV Glenville, WV Morgantown, WV Welch, WV Remote job No Telework eligible No Travel Required Occasional travel - Travel may be required for training and/or work related issues. Relocation expenses reimbursed No Appointment type Permanent Work schedule Full-time - Registered Nurse Accelerated Promotion Program covers the 0610 series ranging from GL-05 through GL-10 grade levels. If eligible, this enables a Registered Nurse to promote up to twice at an accelerated pace through a training program. Service Competitive Promotion potential 10 - Grade 10 - Registered Nurse Accelerated Promotion Program covers the 0610 series ranging from GL-05 through GL-10 grade levels. If eligible, this enables a Registered Nurse to promote up to twice at an accelerated pace through a training program. Job family (Series) * 0610 Nurse Supervisory status No Security clearance Other Drug test Yes Bargaining unit status No Announcement number DHA-2026-0002 Control number 847130700 This job is open to Help The public U.S. Citizens, Nationals or those who owe allegiance to the U.S. Career transition (CTAP, ICTAP, RPL) Federal employees whose job, agency or department was eliminated and are eligible for priority over other applicants. Clarification from the agency This is a public notice under the Direct Hiring Authority open to all U.S. citizens. Please review instructions in the "

Job Title: Wellness Nurse Supervisor: Health Services Director FLSA Status: Hourly, non-exempt Date Approved: September 2025 OVERALL JOB PURPOSE The overall purpose of the Wellness Nurse position is to provide Person-Centered Care consistent with accepted standards and expectations of Sunshine Retirement Living and state regulations. The Wellness Nurse's responsibilities include, but are not limited to, monitoring resident health status, providing physical care, and early diagnosis and intervention of resident changes in health status. Wellness Nurses must communicate politely and effectively with family, primary physicians, and perform all administrative charting or other services as required by regulations and company policy. In assisted living and memory care, the Wellness Nurse ensures care practices that promote safety, dignity, and engagement for residents with cognitive impairment, while serving as a clinical resource and role model for caregiving staff. MINIMUM JOB QUALIFICATIONS AND REQUIREMENTS A current, valid LPN or RN license is required Education and/or experience in long-term care, acute care, or geriatric nursing preferred Supervisory experience preferred Ability to read, write, and speak the English language and to verbally communicate with different levels of staff, families, and any outside customers in a professional and polite manner No disqualifying criminal or care offenses as defined by regulatory guidelines Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations Ability to work under time constraints and meet deadlines Maintain a positive and respectful approach with coworkers. Ability to work in a team setting and be a team player Ability to write nursing/patient progress notes and nursing procedures Ability to effectively present information and respond to questions from department heads and customers (patients, family members, physicians, etc.) in a polite and professional manner Knowledge of dementia care practices or willingness to complete memory care training Satisfactorily pass Sunshine's and state-regulated criminal record clearance, health screening and TB clearance (if applicable) ESSENTIAL JOB DUTIES AND RESPONSIBILITIES Values and upholds the Sunshine Retirement Living Principles and Values, including compassion, responsiveness, teamwork, courtesy, and personalized care Dedicated to delivering a high level of customer service Provides resident care in accordance with accepted standards of practice and within the scope of the LPN or RN license Routinely observes and reports on residents' conditions/changes and then documents in accordance with community policies and as required by regulations Administers medication/treatment as prescribed within the LPN or RN scope of practice Receives, transcribes, and executes physician orders Implements and evaluates resident's plan of care Identifies and secures equipment and supplies. Notifies supervisor when supplies are needed Ensures appropriate and timely response to resident and/or family concerns Responsible for the safety of residents under your supervision Informs appropriate staff about the condition of residents and expectations/needs for the shift assigned at the beginning of each shift and receives report from coworkers throughout and at the end of each shift regarding resident conditions Directs Caregivers to assure care is provided per standards of practice and per community policies and regulations Rounds with Caregiver before end of shift to assure the unit is in proper order Provides guidance and coaching to care staff in managing residents with memory loss, including behavioral interventions, redirection, and validation techniques Ensures proper documentation of care, medications, incidents, and changes in condition using electronic health records Performs other duties as assigned OTHER JOB DUTIES AND RESPONSIBILITIES Adhere to the Resident Rights and promote safety, dignity, and respect among all residents Ensure the safety of residents through appropriate behavioral interventions Promotes employee relations, facilitates communication and problem solving Ensures that community staff follow facility policies and procedures Coaches, mentors, and counsels resident care staff as needed and keeps Health Services Director/Coordinator informed of any concerns Ensures appropriate and timely response to customer service concerns Demonstrates knowledge of resident care and its impact on residents and families Assists resident care staff in performing duties as needed Assists with immediate incident reporting and analysis of incidents and corrective action, when appropriate Maintains confidentiality of community and resident information Attend community meetings and in-service training as required Know the emergency plan, fire evacuation routes, extinguishers, and other facility safety features Cart and chart audits as scheduled Clinical Evaluation Skills Create monthly resident lists for Home Health, Hospice, and Oxygen Ability to work with 911 and attend to emergency calls Ability to work/run a medication cart Report to work on time as scheduled and consistently demonstrate dependability and punctuality. Consistent and regular attendance is required Accept assigned duties in a cooperative manner Complete all other duties assigned by the Health Services Director and/or Executive Director Maintains certifications as necessary such as First Aid, to fulfill state regulations (if applicable) This position has supervisory responsibilities of the care staff Perform all work assigned for the agreed-upon salary, accepting no additional payment or non- perishable gifts from residents, vendors, Community Management, or others Meet the assigned work requirements of the job. Regular attendance is required Serve as a role model for all employees by displaying a responsible, cooperative, and positive attitude Represent the Community in a professional, courteous, and friendly manner Adhere to dress/appearance code. Changes in attire may be dictated by special occasion or weather conditions. If you have questions, check with your supervisor Participate in family communication and care plan meetings as directed by Health Services Director or Health Services Coordinator Adhere to and follow company policies, procedures, and standards Equal Employment Opportunity Statement: Sunshine Retirement Living (The Company) proudly provides equal employment opportunities to all employees and applicants. We celebrate diversity and are committed to creating an inclusive environment where residents, employees, and families feel respected and valued, regardless of race, color, religion, sex, national origin, age, disability, or any other protected status. Salary-History Statement: Sunshine Retirement Living (The Company) is committed to fair and equitable pay practices. We do not request or consider an applicant's past or current salary when making compensation decisions, in compliance with applicable salary history and pay equity laws. PHYSICAL REQUIREMENTS Physical Demands and Work Environment The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 20% or less 20% to 40% 40% to 60% 60% to 80% 80% to 100% Stand X Walk X Sit X Pushing, pulling and/or reaching X Grasping and fine manipulation X Climb or balance X Stoop, kneel, crouch, or crawl X Talk or hear X Taste or smell X Lifts Weight or Exerts Force 20% or less 20% to 40% 40% to 60% 60% to 80% 80% to 100% Up to 10 pounds X Up to 25 pounds X Up to 50 pounds X Up to 100 pounds X More than 100 pounds X The Community reserves the right to revise the duties set forth in this job description at its discretion.

Excel is seeking highly skilled healthcare professionals for travel assignments across the United States. As a Travel Healthcare Professional, you will have the opportunity to work in diverse healthcare settings, providing essential medical care while exploring new locations and cultures. Key Responsibilities: • Provide direct patient care in accordance with healthcare facility policies and procedures. • Collaborate with interdisciplinary teams to ensure comprehensive patient care. • Maintain accurate patient medical records and documentation. • Adhere to infection control standards and other regulatory requirements. • Educate patients and their families on healthcare plans and treatments. Qualifications: • Active state licensure in [specify relevant states] (e.g., RN, LPN, PT, OT). • Minimum [number] years of experience in [specialty]. • BLS/CPR certification (ACLS, PALS, or others as required by specialty). • Excellent communication and interpersonal skills. • Ability to adapt to different environments and work independently. Why Choose Excel Medical Staffing: • Trusted partner with a proven track record in healthcare staffing. • Competitive compensation package including hourly wages and stipends. • Access to a wide range of healthcare facilities and specialties. • Personalized support throughout your assignment. • Opportunity to enhance your skills and build a diverse professional portfolio.

PMHNP job description, consisting of key duties and responsibilities they are mostly required to carry out. Responsible for providing outpatient and residential care to patients showing a change or decline in mental status, chronic or urgent medical conditions Work independently with other members of the medical team, with entitlements to specific clinical privileges approved by the clinic's Medical Executive Board Take part in an interdisciplinary team that provides primary care to employees and patients Perform patients histories and physicals, risk factor assessment, ordering of therapeutic and diagnostic tests; and attend to consultations and appointments Prescribe medications following the clinic's policy, formulary and relevant regulations of the State Consult with physicians on cases that are beyond the scope of qualification of PMHNP Put all relevant patient data in medical records and case presentations Formulate, execute and review healthcare education delivered to patients and families for diseases prevention Ensure smooth communication with other health professionals for effective delivering of clinic service to patients Provide consultation to the clinic's nursing and medical staff for improvement in their work performance, which enhances overall quality service delivery of the clinic The following are some of the key qualities and qualifications commonly required to work as a PMHNP at Florida First Psychiatry Specialist, LLC Proficient in the English language, both in writing and speaking to be able to communicate clearly with all stakeholders, including patients, families, clinic staff and other healthcare professionals Possess and maintain graduate professional nurse, and nurse practitioner registration in a state, which must be unrestricted, current, complete, and active Obtain Psychiatric Nurse Practitioner or Mental Health Nurse Practitioner certification from the American Nurses Credentialing Center (ANCC) Possess Bachelor's degree in Nursing followed by a Master's degree in Psychiatric or Mental Health Nursing from a state approved and accredited school for professional nursing training Possess strong understanding of societies and their impact on mental health; ability to solve problems, monitor and examine patients Be compassionate, sensitive, and possess strong reasoning and thinking skills Possess strong computer skills, including working with word processing and data entering applications, as well as with medical software applications Florida First Psychiatry Specialist Licensed Psychiatry Practice A licensed psychiatry practice, Florida First Psychiatry Specialist is dedicated to helping individuals live vital and fulfilling lives, no matter what challenges life springs on them and their loved ones. Working strategically with patients, Dr. Prasanti Tatini and her team of certified psychiatric practitioners will identify unique strategies to produce superior results so that they can move toward a more rewarding life.

DESCRIPTION Job Title: Wellness Nurse Supervisor: Health Services Director FLSA Status: Hourly, non-exempt Date Approved: September 2025 OVERALL JOB PURPOSE The overall purpose of the Wellness Nurse position is to provide Person-Centered Care consistent with accepted standards and expectations of Sunshine Retirement Living and state regulations. The Wellness Nurse's responsibilities include, but are not limited to, monitoring resident health status, providing physical care, and early diagnosis and intervention of resident changes in health status. Wellness Nurses must communicate politely and effectively with family, primary physicians, and perform all administrative charting or other services as required by regulations and company policy. In assisted living and memory care, the Wellness Nurse ensures care practices that promote safety, dignity, and engagement for residents with cognitive impairment, while serving as a clinical resource and role model for caregiving staff. MINIMUM JOB QUALIFICATIONS AND REQUIREMENTS A current, valid LPN or RN license is required Education and/or experience in long-term care, acute care, or geriatric nursing preferred Supervisory experience preferred Ability to read, write, and speak the English language and to verbally communicate with different levels of staff, families, and any outside customers in a professional and polite manner No disqualifying criminal or care offenses as defined by regulatory guidelines Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations Ability to work under time constraints and meet deadlines Maintain a positive and respectful approach with coworkers. Ability to work in a team setting and be a team player Ability to write nursing/patient progress notes and nursing procedures Ability to effectively present information and respond to questions from department heads and customers (patients, family members, physicians, etc.) in a polite and professional manner Knowledge of dementia care practices or willingness to complete memory care training Satisfactorily pass Sunshine's and state-regulated criminal record clearance, health screening and TB clearance (if applicable) ESSENTIAL JOB DUTIES AND RESPONSIBILITIES Values and upholds the Sunshine Retirement Living Principles and Values, including compassion, responsiveness, teamwork, courtesy, and personalized care Dedicated to delivering a high level of customer service Provides resident care in accordance with accepted standards of practice and within the scope of the LPN or RN license Routinely observes and reports on residents' conditions/changes and then documents in accordance with community policies and as required by regulations Administers medication/treatment as prescribed within the LPN or RN scope of practice Receives, transcribes, and executes physician orders Implements and evaluates resident's plan of care Identifies and secures equipment and supplies. Notifies supervisor when supplies are needed Ensures appropriate and timely response to resident and/or family concerns Responsible for the safety of residents under your supervision Informs appropriate staff about the condition of residents and expectations/needs for the shift assigned at the beginning of each shift and receives report from coworkers throughout and at the end of each shift regarding resident conditions Directs Caregivers to assure care is provided per standards of practice and per community policies and regulations Rounds with Caregiver before end of shift to assure the unit is in proper order Provides guidance and coaching to care staff in managing residents with memory loss, including behavioral interventions, redirection, and validation techniques Ensures proper documentation of care, medications, incidents, and changes in condition using electronic health records Performs other duties as assigned OTHER JOB DUTIES AND RESPONSIBILITIES Adhere to the Resident Rights and promote safety, dignity, and respect among all residents Ensure the safety of residents through appropriate behavioral interventions Promotes employee relations, facilitates communication and problem solving Ensures that community staff follow facility policies and procedures Coaches, mentors, and counsels resident care staff as needed and keeps Health Services Director/Coordinator informed of any concerns Ensures appropriate and timely response to customer service concerns Demonstrates knowledge of resident care and its impact on residents and families Assists resident care staff in performing duties as needed Assists with immediate incident reporting and analysis of incidents and corrective action, when appropriate Maintains confidentiality of community and resident information Attend community meetings and in-service training as required Know the emergency plan, fire evacuation routes, extinguishers, and other facility safety features Cart and chart audits as scheduled Clinical Evaluation Skills Create monthly resident lists for Home Health, Hospice, and Oxygen Ability to work with 911 and attend to emergency calls Ability to work/run a medication cart Report to work on time as scheduled and consistently demonstrate dependability and punctuality. Consistent and regular attendance is required Accept assigned duties in a cooperative manner Complete all other duties assigned by the Health Services Director and/or Executive Director Maintains certifications as necessary such as First Aid, to fulfill state regulations (if applicable) This position has supervisory responsibilities of the care staff Perform all work assigned for the agreed-upon salary, accepting no additional payment or non- perishable gifts from residents, vendors, Community Management, or others Meet the assigned work requirements of the job. Regular attendance is required Serve as a role model for all employees by displaying a responsible, cooperative, and positive attitude Represent the Community in a professional, courteous, and friendly manner Adhere to dress/appearance code. Changes in attire may be dictated by special occasion or weather conditions. If you have questions, check with your supervisor Participate in family communication and care plan meetings as directed by Health Services Director or Health Services Coordinator Adhere to and follow company policies, procedures, and standards Equal Employment Opportunity Statement: Sunshine Retirement Living (The Company) proudly provides equal employment opportunities to all employees and applicants. We celebrate diversity and are committed to creating an inclusive environment where residents, employees, and families feel respected and valued, regardless of race, color, religion, sex, national origin, age, disability, or any other protected status. Salary-History Statement: Sunshine Retirement Living (The Company) is committed to fair and equitable pay practices. We do not request or consider an applicant's past or current salary when making compensation decisions, in compliance with applicable salary history and pay equity laws. PHYSICAL REQUIREMENTS Physical Demands and Work Environment The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 20% or less 20% to 40% 40% to 60% 60% to 80% 80% to 100% Stand X Walk X Sit X Pushing, pulling and/or reaching X Grasping and fine manipulation X Climb or balance X Stoop, kneel, crouch, or crawl X Talk or hear X Taste or smell X Lifts Weight or Exerts Force 20% or less 20% to 40% 40% to 60% 60% to 80% 80% to 100% Up to 10 pounds X Up to 25 pounds X Up to 50 pounds X Up to 100 pounds X More than 100 pounds X The Community reserves the right to revise the duties set forth in this job description at its discretion.

Are you ready to take your Travel career to the next level? See places you have not seen before? Ventura's MedStaff tenured Recruiters are here to help you find your ideal contract; with over 50 years of combined experience. Markets have changed, but Ventura MedStaff has maintained a leader in the forefront of Therapy, Allied and Nursing opportunities. Our recruiters are here to help answer your questions and provide you with the most up to date information. Contracts run 8-13 weeks, with 36-40-hour guarantees, flexible start dates, and a mix of schedules. Contact one of our dedicated Recruiters to discuss more details. Ventura MedStaff benefits represent the care and compassion we provide for our clients. • Health, dental, vision, life, disability benefits and 401k • Tax free stipends when applicable • Gym discounts • Weekly pay • $750.00 referral bonus Please apply or contract us at: *********************** or ************

Are you ready to take your Travel career to the next level? See places you have not seen before? Ventura's MedStaff tenured Recruiters are here to help you find your ideal contract; with over 50 years of combined experience. Markets have changed, but Ventura MedStaff has maintained a leader in the forefront of Therapy, Allied and Nursing opportunities. Our recruiters are here to help answer your questions and provide you with the most up to date information. Contracts run 8-13 weeks, with 36-40-hour guarantees, flexible start dates, and a mix of schedules. Contact one of our dedicated Recruiters to discuss more details. Ventura MedStaff benefits represent the care and compassion we provide for our clients. • Health, dental, vision, life, disability benefits and 401k • Tax free stipends when applicable • Gym discounts • Weekly pay • $750.00 referral bonus Please apply or contract us at: *********************** or ************

**Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services, discharges and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action at an on-site facility. This position will have a limited hybrid with some hours working at home at leader discretion. Candidate must be local, within about a 30-minute driving distance to HCA St. Lucie Medical Center, in Palm Beach County, from home base. The Utilization Management Nurse 2 is an Onsite Nurse located at HCA St. Lucie Medical Center who uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for our Medicare members. + Coordinate and communicate with providers, members, case managers PCP or other parties to facilitate appropriate discharge planning, assist with social determinants and closing gaps to facilitate optimal care and treatment. + Identify barriers to discharge and avoidable readmissions + Understands department, segment, and organizational strategy and operating objectives, including how they interrelate to each area + Works independently, makes appropriate decisions, requires minimal direction and seeks guidance where needed + Evaluate and refer to other programs available to Member + Follows established guidelines/procedures **** This is an Onsite / Hybrid position at HCA St. Lucie Medical Center, located in St. Lucie, Florida. The ideal candidate must be located no more than a 30-minutes driving distance to the Onsite location from their home base.** **This position will work at an Onsite facility and as a Hybrid, will have limited working hours at home based on the leader's discretion. **** **Use your skills to make an impact** **Required Qualifications** + RN License without restrictions in the state of Florida + Must be located no more than 30-minutes driving distance to HCA St. Lucie Medical Center from home base + 2 or more years of clinical experience preferably in an adult/geriatric acute care, skilled or rehabilitation clinical setting + Comprehensive knowledge of Microsoft Word, Outlook and Excel + Ability to work independently under general instructions and with a team. + Independent critical thinking skills + Strong written and verbal communication skills + Valid Driver's License and/or dependable transportation necessary + Travel to Hospital/Provider for onsite reviews to assist Members + This role is considered patient facing. If selected for this role, you will be required to meet criteria to be onsite with Providers/Hospitals/Health Care Facilities + This hybrid position will have limited hours working at home at the leader's discretion + This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB **Preferred Qualifications** + Bachelor's degree in nursing (BSN) + Previous experience in discharge planning, utilization management or case management a plus + Health Plan experience + Previous Medicare/Geriatric Experience a plus + Bilingual is a plus **Work-At-Home Requirements** To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested + Satellite, cellular and microwave connection can be used only if approved by leadership + Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense + Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information **Additional Information** **Scheduled Weekly Hours** + Full time position 40 hour work week + Must be able to work 8:30 am-5pm EST Monday-Friday Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

**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. 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._** **Work Schedule:** Monday to Friday, 9:30 AM - 6:00 PM CST/PST. A proud member of the Elevance Health family of companies, **Carelon Medical Benefits Management** , formerly AIM Specialty Health, is a benefit-management leader in Illinois. Our platform delivers significant cost-of-care savings across an expanding set of clinical domains, including radiology, cardiology and oncology. The **Nurse Reviewer I** is 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 requests to assess 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. + Ensure proper documentation, provider communication, and telephone service per department standards and performance metrics. **Minimum Requirements:** + Requires 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. + A current unrestricted RN license in applicable state(s) required. **Preferred Experience, Skills, and Capabilities:** + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed health care including HMO,PPOand POS plans strongly preferred. + BA/BS degree preferred. + Previous utilization and/or quality management and/or call center experience preferred. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $33.12 to $ 54.41. Locations: Illinois; Nevada 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.

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve. Newsweek Recognizes Sedgwick as America's Greatest Workplaces National Top Companies Certified as a Great Place to Work Fortune Best Workplaces in Financial Services & Insurance Utilization Review Coordinator **PRIMARY PURPOSE** : To assign utilization review requests; to verify and enter data in appropriate system(s); and to provide general support to clinical staff in a team environment. **ARE YOU AN IDEAL CANDIDATE?** We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Accesses, triages and assigns cases for utilization review (UR). + Responds to telephone inquiries proving accurate information and triage as necessary. + Enters demographics and UR information into claims or clinical management system; maintains data integrity. + Obtains all necessary information required for UR processing from internal and external sources per policies and procedures. + Distributes incoming and outgoing correspondence, faxes and mail; uploads review documents into paperless system as necessary. + Supports other units as needed. **ADDITIONAL FUNCTIONS and RESPONSIBILITIES** + Performs other duties as assigned. + Supports the organization's quality program(s). **QUALIFICATIONS** **Education & Licensing** High School diploma or GED required. **Experience** Two (2) years of administrative experience or equivalent combination of experience and education required. Customer service in medical field preferred. Workers compensation, disability and/or liability claims processing experience preferred. **Skills & Knowledge** + Knowledge of medical and insurance terminology + Knowledge of ICD9 and CPT coding + Excellent oral and written communication, including presentation skills + PC literate, including Microsoft Office products + Analytical and interpretive skills + Strong organizational skills + Detail Oriented + Good interpersonal skills + Ability to work in a team environment + Ability to meet or exceed Performance Competencies **WORK ENVIRONMENT** When applicable and appropriate, consideration will be given to reasonable accommodations. **TAKING CARE OF YOU BY** + We offer a diverse and comprehensive benefits package including: + Three Medical, and two dental plans to choose from. + Tuition reimbursement eligible. + 401K plan that matches 50% on every $ you put in up to the first 6% you save. + 4 weeks PTO your first full year. **NEXT STEPS** If your application is selected to advance to the next round, a recruiter will be in touch. _As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $18-20.00/hr. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits._ The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. **If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape. For more, see** **sedgwick.com**

Travel Medsurg RN is needed for 13 weeks to start ASAP in a facility in Georgia. GA or compact license is required. ACLS and BLS certifications are required. COVID FLOOR. Required Skills: Telemetry, IV Start Minimum. One year recent Medsurg experience. Previous travel experience preferred. EMR is Cerner & Soarian. Minimal to no RTO (must be included on submission). To speak with a recruiter please call Ventura Medstaff today at **************.