Utilization review nurse jobs in Town North Country, FL - 137 jobs

One organization. Countless opportunities. At Johns Hopkins All Children's Hospital, we provide expert pediatric care for infants, children and teens with some of the most challenging medical problems. We are committed to providing family-centered care. Taking part in pediatric medical education and clinical research helps us to provide high quality care in more than 50 pediatric specialties and subspecialties. We are seeking a physician assistant (PA) or pediatric acute care nurse practitioner (PNP-AC) committed to caring for pediatric patients with complex cardiac diagnoses. The critical care team in the Cardiovascular Intensive Care Unit (CVICU) cares for neonates, infants, children, and young adults with congenital and acquired heart disease who need intensive medical and surgical management. APPs are an invaluable part of the team in this high-acuity and fast-paced environment in the Heart Institute at Johns Hopkins All Children's Hospital. Passion for learning, critical thinking, and caring for cardiac patients and their families are highly encouraged for success in this role. Responsibilities: Assess, diagnose, and treat pediatric cardiac patients in the CVICU. Conduct comprehensive physical exams, order and interpret diagnostic tests, and formulate evidence-based treatment plans. Recommend pharmacologic and non-pharmacologic therapies, monitor patient responses, and respond appropriately. Provide family-centered care by communicating with patients' families, addressing their concerns, and involving them in the decision-making process. Collaborate with a multidisciplinary team including Cardiology, Cardiovascular Surgery, and many other specialties. Participate in medical rounds, simulations, and educational activities to enhance team knowledge and clinical practice. Contribute to quality improvement initiatives and research projects to advance pediatric cardiac critical care practices. Qualifications: Pediatric Acute Care Nurse Practitioner (PNP-AC) or Physician Assistant (PA) certification and licensure in the state of Florida. Master's degree in Nursing (PNP-AC) or Physician Assistant Studies (PA) from an accredited program. Prior experience in pediatrics, cardiology, and/or critical care fields are preferred but not required. Excellent clinical judgment, critical thinking, and problem-solving skills. Strong communication and interpersonal skills, with the ability to collaborate effectively within a multidisciplinary team. Dedication to providing compassionate and family-centered care to pediatric cardiac patients. Commitment to ongoing professional development and continuous learning. If you are a motivated and compassionate Pediatric Acute Care Nurse Practitioner (PNP-AC) or Physician Assistant (PA) seeking a rewarding career in pediatric cardiac critical care, we encourage you to apply! Join us in our mission to improve the health and well-being of children with congenital and acquired heart disease. What Awaits you? Diverse and collaborative environment Career Growth and development Affordable and comprehensive benefits package. Flexible spending Accounts. Paid Time Off (PTO) 403(b) Savings plan with matching Free Parking Tuition Reimbursement Dependent Child Tuition Relocation Salary Range: Minimum 52.02/hour - Maximum 80.63/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority. We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices. Johns Hopkins Health System and its affiliates are drug-free workplace employers.

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career! Job Description Are you an experienced LPN looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions - this is the position for you! Daily Responsibilities: The Utilization Review LPN is responsible for the pre-certification of determined procedures utilizing the organizations Plan approved criteria. The position helps manage healthcare costs by influencing patient care decision making through case-by-case assessments of the care prior to it's delivery. ESSENTIAL DUTIES AND RESPONSIBILITIES: Evaluates requested services following Plan approved criteria. Demonstrates effective communication methods and skills, using lines of authority appropriately. Establishes a relationship with providers in order to determine/provide needed services for members Arranges discharge planning services prior to pre-planned admissions when available. Acts as liaison and member advocate between the member/family, physician and facilities/agencies. Maintains accurate record of pre-certification decisions. Performs decisions within time frames required by regulatory agencies. Adheres to quality standards and confidentiality policies and procedures. Ensures compliance with all state and federal regulations and guidelines in day-to-day activities. Adapts to changes in policies, procedures, new techniques and additional responsibilities. Qualifications Active FL LPN license with a minimum of 2 years varied clinical experience required. Managed Care experience (utilization review, pre-certification, concurrent review) is preferred. Proficiency in MS Office with basic computer and typing skills. Additional Information Advantages of this Opportunity: • Competitive salary $19 - $26/hr+ (based off experience) • Excellent Medical Benefits Offered • Growth potential • Fun and positive work environment If you are interested in applying to this position please call Jonathan Comstock at (407) 478-0332 Ext. 133

Nurse Reviewer PT (20-30 hours week) - Remote Work Environment Non-Exempt: $40.00 hour Supports Medical Review Services. The Nurse Reviewer plays a critical role in supporting the Medical Review Services department by performing comprehensive medical necessity reviews and policy reviews for Medicaid claims. This involves meticulous examination of claims and medical records to ensure compliance with established guidelines and regulations. The RN will work closely with the Team Lead, Physician Peer Reviewer and contract team. Reviews must be completed timely. Essential Duties and Responsibilities: Conduct comprehensive medical record reviews to assess medical necessity and compliance with established standards of care and applicable policies Manage end-to-end case screening processes, ensuring all activities are completed within established deadlines Document evidence-based criteria applicable to specific contract requirements Record and report screening results, including relevant referral questions, into a centralized database Evaluate medical claims against industry standards, utilizing research of relevant ICD-10, CPT, and HCPCS codes to determine medical necessity Maintain expert knowledge of evolving multi-state Medicaid policies and vendor expectations Participate in ongoing training and consistently meet or exceed productivity and quality assurance standards Knowledge, Experience, Skills and Education: Medical terminology, ICD-10, CPT and HCPCS Clinical criteria (InterQual and MCG) Utilization/Medical record review and chart abstraction Current standards of medical practice Comply with HIPAA/HITECH laws and regulations Experience in: At least three- five years performing medical record review and/or abstraction (Utilization Review experience preferred) Experience performing medical record review, audit for federal or state contracts Knowledge and experience of Medicare and Medicaid policy Proficiency with Microsoft Office (Word, Excel, and Outlook) Proficiency with Adobe PDF files and features Generating accurate, timely, and understandable correspondence Current experience (within the last 3 years) in the application of clinical screening criteria (InterQual and MCG) Skills Requirements include: Professional interpersonal skills; ability to interact with providers, physicians and peers Solid analytical, assessment and documentation skills Effective written and verbal communication, both internally and externally Strong attention to detail Strong attention to deadlines Organizational skills including effective time management, priority setting and process improvement Ability to work independently and as a member of a team Adapt to changing work situations and readily adjusts schedules, tasks and priorities when necessary to meet business fluctuations Educational Background: BSN with active RN licensure in good standing Physical Demands: Remote Work, Prolonged Sitting, Screen Exposure This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice. Healthcare Quality Strategies, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This position qualifies for the following Company benefits: Medical/Dental/Vision, FSA and HSA, group life/AD&D, voluntary life/AD&D, 401k For immediate consideration, please apply via the HQSI Careers Page at: ************ > Careers > Current Employment Opportunities EOE: Minorities/Females/Disabled/Veterans Healthcare Quality Strategies, Inc. is Equal Opportunity, Affirmative Action Employer and an Alcohol/Drug Free Workplace Healthcare Quality Strategies, Inc. is an E-Verify Employer

Nurse Case Manager I Hours: 9am-530pm with 2-3 late evenings a month 1130am-8pm 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. The Nurse Case Manager I 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 or on-site such as at hospitals for discharge planning 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 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. * Current, unrestricted RN license in applicable state(s) required. * Multi-state licensure is required if this individual is providing services in multiple states. Preferred Skills, Capabilities and Experiences: * Certification as a Case Manager is preferred. * BS in a health or human services related field preferred For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $68,880- $103,320 Locations: New York In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law Job Level: Non-Management Exempt Workshift: Job Family: MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Working Title: REGISTERED NURSING CONSULTANT - 50000327 Pay Plan: Career Service 50000327 Salary: $66,686.87 Total Compensation Estimator Tool Requisition # 867418 REGISTERED NURSE CONSULTANT FLORIDA DEPARTMENT OF VETERANS' AFFAIRS Mary Grizzle Office building Homes Program Largo, Pinellas County Starting Salary : $66,686.87 Paid Bi Weekly Excellent retirement package and optional deferred compensation plan. Health, vision, dental, disability, and other supplemental insurance available at reasonable premium rates. Paid vacation and sick leave. Nine (9) paid holidays and personal day. Tuition waiver available for State Universities and Community Colleges (up to 6 credits per semester). Education and employment history must be verifiable. Please attach any credentials you claim (degrees, certifications, etc.) to your application. MINIMUM QUALIFICATIONS: * Must be willing to obtain MDS Certification within first year of employment. * Must possess a current Florida licensure as a Registered Professional Nurse. * Must possess a Bachelor's degree from an accredited college or university with a major in nursing or a related field and two (2) years of nursing experience - OR - have six (6) years of professional nursing experience - OR - possess an Associate's degree and have four (4) years of professional nursing experience. * Availability to travel 75% includes overnight required. * Successful completion of the due diligence process to include, but not limited to, a Level II Background check and drug screen. PREFERRED QUALIFICATIONS: * At least one (1) year of experience working in a long-term care facility with a geriatric population. * Proficiency with Microsoft Office Suite, especially Outlook, Word, and Excel. * Basic experience and familiarity with MDS and Care Plans. * Infection Control Preventionist Certification. Position Description: Serve as a liaison between nursing staff and executive leadership of the FDVA Homes Program. Ensure safe, effective, and evidence-based nursing care. Monitor resident outcomes and quality measures. Coordinates and oversees all functions of the FDVA Homes Program's MDS Assessment process to assure compliance with Federal and State requirements. Performs audits to assure prompt completion and transmission of the required MDS Assessment. Coordinates with Billing to assure accurate RAI-MDS and billing process. Develops and provides educational programs to the Interdisciplinary Team members. Prepare for and participate in regulatory surveys and inspections. Assist in identifying and correcting deficient practices. Ensure staff competency and licensure compliance. Review and update nursing policies, procedures, and standards of care. Oversee infection control and patient safety programs. Performs Other Duties as Assigned. Knowledge Skills and Abilities: Knowledge of Nursing Home State and Federal regulations. Strong analytical and critical-thinking skills. Excellent written and verbal communication skills. This position is a Career Service Position The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer, and does not tolerate discrimination or violence in the workplace. Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center (***************. Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation. The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act. VETERANS' PREFERENCE. Pursuant to Chapter 295, Florida Statutes, candidates eligible for Veterans' Preference will receive preference in employment for Career Service vacancies and are encouraged to apply. Certain service members may be eligible to receive waivers for postsecondary educational requirements. Candidates claiming Veterans' Preference must attach supporting documentation with each submission that includes character of service (for example, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code. Veterans' Preference documentation requirements are available by clicking here. All documentation is due by the close of the vacancy announcement. Location:

BHI helps you manage your TDD patients. And your practice. Today's targeted drug delivery and infusion needs require confident coordination among physicians, provider staff, and patients. BHI helps connect all three to allow doctors to extend care beyond the office, provider staff to centralize management for greater efficiency, and patients to receive TDD right in their own home with experienced nurses. BHI helps bring physicians, provider staff, and patients together for Better Home Infusion. Basic Home Infusion is hiring for a Home Infusion Nurse in the Jacksonville, FL area. This role involves providing high-quality, patient-centered care to individuals receiving intrathecal pain or spasticity management therapy in the comfort of their homes, or in a clinic setting. You will have the ability to maintain your own schedule while traveling within the area (up to, but not limited to 180 miles). This is a full-time, permanent position that operates Monday-Friday, that operates in the home & in a clinic setting. Key Responsibilities · Administer and manage intrathecal pump therapy for patients with chronic pain or spasticity. · Perform pump refills, reprogramming, and troubleshooting in coordination with prescribing providers. · Educate patients and caregivers on medication regimens, pump function, and signs of adverse reactions or infection. · Collaborate with physicians, pharmacists, and other healthcare team members to ensure continuity and quality of care. · Document all care activities, assessments, and communications accurately and in a timely manner in electronic medical records. Qualifications Registered Nurse (RN) with an active, unencumbered license in the state of practice. Additional licensure or compact status preferred Minimum 2 years of nursing experience with at least 1 year in home infusion or pain management. Home health experience preferred Current BLS certification (ACLS preferred). Current TB Skin test or QuantiFERON blood test (within the past 12 months) Excellent clinical judgment, problem-solving, and communication skills. Comfortable working independently in a home setting and managing a mobile work schedule. Valid driver's license and reliable transportation What We Offer: 7 weeks paid, comprehensive training Classroom training in our newly built Simulation Lab and field training with an assigned Preceptor Competitive salary and mileage reimbursement. Comprehensive benefits package (for full-time employees). Supportive and collaborative clinical team 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 job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Ability to perform one-person CPR continuously, according to American Heart/Red Cross standards. The employee is frequently required to travel via car, train or plane, stand, sit, walk, see, hear; use hands and fingers regularly, handle, or feel objects, tools, or controls, reach with hands and arms, bend at the knees and waist - such as to access supplies, equipment and patients and administer medications with precision (e.g. using syringes) The employee must frequently lift and/or move, push and pull equipment, up to 5 pounds and occasionally lift and/or move up to 40 pounds. Nothing in this restricts management's right to assign or reassign duties and responsibilities to this job at any time. This job description reflects management's assignment of essential functions; it does not prescribe or restrict the tasks that may be assigned. At Basic Home Infusion, we are deeply committed to promoting diversity, equity, and inclusion in our provision of intrathecal infusion pain management services. We recognize that these core values are essential for achieving optimal patient outcomes and creating a supportive and inclusive environment for our team members.

Join LifeLink - Join a Life Saving Team! About LifeLink More than four decades ago, a visionary group of innovators, led by renowned nephrologist Dr. Dana Shires, made a life-changing commitment-to save lives through organ and tissue donation. From that bold beginning, LifeLink Foundation was established - founded with heart, purpose, and a mission that still guides us today. What started as a nonprofit with big dreams has grown into a vision-driven organization of more than 700 dedicated professionals across west-central Florida, Georgia, parts of South Carolina, Puerto Rico, and the US Virgin Islands. At LifeLink, we are united by our mission: To honor donors and save lives through organ and tissue donation. Our vision remains clear: To maximize the gift of life while giving hope to donor families and transplant patients. We are grounded in the values that shape our work and culture-Compassion. Excellence. Legacy. People. Quality. If you're inspired by purpose, driven by impact, and ready to help save and heal lives, LifeLink is the place for you. What You'll Do As a Family Care Coordinator, you will directly contribute to LifeLink's life-saving mission. Your primary responsibility is to work in conjunction with Hospitals in our service area to respond to referrals and evaluate for the purpose of determining a potential organ/tissue donor. Applying LifeLink Organ Recovery policies and procedures in performing and documenting, donor evaluation, family approach, authorization/donor designation, and the medical/social behavior interview with appropriate family members/associates for the purpose of transplantation. Participate in rotation call schedule to ensure coverage of this position's responsibilities 24/7. Case dynamics and logistics will warrant regular automobile travel with (infrequent) possible air travel. Key Responsibilities: Participate in the Family Care Coordinator (FCC) call schedule. Referral, pre-authorization and authorization responsibilities will consist of but may not be limited to: Onsite referral evaluation to hospitals in our designated service area Review of patient's hospital chart for determination of medical suitability Responsible for understanding of medical management to preserve the option for donation Determine hospital plan related to brain death testing and/or end of life discussions Determine appropriate time for family discussion related to donation conversation Understanding policy/procedure of both hospital and LifeLink in determination of Brain Death/testing Following LifeLink policy and procedure and state statues when determining legal next of kin and documentation of authorization for the purpose of transplantation. Helping family to navigate the process of organ donation and offering resources and compassion with end of life decisions. Post authorization responsibilities will consist of but may not be limited to: Case start-up consisting of: Starting, beginning organ donation order set, obtaining blood for serologies, and lymph node cutdown for HLA tissue typing Report to oncoming Vascular Coordinator Provide donor families with follow-up information and support as needed Works with hospital development and public education program on development initiatives Who You Are Passionate about helping others and making a difference Aligned with LifeLink's core values of Compassion, Excellence, Legacy, People, and Quality Degreed RN, Critical Care experience Demonstrate excellent interactive verbal communication skills Availability to handle rotation of 24/7 call responsibilities and a work schedule that may require response to emergency back-up call coverage Availability for automobile and possible air travel on a regular basis Current drivers license with good verifiable driving record Bilingual (English/Spanish) a plus A collaborator who thrives in a mission-first environment Why LifeLink? Be part of an organization with a legacy of saving lives and giving hope Join a passionate and supportive team across Florida, Georgia, and Puerto Rico COMPANY PAID Medical, Dental, Disability & Life Insurance Generous COMPANY PAID Pension Plan for your Retirement Paid Vacation, Sick Days & Holidays Growth opportunities in a mission-driven, high-impact nonprofit Work with purpose, knowing your efforts directly touch lives Working Conditions: Local/State auto/air travel is required. Variable/rotation on-call days/hours including nights/weekends/holidays depending on call schedule and case duration. Possible high stress / extended hours while on call. Team-oriented and interactive environment. TB Classification: Medium Diversity, Equity & Inclusion LifeLink is proud to be an equal opportunity employer. We celebrate diversity and are committed to building an inclusive environment that reflects the communities we serve. Ready to Help Change Lives? Your next career move could be the most meaningful one yet.

Mission Statement The Children's Network of Hillsborough is committed to working with the community to protect children and preserve families. General Purpose of Job To provide nurse care coordination for children in the child welfare system. This includes children with special health care needs. The Nurse Care Coordinator (NCC) will coordinate, assist, and consult regarding medical health services to promote quality outcomes. The NCC will monitor the timelines and coordination of health services and integration of those services in support of permanency goals for children in care, ensuring a coordinated effort to maximize the potential of children and to provide them with optimal care. Qualifications To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Essential Duties and Responsibilities Act as liaison between Health Plans, Case Management Organization (CMO), the Department of Children & Families (DCF) and specialty and/or community providers regarding health services. Create plan of care and coordinate medical services for dependent children, including Health Risk Assessments, timely Well-Child Checkups and follow-up for specialty appointments and required referrals. Works with child welfare case managers to coordinate health care and meet all wellness measures. Provide reviews of medical, dental and optometric services and inform child welfare case managers and caretakers of needed follow-up. Documents reviews in FSFN and assures records are uploaded into the appropriate computer program. Provide information for and attend court hearings and case staffings as needed or requested. Participate in health plan case management integrated care team and/or CBC Multidisciplinary team meetings if needed. Participate with health care plan in discharge planning and coordination from in-patient health care facility including monitoring of post-discharge follow-up appointments, ordered services, durable medical equipment and assuring that prescriptions are filled as needed. Process information on any medication compliance concerns and notify physician, case manager and health plan. Review the health and wellness reports, FSFN reports and other data sources for status of required annual physical, dental and vision screenings for children placed in out of home care. Participate, as needed, in planning for youth who are transitioning from the child welfare system. This may include participation in routine staffings to providing education and coordination of services. Cultivate and coordinate an effective communication system with providers and child welfare staff for the exchange of appropriate information. Provide education and support to families related to the care of their child. Monitor email on daily basis. Circulate pertinent child-related information to Child Welfare Case Managers and other designated Case Management Organization employees. Enter data into automated systems and produce required reports from the data system. Data entered into FSFN must be done within 48 hours of receiving the information. Works in a collaborative and positive manner as a member of the healthcare team with the co-workers, families, caseworkers, guardians, physicians and their office personnel, schools, vendors and other related organizations. Other duties may be assigned as special projects may be requested. Working Hours CNHC's believes in work life balance for all employees. This is an in-office position, Monday-Friday from 8:00am to 5:00pm averaging forty (40) hours per week. Working hours may vary based on business needs. Travel Travel inside Circuit 13 (Hillsborough County) may be required as well as occasional travel outside the circuit for training purposes. Training CNHC's believes in work life balance for all employees. This is an in-office position, Monday-Friday from 8:00am to 5:00pm averaging forty (40) hours per week. Working hours may vary based on business needs. Supervisory Responsibilities This position does not have supervisory responsibilities Qualifications Education and/or Experience Registered Nurse (RN), with current Florida nursing license is required. Three (3) years nursing experience in the child welfare or behavioral health care setting, preferred Pediatric and/or care coordination experience is helpful. Skills and Abilities Must possess strong clinical expertise and the ability to assess the medical and developmental needs of children and families involved in the welfare system. Exceptional organizational and time-management skills are essential for coordinating care plans, managing health records, and ensuring timely access to medical, therapeutic, and support services. Effective communication and interpersonal abilities are crucial for collaborating with child welfare staff, healthcare providers, and families to advocate for the well-being of children. The role requires critical thinking and problem-solving skills to navigate complex cases, address barriers to care, and adapt to evolving needs while prioritizing the safety and health of children. Proficiency in documenting and utilizing care management systems is necessary for tracking progress and maintaining compliance with regulations Pre-employment Requirements Certificates, License, Registrations, backgrounds, drug screens, Etc. Proof of education is required Proof of State of Florida Licensure as a Nurse Valid driver's license required, with proof of insurance Driver's license check is a requirement Criminal background screening (fingerprinting) (Local Law Enforcement and FBI/FDLE) Drug Screening is a requirement Children's Network participates in E-Verify Other Requirements Language Skills Must possess strong language skills, including the ability to communicate clearly and effectively with diverse stakeholders, such as families, healthcare providers, social workers, and legal professionals. This involves the ability to explain medical information in an easily understandable way, ensuring that families and caregivers can make informed decisions about their child's care. Strong written communication skills are essential for documenting care plans, progress notes, and reports accurately and professionally. Additionally, the ability to listen actively and empathetically, especially in sensitive or high-stress situations, is critical for building trust and supporting families in navigating the child welfare system. Cultural competency in language use is also important to ensure that communication is respectful, inclusive, and tailored to the needs of the children and families served. Mathematical Skills Must possess the ability to interpret and analyze numerical data from medical records, treatment plans, and financial documents. Proficiency in using mathematical formulas for health assessments, tracking growth and development metrics, and calculating medical statistics is essential. Additionally, the role may require the ability to manage and allocate resources effectively, ensuring the most efficient use of healthcare services within a budget. Attention to detail and accuracy in all numerical tasks are critical to ensuring the safety and well-being of children and families under care. Reasoning Ability Must demonstrate strong reasoning abilities to assess complex medical and emotional needs of children and families, ensuring that care plans are both effective and responsive. This includes the capacity to analyze medical histories, understand psychosocial factors, and apply clinical guidelines to create comprehensive care strategies. The role requires critical thinking to evaluate the effectiveness of interventions, address emerging challenges, and identify barriers to achieving optimal health outcomes. The ability to anticipate potential risks, prioritize urgent needs, and make informed decisions that align with child welfare policies is essential. Additionally, strong reasoning skills help in collaborating with other professionals, ensuring that decisions are evidence-based, ethical, and focused on the best interests of the children and families served. Physical Demands The physical demands of this position are generally moderate. The role may require extended periods of sitting, standing, and using a computer. Occasional lifting of office supplies, files, or materials up to 25 pounds may be required. Reasonable accommodation can be made to enable individuals with disabilities to perform the essential job functions. Work Environment This is an in-office-based position focused on administrative work, where the noise level may be moderate. The role may involve occasional travel among agency locations, extended periods of computer work, and frequent interactions across multiple departments. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential job functions. ADA: Children's Network of Hillsborough, LLC will make reasonable accommodations in compliance with the Americans with Disabilities Act of 1990. EEO: Children's Network of Hillsborough, LLC does not discriminate based on race, national origin, gender, religion, veteran status, or disability in employment, in provision of services, or in access to programs. Children's Network of Hillsborough, LLC is a Drug-Free Workplace. Remember: If you are currently an employee of Children's Network of Hillsborough Florida, LLC, or one of our Case Management Organizations, it is necessary that you notify your current leadership, prior to applying.

LifeWorks Wellness Center is looking for a Registered Nurse to join our team of health care professionals. Our clinic is expanding at a rapid rate and so is our team! LifeWorks Wellness Center is the largest integrated practice in the US, as well as Florida's top natural health clinic. We are proud to provide patients with alternative medical doctors that treat a wide range of chronic health conditions, naturally. People travel from all over the world to see our practitioners and receive our lifesaving holistic treatment programs. BONUS - $1,000 SIGN-ON BONUS UPON COMPLETION OF 6 MONTHS OF CONTINUOUS EMPLOYMENT. Job Duties: Understands patient's treatment program. Monitors patient's progress through their treatment program. Order services (labs, x-ray, etc.) based on practitioner's instructions. Manages specialty referrals to ensure results received back in a timely manner. Ensure patient has follow up exams at necessary points on their treatment program. Works in close coordination with Nutritional Consultant to ensure patient questions are answered regarding supplements and diet. Instruct patients and the family about best practices on home care. Support practitioners in managing patient emergencies to resolution. Maintaining a level-head throughout any emergency situations and communicating to patients with empathy. Maintains patient charts with all patient communication, interactions, and instructions. Provides patient education as directed by the doctor. Maintains safe, secure, and healthy work environment by establishing and following protocols and policies. Complying with all legal and health regulations. Serves and protects the doctor's practice by adhering to professional standards, policies, protocols, and federal, state, and local requirements. Education and/or Experience: Current Registered Nurse (RN) license in the state of practice. Graduate of Highschool/GED or equivalent 2+ years in healthcare Experience using EMR software Superior communication and patient service skills Excellent attention to detail. Ability to multitask and experience working in a fast paced environment Basic IV Holistic Nursing Certification is a plus Language Skills: Must speak English. Any other language is a plus. Must have excellent interactive communication skills, making patients feel comfortable and at-ease. Physical Demands: While performing the duties of this job, will be on the computer and phone minimum 6 hours a day. May meet with patients in person at the clinic. There is an emotional demand with patient's who may be upset or are very sick. Must be able to be an emotional support for the patients as well as parents/caregivers. Compensation: $36- $38 / hour Benefits: Employer sponsored Health, dental and vision insurance Health savings account Employee discount Paid Time Off Holiday Pay No weekend hours/no night hours LifeWorks Wellness Center (LWC) is an equal employment opportunity employer. All individuals seeking employment are considered without prejudice to race, color, religion, national origin, age, sex, marital status, ancestry, physical or mental disability, pregnancy status, veteran status, gender identity, sexual orientation or any other characteristic protected under applicable federal, state, or local law. Additionally, LWC will provide all reasonable accommodations for qualified individuals with known disabilities, unless doing so would result in undue hardship to the company.

**************************** 5K SIGN ON BONUS Freedom Square of Seminole is an upscale Senior Living Community located in beautiful Seminole, Florida. Designed like a quaint town square with paved brick streets and a welcoming gazebo, Freedom Square retirement community in Seminole, Florida offers a wide variety of elegantly appointed residential options, a wealth of exceptional services and amenities and a full calendar of fun, engaging activities - all just a short drive from Lake Seminole and the beautiful beaches of the Gulf Coast! Situated on 15 acres with two ponds, we offer a beautiful garden-like setting for retirement living. As a life care community, Freedom Square makes aging in place simple. Residents are able to seamlessly transition from independent living to assisted living, memory care and skilled nursing care, as their healthcare needs change. Freedom Square of Seminole is looking for patient-centered LPN's to help care for our residents. Come experience the Freedom Square of Seminole difference! We are an elegant, upscale Senior Living Community, nestled in a 15-acre certified wildlife habitat. What makes us stand out against the others? * We provide a fun workplace culture - including monthly luncheons and campus-wide events * Our community and facilities are clean * Our patients are low acuity * We have good staffing ratios * Benefits for Full and Part Time Staff * Paid Time Off and Paid Holidays * Career Advancement Opportunities * Paid Training * Revised Wage and Bonus Structure * Resident Scholarship Fund We are looking for energetic individuals who enjoy working in a fast-paced, team-focused environment. As a nurse at Freedom Square of Seminole, you are held to a high standard. Our team members provide extraordinary care and hold each other accountable. If this sounds like a good fit, we'd love to hear from you! The staff nurse is responsible for the accurate and timely administration of medications, treatments, documentation and emergency call lights, inside our skilled nursing center. Duties: * Administer medication and treatments to residents of our healthcare center. * Assist with admission and discharge process * Keep physician and family aware of change(s) in resident condition * Make rounds with physicians and transcribes orders * Assure continuity of services and care Qualifications: * Current nursing license with the state of Florida * 6 months nursing experience, preferred * Geriatric involvement preferred What We Offer: * Work today, get paid tomorrow with DailyPay! Freedom Square of Seminole now offers DailyPay - a program that allows employees to access their earned income on-demand, as it's earned. * Benefits for full and part time staff, including health, dental, vision, 401K and more! * Fun, caring, inclusive work environment! * Monthly company luncheons and employee appreciation events! Freedom Square of Seminole fully embraces a culture of hospitality. To that end, we include the following hospitality promises as a guide for our interpersonal interactions with residents, co-workers and guests: * We greet residents, employees and guests, warmly, by name and with a smile. * We treat everyone with courteous respect. * We strive to anticipate resident, employee and guest needs and act accordingly. * We listen and respond enthusiastically in a timely manner. * We hold ourselves and one another accountable. * We embrace and value our differences. * We make residents, employees and guests feel important. * We ask "Is there anything else I can do for you?" * We maintain high levels of professionalism, both in conduct and appearance, at all times. * We pay attention to the details. #clinical

QUALIFICATIONS * Active practicing licensure with the College of Registered Psychiatric Nurses of Manitoba or eligible for active practicing licensure with the College of Registered Psychiatric Nurses of Manitoba (CRPNM) * Current Basic Cardiac Life Support (BCLS) Training * Successful completion of First Aide Certification * Successful completion of Non-Violent Crisis Intervention (NVCI) * Successful completion of Applied Suicide Intervention Skills Training (ASIST) * One (1) year equivalent full-time experience in a Mental Health setting as a Registered Psychiatric Nurse within the last three (3) years * Knowledge, competence and ability to demonstrate clinical nursing skills and concepts in accordance with approved nursing standards * Ability to make effective decisions regarding nursing care * Basic knowledge and skills to work with computers, and electronic software programs * Demonstrated effective problem solving, organizational skills and the ability to work independently * Demonstrated effective verbal and written communication skills * Ability to maintain positive working relationships with co-workers and clients * Satisfactory employment record required * Province of Manitoba Class 5 Drivers License, and access to a personal vehicle to provide service within Prairie Mountain Health POSITION SUMMARY Consistent with the vision, mission and values of the Prairie Mountain Health sites, and affiliate sites, the Nurse II provides comprehensive nursing care to patients/residents/clients in accordance with established standards, policies, and procedures. Nurse IIs recognize and fulfill their professional responsibilities by practicing in a manner consistent with professional obligations to take actions as per the Canadian Nurses Association Code of Ethics for Registered Nurses and Registered Psychiatric Nurses, The College of Registered Nurses of Manitoba Standards of Practice for Registered Nurses, The College of Psychiatric Nurses of Manitoba Standards of Psychiatric Nursing Practice, the scope of practice as defined by the Regulated Health Professions Act (RHPA), and the Registered Psychiatric Nurses Act, and other Provincial and Federal legislation. RESPONSIBILITIES: * The Nurse II is required to practice in accordance with the following to their level of scope of practice, expertise, training and experience. * The Regulated Health Professions Act (RHPA) or the Registered Psychiatric Nurse Act of Manitoba. * The Standards of Practice (CRNM or CRPNM). * Entry level competencies for RNs or RPNs. * Professional Code of Ethics. * Obtain and maintains the relevant competencies for the position offered by PMH. * Other duties as assigned.

Monash IVF Group are leading the future of reproductive care Monash IVF Group is renowned for advancing the delivery of reproductive health services for contemporary lifestyles. As leaders in our field, we offer a dynamic workplace to those seeking to make a difference. You'll be joining a team of multidisciplinary specialists who collaborate to improve the experience and outcomes for patients with care and compassion. Monash IVF Group values each and every one of our employees Leading the evolution of care also means caring for our people. We ensure all employees feel included, supported and valued. Being part of the Monash IVF Group gives you access to many benefits, including the following: * A Learning & Development Framework that supports your professional development * Access to a contemporary Employee Assistance Program for employee wellbeing; physical, mental, social and financial. * Fitness Passport Access * Discounts on MIVFG fertility and ultrasound services * Paid IVF Leave * Paid Parental Leave - 12 weeks plus superannuation A role with unique responsibilities Our IVF Nurse plays a significant role in the patient journey at Monash IVF. You are responsible for coordinating treatment and delivering nursing services for all patients. With exceptional service, underpinned by a caring, compassionate nature, you will directly enhance the patient experience. You will provide information, education and support to patients before, during and after IVF treatment. Are you the ideal candidate for us? The ideal candidate will see their role as vital to the success of the organisation. Understanding there are ups and down in reproductive health, our IVF Nurse will be sensitive to the needs of patients and will support their wellbeing through timely and considered communication. Ideally you will bring the following: * Current RN registration * Recent experience in IVF/Fertility nursing (desirable), otherwise minimum 3 years experience in a nursing team environment * Phlebotomy and ultrasound scanning competency (desirable) * A caring compassionate nature to nurture a patients fertility journey * Ability to apply the 5E patient experience principles- empathy, entrust, engage, empower, expectation * A willingness to work collaboratively within a fast paced clinic * Exceptional organisational and multi tasking skills * Outstanding interpersonal and communication skills * A willingness to work collaboratively within a multidisciplinary team and across other departments * A willingness to embrace the Monash IVF Group principles - Care, Collaborate, Communicate, Commitment, Create. If you're ready to join the brave leaders of reproductive care, please apply now. Closing Date: 5 February (unless filled prior) Bella Pileggi P&C Advisor ****************************** All personal information received by us from you or about you will be stored, used and disclosed by us in accordance with our Privacy of Your Information Policy

RN Nurse Needed!!! All nurses contracted by the Provider to render services shall be continuously licensed, certified, or registered, as required by law, rule, policy, and the Department of Health, in their respective areas of expertise, pursuant to applicable law, in the State of Florida. The Provider shall have policies and procedures in place in the case of a medical emergency within the facility. All staff that has direct contact with youth is to be trained and understand that they are to immediately call 9-1-1 in a medical emergency that poses the need for urgent medical attention (for example, a youth unresponsive/unconscious, bleeding profusely, acutely ill, etc.). KEY RESPONSIBILITIES: 1. Documentation of youths' healthcare status upon admission: a) Reviewing the Health Admission Screening form provided by the facility intake staff during the admission process for all youth. b) Conducting nursing assessments as indicated by intake documentation. c) Developing a nursing care plan for youth with medical conditions. Plans shall include all known medical and dental appointments, current medications, and names of youths' community practitioners. d) Completing appropriate Medical Alerts, including nutrition and diet concerns. 2. Provide episodic and emergency care while on site. Youth that require care beyond First Aid for minor injuries or illness must be referred to the Emergency Room or call for EMS/911 assistance. When Nurse is not on-site, the program will follow standard policy and procedure governing medical and mental health concerns for non-licensed staff. The nurse is not to be utilized as an on-call medical resource. 3.Providing health education for youth and parents/guardians on specific medications and chronic and acute health conditions for youths. Subject matter includes wellness with fitness, nutrition, and positive coping skills. 4.Medication Management Process. The Registered Nurse is responsible for oversight and management of medication distribution, secure storage, and accountability of medications. This includes oversight of the following: a) Medication administration during on-site hours. When the Registered Nurse is on-site, medications shall be administered only by the Registered Nurse. b) Ensuring that non-licensed staff are trained and know how to assist youth with self-administration of medications during hours when no licensed nurse is on-site. The responsibility of training and verifying competency of non-licensed staff in this task may not be delegated to other non-licensed staff. c) Verification of youths' medications brought to the shelter. This shall include communication with the youths' community pharmacy, medical provider, and parent/guardian. d) Management of the Pyxis medication storage system, including medication inventory counts. The counts shall be conducted by the Registered Nurse and assigned staff persons trained in the appropriate medication counting system. The nurse is responsible for administering the medications to youth safely and accurately when on-site. When the nurse is not on-site, medication delivery shall be conducted by non-licensed trained staff persons. e) Monitoring Medication Distribution Logs (MDL) daily to ensure that medications provided by the non-licensed program staff through assisting the youth with self-administration are provided as prescribed. f) Reorder over the counter medications and first aid supplies. g) Monitoring medication side effects when administering medications. Review documented side effect monitoring by non-licensed staff and provide additional training as needed. h) Conducting Root Cause Analysis of medication errors, including omission of medications. 5. Development and implementation of applicable Universal Precautions and Infection Control standards. Education of youth and staff regarding Infection Control standards. 6. Staff education and training regarding acute and chronic health conditions, wellness, exercise and fitness, dietary and nutritional needs of adolescents, and Universal Precautions/Infection Control. 7. Review and evaluation of all medical CCC incidents pertaining to the Registered Nurse's assigned CINS/FINS Shelter. Make recommendations about Corrective Action to be taken to correct deficiencies and address issues in response to these incidents. 8. Evaluate CCC reporting information and data collected through the Care Fusion Knowledge Portal to identify emerging medical concerns and trends. 9. Assist the CINS/FINS Shelter Program Director and staff in the Quality Improvement Process, including guidance regarding health care standards. Requirements To ensure the provision of necessary and appropriate healthcare, the Provider shall maintain the following medical staffing: A. Registered Nurse (RN) RNs shall have an active and clear Florida license in accordance with chapter 464, Florida Statutes. B. The Provider shall notify the Contract Manager if there are changes in personnel. The Provider shall report vacancies as they occur to the Contract Manager. C. Special alerts identified on staff licensures shall be communicated immediately in writing to the Contract Manager EDUCATION/EXPERIENCE/CERTIFICATION: To practice in the profession, registered nurses must become licensed. While licensure requirements vary according to state, they typically include passage of a state-approved training program and the National Council Licensure Examination for Registered Nurses (NCLEX-RN). Administered by the National Council of State Boards of Nursing, the NCLEX-RN covers topics like psychosocial and physiological integrity, health promotion and infection control (*************** Depending on the state, RNs may be required to meet additional licensure requirements.

Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding thattogetherwe are even better. The ARNPfunctions as a member of the medical care management team for physician practice patients (surgical and non-surgical). Provide services similar to those of a physician.The ARNP may diagnose medical conditions, plan and implement treatment collaboratively agreed to in the AdventHealth Medical Group medical staff delineation of clinical privileges for Advanced Registered Nurse Practitioners.Examine patients, take medical histories, maintain patient records, identify health risks factors, prescribe medications, make referrals.Focus on patient wellness and disease prevention.Provide health education services and/or counsel patients on how to make healthy lifestyle choices.Will need to work weekdays, occassional weekends and nights for call coverage. EDUCATION AND EXPERIENCE REQUIRED: • Masters of Nursing • One + years' experience • Valid AHA BLS Certification Licensure as an APRNin the State of Florida • Advanced Registered Nurse Certification

Nurse Reviewer PT (20-30 hours week) - Remote Work Environment Non-Exempt: $40.00 hour Supports Medical Review Services. The Nurse Reviewer plays a critical role in supporting the Medical Review Services department by performing comprehensive medical necessity reviews and policy reviews for Medicaid claims. This involves meticulous examination of claims and medical records to ensure compliance with established guidelines and regulations. The RN will work closely with the Team Lead, Physician Peer Reviewer and contract team. Reviews must be completed timely. Essential Duties and Responsibilities: Conduct comprehensive medical record reviews to assess medical necessity and compliance with established standards of care and applicable policies Manage end-to-end case screening processes, ensuring all activities are completed within established deadlines Document evidence-based criteria applicable to specific contract requirements Record and report screening results, including relevant referral questions, into a centralized database Evaluate medical claims against industry standards, utilizing research of relevant ICD-10, CPT, and HCPCS codes to determine medical necessity Maintain expert knowledge of evolving multi-state Medicaid policies and vendor expectations Participate in ongoing training and consistently meet or exceed productivity and quality assurance standards Knowledge, Experience, Skills and Education: Medical terminology, ICD-10, CPT and HCPCS Clinical criteria (InterQual and MCG) Utilization/Medical record review and chart abstraction Current standards of medical practice Comply with HIPAA/HITECH laws and regulations Experience in: At least three- five years performing medical record review and/or abstraction (Utilization Review experience preferred) Experience performing medical record review, audit for federal or state contracts Knowledge and experience of Medicare and Medicaid policy Proficiency with Microsoft Office (Word, Excel, and Outlook) Proficiency with Adobe PDF files and features Generating accurate, timely, and understandable correspondence Current experience (within the last 3 years) in the application of clinical screening criteria (InterQual and MCG) Skills Requirements include: Professional interpersonal skills; ability to interact with providers, physicians and peers Solid analytical, assessment and documentation skills Effective written and verbal communication, both internally and externally Strong attention to detail Strong attention to deadlines Organizational skills including effective time management, priority setting and process improvement Ability to work independently and as a member of a team Adapt to changing work situations and readily adjusts schedules, tasks and priorities when necessary to meet business fluctuations Educational Background: BSN with active RN licensure in good standing Physical Demands: Remote Work, Prolonged Sitting, Screen Exposure This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice. Healthcare Quality Strategies, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This position qualifies for the following Company benefits: Medical/Dental/Vision, FSA and HSA, group life/AD&D, voluntary life/AD&D, 401k For immediate consideration, please apply via the HQSI Careers Page at: ************ > Careers > Current Employment Opportunities EOE: Minorities/Females/Disabled/Veterans Healthcare Quality Strategies, Inc. is Equal Opportunity, Affirmative Action Employer and an Alcohol/Drug Free Workplace Healthcare Quality Strategies, Inc. is an E-Verify Employer

Why You Should Work For Us: HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career! Job Description Job Title: Utilization Review/Outpatient Care RN Are you an experienced Registered Nurse with Utilization Review experience looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions - this is the position for you! Position Summary: As the Utilization Review/Outpatient Care RN, you would be responsible for reviewing and collecting medical information in order to determine medical necessity of services requested. Hours for this Position: Monday-Friday daytime hours (40 hours/week) Advantages of this Opportunity: Pay $28-$32 per hour, negotiable based on experience Work for a prominent Healthcare company who pride themselves on partnership, integrity, teamwork, and accountability Be a part of a team who serves the full spectrum of member needs Weekly deposit options Great benefits offered More Insight of Daily Responsibilities: Ensures that services provided to eligible members are within benefit plan Initiates and continues direct communication with health care providers involved with the care of the member Identifies appropriate clinical settings for services being requested Identifies and refers cases appropriate for case management Identifies potential quality of care issues and refers to Quality Department Determines appropriate utilization management of services requested Qualifications What We Look For: Clear and active RN license in state of FL 2+ years of acute clinical/surgical position Recent experience with utilization management Additional Information Interested in being considered in this position? TAKE THE NEXT STEP! Click the green I'M INTERESTED button to send me your resume.

**Nurse Case Manager I** **Hours: 9am-530pm with 2-3 late evenings a month 1130am-8pm** **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. The **Nurse Case Manager I** 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 or on-site such as at hospitals for discharge planning **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 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. + Current, unrestricted RN license in applicable state(s) required. + Multi-state licensure is required if this individual is providing services in multiple states. **Preferred Skills, Capabilities and Experiences** : + Certification as a Case Manager is preferred. + BS in a health or human services related field preferred For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $68,880- $103,320 **Locations: New York** 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.

BHI helps you manage your TDD patients. And your practice. Today's targeted drug delivery and infusion needs require confident coordination among physicians, provider staff, and patients. BHI helps connect all three to allow doctors to extend care beyond the office, provider staff to centralize management for greater efficiency, and patients to receive TDD right in their own home with experienced nurses. BHI helps bring physicians, provider staff, and patients together for Better Home Infusion. Basic Home Infusion is hiring for a Home Infusion Nurse in the Delray Beach, FL area. This role involves providing high-quality, patient-centered care to individuals receiving intrathecal pain or spasticity management therapy in the comfort of their homes, or in a clinic setting. This is a full-time, permanent position that operates Monday-Friday. The nurse will work in an infusion clinic, refilling patients on their scheduled days/times, and seeing patients in their homes the other days. Key Responsibilities · Administer and manage intrathecal pump therapy for patients with chronic pain or spasticity. · Perform pump refills, reprogramming, and troubleshooting in coordination with prescribing providers. · Educate patients and caregivers on medication regimens, pump function, and signs of adverse reactions or infection. · Collaborate with physicians, pharmacists, and other healthcare team members to ensure continuity and quality of care. · Document all care activities, assessments, and communications accurately and in a timely manner in electronic medical records. Qualifications Registered Nurse (RN) with an active, unencumbered license in the state of practice. Additional licensure or compact status preferred Minimum 2 years of nursing experience with at least 1 year in home infusion or pain management. Home health experience preferred Current BLS certification (ACLS preferred). Current TB Skin test or QuantiFERON blood test (within the past 12 months) Excellent clinical judgment, problem-solving, and communication skills. Comfortable working independently in a home setting and managing a mobile work schedule. Valid driver's license and reliable transportation What We Offer: 7 weeks paid, comprehensive training Classroom training in our newly built Simulation Lab and field training with an assigned Preceptor Competitive salary and mileage reimbursement. Comprehensive benefits package (for full-time employees). Supportive and collaborative clinical team 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 job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Ability to perform one-person CPR continuously, according to American Heart/Red Cross standards. The employee is frequently required to travel via car, train or plane, stand, sit, walk, see, hear; use hands and fingers regularly, handle, or feel objects, tools, or controls, reach with hands and arms, bend at the knees and waist - such as to access supplies, equipment and patients and administer medications with precision (e.g. using syringes) The employee must frequently lift and/or move, push and pull equipment, up to 5 pounds and occasionally lift and/or move up to 40 pounds. Nothing in this restricts management's right to assign or reassign duties and responsibilities to this job at any time. This job description reflects management's assignment of essential functions; it does not prescribe or restrict the tasks that may be assigned. At Basic Home Infusion, we are deeply committed to promoting diversity, equity, and inclusion in our provision of intrathecal infusion pain management services. We recognize that these core values are essential for achieving optimal patient outcomes and creating a supportive and inclusive environment for our team members.

QUALIFICATIONS * Active practicing licensure with the College of Registered Nurses of Manitoba or eligible for active practicing licensure with the College of Registered Nurses of Manitoba (CRNM) * Current Basic Cardiac Life Support (BCLS) Training * One (1) year equivalent full-time experience in acute care as a Registered Nurse within the last three (3) years * Knowledge, competence and ability to demonstrate clinical nursing skills and concepts in accordance with approved nursing standards * Ability to make effective decisions regarding nursing care * Basic knowledge and skills to work with computers, and electronic software programs * Demonstrated effective problem solving, organizational skills and the ability to work independently * Demonstrated effective verbal and written communication skills * Ability to maintain positive working relationships with co-workers and clients * Satisfactory employment record required