Utilization review nurse jobs in West Valley City, UT - 53 jobs

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

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA This position is responsible for maintaining the financial integrity of both the patient and the organization through the provision of quality based patient care focusing on the medical necessity and efficiency of the delivery of such care; achieved via managing the cost of care while providing timely and accurate information to third party payers and medical care team. This position may be required to access and administer medications within their scope of practice and according to state law. Required One year Utilization Review or Case Management experience. Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes. Responsibilities Applies approved utilization criteria to monitor appropriateness of admissions with associated levels of care and continued stay review. Communication to third-party payers for initial and concurrent clinical review. Reviews patient chart to ensure patient continues to meet medical necessity. Documentation of all actions and information shared with care team members or third-party payer. Alerts and discusses with physician/provider and case manager/discharge planner when patient no longer meets medical necessity criteria for the inpatient stay. Discusses with physicians the appropriateness of resource utilization. Tracks length of stay (LOS) and resource utilization to identify at risk patients. Refers to UR committee any case that surpasses expected LOS, expected cost, or over/under-utilization of resources. Performs verbal/fax clinical review with payer as determined by nursing judgment and/or collaboration with the payer per university contractual obligation. Participant in UR Committee as needed. Collects data on variances in LOS, avoidable days, costs/barriers to discharge/transition and denied days. Prepares appeals on denied cases when appropriate. At the discretion of department operational and patient care needs, this position is required to work rotating schedules, which may include variable hours, weekends, nights, and holidays to meet the staffing and patient care demands of a 24/7 complex health system. Regular, reliable, and punctual attendance during assigned shifts is considered an essential function of the role. Knowledge / Skills / Abilities Demonstrated availability to work variable and rotating shifts, including nights, weekends, and holidays, in a 24/7 patient care environment. Ability to perform the essential functions of the job as outlined above. Demonstrated team leadership, relationship building, critical analysis, and written and verbal communication skills. Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria. The ability to demonstrate knowledge of the principles of life span growth and development and the ability to assess data regarding the patient's status and provide care as described in the department's policies and procedures manual. Ability to work autonomously and as a team member. Qualifications QualificationsRequired One year Utilization Review or Case Management experience. Licenses Required Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 days of hire under the interstate compact if switching residency to State of Utah. Must maintain current Interstate Compact (multi-state) license if residency is not being changed to Utah. * Additional license requirements as determined by the hiring department. Qualifications (Preferred) Preferred Basic Life Support Health Care Provider card. Proficiency in application of InterQual Criteria, knowledge of ICD-9, DRG's and CPT Codes. Utilization Review Certification designation. Knowledge of CMS Regulations. Working Conditions and Physical Demands Employee must be able to meet the following requirements with or without an accommodation. This is a sedentary position in an office setting that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions. This position does not provide care to patients. Physical Requirements Color Determination, Far Vision, Listening, Near Vision, Sitting, Speaking

Advantmed is a leading provider of risk adjustment, quality improvement and value-based solutions to health plans and providers. We drive market leading performance with integrated technology, service, and program solutions that optimize the risk and quality performance of our partners. Our solutions focus on identifying, managing, and documenting risk and quality performance, and the proactive clinical engagement of high acuity populations. The building B.L.O.C.K.S. of our team's success! Bring the fun Leverage together for better Outperform yourself Care at every touchpoint Keep your word. Keep it real Stay curious & listen well Primary Purpose: We are proud of the quality care we provide members, and our team is rapidly expanding to meet the demands of our growing business; we are seeking a highly skilled and compassionate certified Nurse Practitioner to join our Advantmed provider network. In this role, you will be responsible for conducting in-home wellness risk adjustment assessments for Medicare members and other at-risk populations. Your primary objective will be to assess the overall health and well-being of member beneficiaries to ensure accurate and comprehensive risk adjustment coding, leading to greater value-based care. This role is 1099 (PRN) and offers tremendous flexibility and opportunity for those who are balancing competing priorities. Learn more about our primary purpose here Follow us on LinkedIn: ****************************************** NP Responsibilities: In-home Clinical Assessments Travel to members' homes and conduct comprehensive health evaluations Conduct Annual Wellness Visits and health assessments for members with chronic conditions. Perform: Medical history and physical examinations Review of systems Vital signs collection Medication review and reconciliation Possible preventive health screenings Hemoglobin A1C Spirometry KED (Kidney Health Evaluation) DRE (Diabetic Retinal Exam) FIT Patient Education & Engagement Deliver preventive health education and counseling opportunities. Educate patients on ongoing health monitoring, medication adherence, and chronic condition management. Support informed decision-making and ensure true, informed consent. Engage in goals of care discussions when appropriate. Care Coordination & Quality Support Identify clinically relevant diagnoses for care management and risk adjustment documentation. Communicate findings used to generate post visit summaries for the primary care provider. Identify and help close quality care gaps (e.g., screenings, labs, follow-ups). Collaborate enthusiastically with the broader care team to enhance clinical quality and patient experience. Compliance & Professional Standards Adhere to HIPAA regulations and safeguard protected health information (PHI). Maintain accurate, timely, and compliant EMR documentation. Perform additional duties as assigned in alignment with organizational goals. An enthusiastic collaborator contributing to the enhancement of care delivery Providers are expected to commit a minimum of 30 hours per month Locations: Utah County, Utah Requirements Travel Requirements Daily travel expectations remain within a 55-mile radius of the assigned home location. NP Qualifications: Must have a valid unencumbered NP License for the state you will be working in This role requires travel up to a maximum 55-mile radius originating in the assigned job posting county Preference is given to weekday schedules Preference is given to standard working hour schedules Previous in-home risk assessment experience preferred Previous 1099 (PRN) experience is preferred but not required 3 years patient care experience preferred (primary care/adult/geriatric, EMR) May be requested to obtain additional NP licensure supported by Advantmed Access to reliable transportation that will enable you to travel to members' homes within a designated area Strong ability to work within our EMR system Ability to work independently Bilingual is a plus Benefits Advantmed offers: Competitive compensation of ~$100 per completed in-home health assessment Paid mileage Flexible work schedule, choose your own schedule No on call Visits ready to be scheduled immediately Appointment confirmation support Dedicated coordinator support Advanced member scheduling coverage State of art technology

In partnership with Intermountain Health, Surgery Partners is seeking experienced OR nurse to join our Team! We are open Tuesday-Friday. No Holidays! No Weekends! Our specialties include: cataracts, ENT, podiatry, ortho, plastics, oculoplastics and colorectal. Job Summary The Nurse Circulator assists in provision of nursing care to patients in an Ambulatory Surgical Center setting. Assumes total responsibility for patient care in accordance with physician's orders and centers policies. During operations and other surgical procedures, the circulator assists by acting as an intermediary between the operating room staff and the rest of the surgical center. Responsibilities Performs circulating functions including monitoring, recording and communicating patient condition and managing overall nursing care of patient before, during and after procedure. Prepares operating rooms including equipment and supplies for use. Performs patient positioning and ensures patient safety throughout procedure. Qualifications: • Graduate of Accredited School of Nursing; current state RN license. • BLS required. • Minimum one year in the OR, ability to scrub as well as circulate preferred. Our employees are critical to our success and we value their contributions. Surgery Partners offers a competitive compensation and benefits package and an opportunity to grow and develop your career in an environment that values employee ideas and diversity. Equal Opportunity Employer. We maintain a drug-free workplace and require pre-employment drug screening. Benefits: Comprehensive health, dental, and vision insurance Health Savings Account with an employer contribution Life Insurance PTO 401(k) retirement plan with a company match And more! Equal Employment Opportunity & Work Force Diversity Our organization is an equal opportunity employer and will not discriminate against any employee or applicant for employment based on race, color, creed, sex, religion, marital status, age, national origin or ancestry, physical or mental disability, medical condition, parental status, sexual orientation, veteran status, genetic testing results or any other consideration made unlawful by federal, state or local laws. This practice relates to all personnel matters such as compensation, benefits, training, promotions, transfers, layoffs, etc. Furthermore, our organization is committed to going beyond the legal requirements of equal employment opportunity to take positive actions which ensure diversity in the workplace and result in a multi-cultural organization.

Who we are: Restore Hyper Wellness is the leader in proactive health and wellness Title: Mobile IV Nurse - Northern Utah Location: This is a mobile, in-home service role primarily located in Salt Lake City and Northern Utah (Bountiful, Farmington, and Ogden). About the Role: At Restore Hyper Wellness, we believe in helping people feel their best so they can do more of what they love. The Mobile IV Nurse is a part-time, field-based position ideal for a nurse who enjoys working independently, connecting one-on-one with clients, and delivering high-quality care outside of a traditional clinical setting. You'll provide in-home IV therapy services to Restore clients, ensuring every visit is safe, professional, and positive. This role is perfect for an RN who is passionate about helping people feel their best and is looking for a few flexible days of work per week. You'll work closely with our Mobile IV team to deliver exceptional care while representing Restore's mission and standards in the community. Work You'll Do: * Provide mobile IV therapy services in clients' homes in accordance with Restore protocols and Utah state regulations * Perform client intakes, review health histories, and ensure appropriate medical clearance prior to treatment * Safely start IVs, monitor clients during treatment, and provide post-service care instructions * Educate clients on IV options, nutrients, and wellness services in a clear, supportive, and approachable way * Create a calm, professional, and reassuring experience for clients in their home environment * Maintain accurate documentation, medical records, and treatment notes for each visit * Communicate effectively with the Mobile IV Manager regarding scheduling, client needs, and follow-ups * Uphold Restore's high standards for cleanliness, safety, and professionalism in every visit What We're Looking For: * Active Registered Nurse (RN) license in the state of Utah * Comfortable working independently in a mobile / in-home setting * Strong IV skills and confidence starting IVs in varied environments * Friendly, professional, and patient-focused demeanor * Clear communicator with a compassionate, service-oriented mindset * Reliable, punctual, and well-organized * Passion for health, wellness, and helping people feel their best * Availability for part-time work (a few days per week) * Previous IV therapy or wellness experience is a plus, but not required-training is provided What You Get: * Flexible, part-time schedule * Supportive team and clear clinical protocols * Meaningful, one-on-one client interactions * Competitive hourly compensation * Opportunity to work in a fast-growing wellness space without hospital-style burnout This is a remote position. Compensation: $37.00 per hour Restore Hyper Wellness is the award-winning industry leader and creator of an innovative new category of care-Hyper Wellness. Restore delivers expert guidance and the most extensive array of cutting-edge modalities available under one roof. With over 100+ locations nationwide and a fast-growing retail footprint, Restore is making true health more accessible than ever before. Restore is one of America's fastest-growing companies right now, and for good reason. Inc. 5000 just named Restore the #1 hottest franchise in America, and #113th company in America. We are on a blazing mission to restore people's health and wellness so that they can do more of what they love every day. Our daily metric? How many people we helped that day. That's why it is paramount that we attract people who are as passionate about helping people as we are. Join us on our mission to help people feel better so they can do more of what they love.

Who we are: Restore Hyper Wellness is the leader in proactive health and wellness Title: Mobile IV Nurse - Northern Utah Location: This is a mobile, in-home service role primarily located in Salt Lake City and Northern Utah (Bountiful, Farmington, and Ogden). About the Role: At Restore Hyper Wellness, we believe in helping people feel their best so they can do more of what they love. The Mobile IV Nurse is a part-time, field-based position ideal for a nurse who enjoys working independently, connecting one-on-one with clients, and delivering high-quality care outside of a traditional clinical setting. You'll provide in-home IV therapy services to Restore clients, ensuring every visit is safe, professional, and positive. This role is perfect for an RN who is passionate about helping people feel their best and is looking for a few flexible days of work per week. You'll work closely with our Mobile IV team to deliver exceptional care while representing Restore's mission and standards in the community. Work You'll Do: Provide mobile IV therapy services in clients' homes in accordance with Restore protocols and Utah state regulations Perform client intakes, review health histories, and ensure appropriate medical clearance prior to treatment Safely start IVs, monitor clients during treatment, and provide post-service care instructions Educate clients on IV options, nutrients, and wellness services in a clear, supportive, and approachable way Create a calm, professional, and reassuring experience for clients in their home environment Maintain accurate documentation, medical records, and treatment notes for each visit Communicate effectively with the Mobile IV Manager regarding scheduling, client needs, and follow-ups Uphold Restore's high standards for cleanliness, safety, and professionalism in every visit What We're Looking For: Active Registered Nurse (RN) license in the state of Utah Comfortable working independently in a mobile / in-home setting Strong IV skills and confidence starting IVs in varied environments Friendly, professional, and patient-focused demeanor Clear communicator with a compassionate, service-oriented mindset Reliable, punctual, and well-organized Passion for health, wellness, and helping people feel their best Availability for part-time work (a few days per week) Previous IV therapy or wellness experience is a plus, but not required-training is provided What You Get: Flexible, part-time schedule Supportive team and clear clinical protocols Meaningful, one-on-one client interactions Competitive hourly compensation Opportunity to work in a fast-growing wellness space without hospital-style burnout This is a remote position. Compensation: $37.00 per hour Restore Hyper Wellness is the award-winning industry leader and creator of an innovative new category of care-Hyper Wellness . Restore delivers expert guidance and the most extensive array of cutting-edge modalities available under one roof. With over 100+ locations nationwide and a fast-growing retail footprint, Restore is making true health more accessible than ever before. Restore is one of America's fastest-growing companies right now, and for good reason. Inc. 5000 just named Restore the #1 hottest franchise in America, and #113th company in America. We are on a blazing mission to restore people's health and wellness so that they can do more of what they love every day. Our daily metric? How many people we helped that day. That's why it is paramount that we attract people who are as passionate about helping people as we are. Join us on our mission to help people feel better so they can do more of what they love.

Job DescriptionBenefits: 401(k) Dental insurance Paid time off Tranquility Place is one of the last privately owned methadone clinics in Utah and we are looking to hire a dosing nurse. Going on ten years changing lives one person at a time. Relaxed, supportive, transparent, management. Interactive team spirit. Collaborative, supportive environment. A small company that cares for employees as well as for the people we serve. We offer strong team spirit and staff involvement, honesty and trust at all levels, and compassionate service to employees and clients alike. Job Requirements and Duties Must be at minimum a Licensed Practical Nurse (LPN) with an active license in the state of Utah Must pass background check Competent with computer and software (software training done in house) Administers medication to patients Hand out takehome doses Prepares specimens for UA lab

The Hospitalists Coordinator is responsible for coordinating and organizing the clinical care provided to inpatients under the Hospitalists Service. This is a clinically supportive role that facilitates, directs, and assigns patient loads, new admissions, and organizes logistics for physicians rounding of patients. **Position Details** · **Shift Details:** Part time, 21 hours/week, swing (1500 - 0000) and night shift (1800 - 0600), some weekend and holiday requirements · **Department:** Hospitalist · **Primary Location:** Valley Center Tower · **Additional Details:** Two years of clinical hospital experience required. Job Essentials Clinical Excellence: Reviews hospitalists' patient census and uses clinical expertise to divide patient loads to create work-list each day. This includes reviewing on-going census changes due to discharges and new admissions, reviewing pertinent patient information to facilitate physician rounding, and planning the day for physicians to see patients in an appropriate order. Organizes the logistics for physician rounds by gathering paperwork, forms, and medication reconciliation and prepares orders and prescriptions for discharging patients by obtaining patient information, preferred pharmacy, preferred place to obtain follow up labs, etc. at the direction of the physician. Maintains appropriate communication with community physicians and assists the Hospitalists with appropriate hand-off. Screens and, where appropriate, answers questions from patients and families post discharge. Fields questions from pharmacies, mortuaries, etc. and appropriately fill out forms for death certificates and billing requests. Patient Engagement: Works with physicians and patients to actively improve patient engagement and patient satisfaction scores by answering questions in ways patients can understand, spending time alleviating family and patient concerns, and providing written information and resources. Operational Effectiveness: Uses resources effectively and looks for ways to reduce cost while maintaining positive clinical and service outcomes. Works with Hospitalists, Case Management, and Social Services to identify barriers to care, reduce length of staym and decrease cost. Employee Engagement: Role models and fosters an environment of professionalism and personal engagement in the department and hospital by treating each other with mutual respect and working with physicians, members of the interdisciplinary team, and management to create a dynamic environment that fosters trust and feedback. Physician Engagement: Works with Physicians to develop standardized processes and approaches for treatment for various diseases using evidence based medicine. Provides physician reminders for consistent, quality practice. Works to represent Intermountain Healthcare in a positive way by explaining the hospitalists' role to patients and families in a way they can understand. Reinforces Hospitalists role, manages up each physician, and thoroughly describes Primary Care Provider and Hospitalists relationship to patients and families. Community Stewardship: Participates in opportunities to market the hospitalists program to outlying clinics. Performs follow up phone calls on discharged patients to ensure questions are answered and concerns are addressed. Minimum Qualifications Current RN License in state of practice. - and - Basic Life Support Certification (BLS) for healthcare providers. Two years of clinical hospital experience. - and - Basic computer experience. - and - Professional verbal and written communication skills. - and - RNs hired or promoted into this role need to have or obtain their BSN within three years of hire or promotion. Preferred Qualifications Bachelor's degree in Nursing (BSN). Education must be obtained from an accredited institution. Degree will be verified. Experience in training and auditing procedures. - and - Clear understanding of health care products, ethics policies, and internal processes. - and - Working knowledge of IDX, Clinical Workstation, AS400, LINC, OVID, and the Int. Ongoing need for employee to see and read information, labels, monitors, identify equipment and supplies, and be able to assess patient needs. - and - Frequent interactions with patient care providers, patients, and visitors that require employee to verbally communicate as well as hear and understand spoken information, alarms, needs, and issues quickly and accurately, particularly during emergency situations. - and - Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer use and typing for documenting patient care, accessing needed information, etc. **Location:** Valley Center Tower **Work City:** Murray **Work State:** Utah **Scheduled Weekly Hours:** 21 The hourly range for this position is listed below. Actual hourly rate dependent upon experience. $40.39 - $60.96 We care about your well-being - mind, body, and spirit - which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged. Learn more about our comprehensive benefits package here (***************************************************** . Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process. All positions subject to close without notice.

at Orem Rehab & Skilled Nursing. *Flexible shift options available! Pay: $31.00 - $40.00+ (Depending on experience.) Shifts: 6 pm - 10 pm Time Type: Part-time *The Many Perks We Offer!! - *Bonus Programs! *Daily Pay options! - Get paid when you want! *Quick Career Advancement Opportunities! - We will help you rise to the top! *Flexibly Schedule options. *Career Path Development *Tuition Reimbursement Program *GET PAID TO BRING YOUR FRIENDS! Referral Bonus opportunity *Cell Phone, Movie Ticket, and other major Discounts *Medical, Dental, Life Insurance *Mentorship and Training *401(k) with Matching Contributions *Health Insurance, Dental Insurance, Vision Insurance, Life Insurance, Etc... +Plus many more! Please ask us about all of the amazing perks we offer! About The Team: We are a culturally driven facility that strives to put our employees first! It is actually our motto that "Employees Come First" here at Orem Rehab. You will hear this all the time working with our leaders. We enjoy celebrating our accomplishments on a regular basis. Here at Orem Rehab, we have a passion for learning, embrace change, and encourage growth! Our team is driven to provide exceptional service by cultivating a workforce that is dedicated to upholding our company's mission of delivering care with compassion and integrity. We value innovation and creativity in our buildings. Responsibilities: Identify patients' care requirements, focus on their needs and act on them Nurture a compassionate environment by providing psychological support Resolve or report on patients' needs or problems Prepare patients for examinations and perform routine diagnostic checks (monitor pulse, blood pressure and temperature, provide drugs and injections etc...) Monitor and record patient's condition and document provided care services Treat medical emergencies Administer workloads Follow care regulations and standards Work within and cooperate with a multidisciplinary team Job Requirements: Must have an active Utah State RN License or Utah or compact state nursing license (RN). Our Mission Statement: As a family we are focused on providing personalized quality care through hope, compassion, and dedication to excellence! Our Vision Statement: Together we grow with our community to prove quality clinical care by creating a fun, uplifting culture, with a home like environment!! We are looking for qualified RNs or LPNs to work with a great team here at our facility!! Please apply here now or contact our recruitment director for any help: James Mendenhall HR Manager Orem Rehab and Skilled Nursing Center 575 E. 1400 S. Orem, UT 84097. ********************** - Main office # ************** Work schedule Monday to Friday On call Day shift Night shift Weekend availability Supplemental pay Bonus pay Other Benefits Flexible schedule Referral program Employee discount Paid training Other

Benefits: 401(k) Competitive salary Dental insurance Health insurance Paid time off Job Title: Night Emergency Room Registered Nurse (RN) Employment Type: Full-time (Night Shift) About Us: Join our dedicated healthcare team in Toole, UT, where we are committed to providing exceptional emergency care. We are currently seeking a skilled and compassionate Night Emergency Room RN to join our dynamic ER team. Key Responsibilities: Provide high-quality care to patients in the emergency room during night shifts. Assess and triage patients based on the severity of their condition. Administer medications and treatments as prescribed. Collaborate with physicians and other healthcare professionals to develop and implement patient care plans. Monitor patients' vital signs and respond to changes in their condition. Maintain accurate and detailed patient records. Follow all safety protocols and infection control procedures to ensure patient safety. Qualifications: Graduate of an accredited nursing program. Current and valid RN license in good standing. Previous experience in an emergency room setting preferred. Basic Life Support (BLS) and Advanced Cardiovascular Life Support (ACLS) certifications required. Strong clinical skills and attention to detail. Excellent communication and interpersonal skills. Ability to work efficiently in a fast-paced and high-stress environment. Benefits: Competitive salary and comprehensive benefits package. Health, dental, and vision insurance. Paid time off and retirement savings plan. Opportunities for professional growth and development. Supportive and collaborative work environment. How to Apply: If you are a dedicated and compassionate professional with the required qualifications, we encourage you to apply. Please submit your resume and cover letter detailing your experience and certifications. Join us in making a difference in emergency care. Apply today! Great jobs. Great company. Great community of caregivers. At Aura Staffing Partners, we know that partnering with you to find the right opportunity in healthcare is just the beginning. We don't leave you high and dry, instead we help you grow even brighter with quarterly reviews, continued training and plenty of communication.

Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching strategy to provide quality and cost-effective member care. Job Duties Facilitates clinical/medical reviews of retrospective medical claim reviews, medical claims and previously denied cases in which an appeal has been made, or is likely to be made, to ensure medical necessity and appropriate/accurate billing and claims processing. Reevaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of relevant and applicable state and federal regulatory requirements and guidelines, knowledge of Molina policies and procedures, and individual judgment and experience to assess the appropriateness of services provided, length of stay, level of care, and inpatient readmissions. Validates member medical records and claims submitted/correct coding, to ensure appropriate reimbursement to providers. Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review including diagnosis-related group (DRG) validation, itemized bill review, appropriate level of care, inpatient readmission, and any opportunities identified by the payment integrity analytical team; makes decisions and recommendations pertinent to clinical experience. Prepares and presents cases representing Molina, along with the chief medical officer (CMO), for administrative law judge pre-hearings, state insurance commissions, and judicial fair hearings. Reviews medically appropriate clinical guidelines and other appropriate criteria with medical directors on denial decisions. Supplies criteria supporting all recommendations for denial or modification of payment decisions. Serves as a clinical resource for utilization management, CMOs, physicians and member/provider inquiries/appeals. Provides training and support to clinical peers. Identifies and refers members with special needs to the appropriate Molina program per applicable policies/protocols. Job Qualifications REQUIRED QUALIFICATIONS: At least 2 years clinical nursing experience, including at least 1 year of utilization review, medical claims review, long-term services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. Registered Nurse (RN). License must be active and unrestricted in state of practice. Experience demonstrating knowledge of ICD-10, Current Procedural Technology (CPT) coding and Healthcare Common Procedure Coding (HCPC). Experience working within applicable state, federal, and third-party regulations. Analytic, problem-solving, and decision-making skills. Organizational and time-management skills. Attention to detail. Critical-thinking and active listening skills. Common look proficiency. Effective verbal and written communication skills. Microsoft Office suite and applicable software program(s) proficiency. PREFERRED QUALIFICATIONS: Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), or other health care certifications. Nursing experience in critical care, emergency medicine, medical/surgical or pediatrics. Billing and coding experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V. Pay Range: $29.05 - $67.97 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA * This position is responsible for maintaining the financial integrity of both the patient and the organization through the provision of quality based patient care focusing on the medical necessity and efficiency of the delivery of such care; achieved via managing the cost of care while providing timely and accurate information to third party payers and medical care team. * This position may be required to access and administer medications within their scope of practice and according to state law. Required * One year Utilization Review or Case Management experience. Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes. Responsibilities * Applies approved utilization criteria to monitor appropriateness of admissions with associated levels of care and continued stay review. * Communication to third-party payers for initial and concurrent clinical review. * Reviews patient chart to ensure patient continues to meet medical necessity. * Documentation of all actions and information shared with care team members or third-party payer. * Alerts and discusses with physician/provider and case manager/discharge planner when patient no longer meets medical necessity criteria for the inpatient stay. * Discusses with physicians the appropriateness of resource utilization. * Tracks length of stay (LOS) and resource utilization to identify at risk patients. * Refers to UR committee any case that surpasses expected LOS, expected cost, or over/under-utilization of resources. * Performs verbal/fax clinical review with payer as determined by nursing judgment and/or collaboration with the payer per university contractual obligation. * Participant in UR Committee as needed. * Collects data on variances in LOS, avoidable days, costs/barriers to discharge/transition and denied days. * Prepares appeals on denied cases when appropriate. * At the discretion of department operational and patient care needs, this position is required to work rotating schedules, which may include variable hours, weekends, nights, and holidays to meet the staffing and patient care demands of a 24/7 complex health system. Regular, reliable, and punctual attendance during assigned shifts is considered an essential function of the role. Knowledge / Skills / Abilities * Demonstrated availability to work variable and rotating shifts, including nights, weekends, and holidays, in a 24/7 patient care environment. * Ability to perform the essential functions of the job as outlined above. * Demonstrated team leadership, relationship building, critical analysis, and written and verbal communication skills. * Demonstrated knowledge of payers, payer systems, cost effective utilization management and InterQual criteria. * The ability to demonstrate knowledge of the principles of life span growth and development and the ability to assess data regarding the patient's status and provide care as described in the department's policies and procedures manual. * Ability to work autonomously and as a team member. Qualifications Qualifications Required * One year Utilization Review or Case Management experience. Licenses Required * Current license to practice as a Registered Nurse in the State of Utah, or obtain one within 90 days of hire under the interstate compact if switching residency to State of Utah. Must maintain current Interstate Compact (multi-state) license if residency is not being changed to Utah. * Additional license requirements as determined by the hiring department. Qualifications (Preferred) Preferred * Basic Life Support Health Care Provider card. * Proficiency in application of InterQual Criteria, knowledge of ICD-9, DRG's and CPT Codes. * Utilization Review Certification designation. * Knowledge of CMS Regulations. Working Conditions and Physical Demands Employee must be able to meet the following requirements with or without an accommodation. * This is a sedentary position in an office setting that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions. This position does not provide care to patients. Physical Requirements Color Determination, Far Vision, Listening, Near Vision, Sitting, Speaking

Advantmed is a leading provider of risk adjustment, quality improvement and value-based solutions to health plans and providers. We drive market leading performance with integrated technology, service, and program solutions that optimize the risk and quality performance of our partners. Our solutions focus on identifying, managing, and documenting risk and quality performance, and the proactive clinical engagement of high acuity populations. The building B.L.O.C.K.S. of our team's success! Bring the fun Leverage together for better Outperform yourself Care at every touchpoint Keep your word. Keep it real Stay curious & listen well Primary Purpose: We are proud of the quality care we provide members, and our team is rapidly expanding to meet the demands of our growing business; we are seeking a highly skilled and compassionate certified Nurse Practitioner to join our Advantmed provider network. In this role, you will be responsible for conducting in-home wellness risk adjustment assessments for Medicare members and other at-risk populations. Your primary objective will be to assess the overall health and well-being of member beneficiaries to ensure accurate and comprehensive risk adjustment coding, leading to greater value-based care. This role is 1099 (PRN) and offers tremendous flexibility and opportunity for those who are balancing competing priorities. Learn more about our primary purpose here Follow us on LinkedIn: ****************************************** NP Responsibilities: In-home Clinical Assessments Travel to members' homes and conduct comprehensive health evaluations Conduct Annual Wellness Visits and health assessments for members with chronic conditions. Perform: Medical history and physical examinations Review of systems Vital signs collection Medication review and reconciliation Possible preventive health screenings Hemoglobin A1C Spirometry KED (Kidney Health Evaluation) DRE (Diabetic Retinal Exam) FIT Patient Education & Engagement Deliver preventive health education and counseling opportunities. Educate patients on ongoing health monitoring, medication adherence, and chronic condition management. Support informed decision-making and ensure true, informed consent. Engage in goals of care discussions when appropriate. Care Coordination & Quality Support Identify clinically relevant diagnoses for care management and risk adjustment documentation. Communicate findings used to generate post visit summaries for the primary care provider. Identify and help close quality care gaps (e.g., screenings, labs, follow-ups). Collaborate enthusiastically with the broader care team to enhance clinical quality and patient experience. Compliance & Professional Standards Adhere to HIPAA regulations and safeguard protected health information (PHI). Maintain accurate, timely, and compliant EMR documentation. Perform additional duties as assigned in alignment with organizational goals. An enthusiastic collaborator contributing to the enhancement of care delivery Providers are expected to commit a minimum of 30 hours per month Locations: Weber County, Utah Requirements Travel Requirements Daily travel expectations remain within a 55-mile radius of the assigned home location. NP Qualifications: Must have a valid unencumbered NP License for the state you will be working in This role requires travel up to a maximum 55-mile radius originating in the assigned job posting county Preference is given to weekday schedules Preference is given to standard working hour schedules Previous in-home risk assessment experience preferred Previous 1099 (PRN) experience is preferred but not required 3 years patient care experience preferred (primary care/adult/geriatric, EMR) May be requested to obtain additional NP licensure supported by Advantmed Access to reliable transportation that will enable you to travel to members' homes within a designated area Strong ability to work within our EMR system Ability to work independently Bilingual is a plus Benefits Advantmed offers: Competitive compensation of ~$100 per completed in-home health assessment Paid mileage Flexible work schedule, choose your own schedule No on call Visits ready to be scheduled immediately Appointment confirmation support Dedicated coordinator support Advanced member scheduling coverage State of art technology

In partnership with Intermountain Health, Surgery Partners is seeking experienced OR nurse to join our Team! We are open Tuesday-Friday. No Holidays! No Weekends! Our specialties include: cataracts, ENT, podiatry, ortho, plastics, oculoplastics and colorectal. Job Summary The Nurse Circulator assists in provision of nursing care to patients in an Ambulatory Surgical Center setting. Assumes total responsibility for patient care in accordance with physician's orders and centers policies. During operations and other surgical procedures, the circulator assists by acting as an intermediary between the operating room staff and the rest of the surgical center. Responsibilities * Performs circulating functions including monitoring, recording and communicating patient condition and managing overall nursing care of patient before, during and after procedure. * Prepares operating rooms including equipment and supplies for use. * Performs patient positioning and ensures patient safety throughout procedure. Qualifications: * Graduate of Accredited School of Nursing; current state RN license. * BLS required. * Minimum one year in the OR, ability to scrub as well as circulate preferred. Our employees are critical to our success and we value their contributions. Surgery Partners offers a competitive compensation and benefits package and an opportunity to grow and develop your career in an environment that values employee ideas and diversity. Equal Opportunity Employer. We maintain a drug-free workplace and require pre-employment drug screening. Benefits: * Comprehensive health, dental, and vision insurance * Health Savings Account with an employer contribution * Life Insurance * PTO * 401(k) retirement plan with a company match * And more! Equal Employment Opportunity & Work Force Diversity Our organization is an equal opportunity employer and will not discriminate against any employee or applicant for employment based on race, color, creed, sex, religion, marital status, age, national origin or ancestry, physical or mental disability, medical condition, parental status, sexual orientation, veteran status, genetic testing results or any other consideration made unlawful by federal, state or local laws. This practice relates to all personnel matters such as compensation, benefits, training, promotions, transfers, layoffs, etc. Furthermore, our organization is committed to going beyond the legal requirements of equal employment opportunity to take positive actions which ensure diversity in the workplace and result in a multi-cultural organization.

Benefits: * Competitive salary * Dental insurance * Health insurance * Training & development Restore Hyper Wellness is the leading retail provider of alternative health and wellness modalities in the United States. Our goal is to make Hyper Wellness widely accessible, affordable, and fun. This means helping people from all walks of life feel better and perform at a higher level so they can do more of what they love in life. Inc. 5000 ranked Restore as the #113 Fastest Growing Company in America, the #17 Fastest Growing Company in Texas, and the #1 Hottest Franchise in America. Job Summary Do you have a passion for nursing but are tired of the hectic, high-stress environment of a clinic or ER? This is your chance to take your career in an exciting, new direction. Restore is seeking an outgoing, experienced Nurse to join our team of wellness professionals on a mission to help people feel better so they can do more of what they love. We're the antithesis of a traditional medical office or clinic, offering innovative wellness services in a fun, comfortable environment. Our nurses have described working for Restore as "the most fun you can have at a nursing job while still helping people in a meaningful way." This is your opportunity to take an active role in assisting individuals on their health and wellness journey and leading a team of nurses to support the Restore mission. Responsibilities Medical Operations & Clinical Duties * Administer IV Drip Therapy and Intramuscular (IM) Shots to deliver our menu of vitamins, minerals, and antioxidants. * Educate clients on the qualities and benefits of our IV Drip and Intramuscular (IM) Shot ingredients. * Administer Hyperbaric Oxygen Therapy sessions. * Utilize blood test offerings to help clients optimize their wellness. * Promote memberships and medical services based on client needs. * Document client visits via electronic medical records. * Address and answer client questions using the Restore Nursing Reference Guide under the supervision of the Medical Director and network of licensed Advanced Practice Providers. * Communicate to the medical compliance team any issues or adverse effects clients experience. * Provide therapeutic communication along with exceptional customer service * Assist staff with store services. * Assist with off-site nursing events and special projects. * This position reports to the Lead Nurse. * Maintain a safe and clean working environment. Qualifications * You're a licensed Registered Nurse (RN) in the state of Utah. * You have at least two years of experience as a nurse in an acute care setting (ER, ICU, Med-Surg or similar). * You are BLS (Basic Life Support) certified * You have experience and are skilled in administering IV/IM injections. * You're comfortable using electronic medical records to document client details. * You maintain a non-judgemental outlook and have a demonstrated ability to work with a diverse clientele. * Your verbal and written communication skills are on point. * You value ethics and integrity. * You embrace a team environment and also excel at working independently. * You're willing to adhere to all policies and procedures and understand the importance of maintaining medical compliance. Compensation: $36.00 per hour Restore Hyper Wellness is the award-winning industry leader and creator of an innovative new category of care-Hyper Wellness. Restore delivers expert guidance and the most extensive array of cutting-edge modalities available under one roof. With over 100+ locations nationwide and a fast-growing retail footprint, Restore is making true health more accessible than ever before. Restore is one of America's fastest-growing companies right now, and for good reason. Inc. 5000 just named Restore the #1 hottest franchise in America, and #113th company in America. We are on a blazing mission to restore people's health and wellness so that they can do more of what they love every day. Our daily metric? How many people we helped that day. That's why it is paramount that we attract people who are as passionate about helping people as we are. Join us on our mission to help people feel better so they can do more of what they love.

Benefits: Competitive salary Dental insurance Health insurance Training & development Company OverviewRestore Hyper Wellness is the leading retail provider of alternative health and wellness modalities in the United States. Our goal is to make Hyper Wellness widely accessible, affordable, and fun. This means helping people from all walks of life feel better and perform at a higher level so they can do more of what they love in life. Inc. 5000 ranked Restore as the #113 Fastest Growing Company in America, the #17 Fastest Growing Company in Texas, and the #1 Hottest Franchise in America. Job SummaryDo you have a passion for nursing but are tired of the hectic, high-stress environment of a clinic or ER? This is your chance to take your career in an exciting, new direction. Restore is seeking an outgoing, experienced Nurse to join our team of wellness professionals on a mission to help people feel better so they can do more of what they love. We're the antithesis of a traditional medical office or clinic, offering innovative wellness services in a fun, comfortable environment. Our nurses have described working for Restore as “the most fun you can have at a nursing job while still helping people in a meaningful way.” This is your opportunity to take an active role in assisting individuals on their health and wellness journey and leading a team of nurses to support the Restore mission. Responsibilities Medical Operations & Clinical Duties Administer IV Drip Therapy and Intramuscular (IM) Shots to deliver our menu of vitamins, minerals, and antioxidants. Educate clients on the qualities and benefits of our IV Drip and Intramuscular (IM) Shot ingredients. Administer Hyperbaric Oxygen Therapy sessions. Utilize blood test offerings to help clients optimize their wellness. Promote memberships and medical services based on client needs. Document client visits via electronic medical records. Address and answer client questions using the Restore Nursing Reference Guide under the supervision of the Medical Director and network of licensed Advanced Practice Providers. Communicate to the medical compliance team any issues or adverse effects clients experience. Provide therapeutic communication along with exceptional customer service Assist staff with store services. Assist with off-site nursing events and special projects. This position reports to the Lead Nurse. Maintain a safe and clean working environment. Qualifications You're a licensed Registered Nurse (RN) in the state of Utah. You have at least two years of experience as a nurse in an acute care setting (ER, ICU, Med-Surg or similar). You are BLS (Basic Life Support) certified You have experience and are skilled in administering IV/IM injections. You're comfortable using electronic medical records to document client details. You maintain a non-judgemental outlook and have a demonstrated ability to work with a diverse clientele. Your verbal and written communication skills are on point. You value ethics and integrity. You embrace a team environment and also excel at working independently. You're willing to adhere to all policies and procedures and understand the importance of maintaining medical compliance. Compensation: $36.00 per hour Restore Hyper Wellness is the award-winning industry leader and creator of an innovative new category of care-Hyper Wellness . Restore delivers expert guidance and the most extensive array of cutting-edge modalities available under one roof. With over 100+ locations nationwide and a fast-growing retail footprint, Restore is making true health more accessible than ever before. Restore is one of America's fastest-growing companies right now, and for good reason. Inc. 5000 just named Restore the #1 hottest franchise in America, and #113th company in America. We are on a blazing mission to restore people's health and wellness so that they can do more of what they love every day. Our daily metric? How many people we helped that day. That's why it is paramount that we attract people who are as passionate about helping people as we are. Join us on our mission to help people feel better so they can do more of what they love.

Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching strategy to provide quality and cost-effective member care. ESSENTIAL JOB DUTIES: Facilitates clinical/medical reviews of retrospective medical claim reviews, medical claims and previously denied cases in which an appeal has been made, or is likely to be made, to ensure medical necessity and appropriate/accurate billing and claims processing. Reevaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of relevant and applicable state and federal regulatory requirements and guidelines, knowledge of Molina policies and procedures, and individual judgment and experience to assess the appropriateness of services provided, length of stay, level of care, and inpatient readmissions. Validates member medical records and claims submitted/correct coding, to ensure appropriate reimbursement to providers. Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. Identifies and reports quality of care issues. Assists with complex claim review including diagnosis-related group (DRG) validation, itemized bill review, appropriate level of care, inpatient readmission, and any opportunities identified by the payment integrity analytical team; makes decisions and recommendations pertinent to clinical experience. Prepares and presents cases representing Molina, along with the chief medical officer (CMO), for administrative law judge pre-hearings, state insurance commissions, and judicial fair hearings. Reviews medically appropriate clinical guidelines and other appropriate criteria with medical directors on denial decisions. Supplies criteria supporting all recommendations for denial or modification of payment decisions. Serves as a clinical resource for utilization management, CMOs, physicians and member/provider inquiries/appeals. Provides training and support to clinical peers. Identifies and refers members with special needs to the appropriate Molina program per applicable policies/protocols. REQUIRED QUALIFICATIONS: At least 2 years clinical nursing experience, including at least 1 year of utilization review, medical claims review, long-term services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. Registered Nurse (RN). License must be active and unrestricted in state of practice. Experience demonstrating knowledge of ICD-10, Current Procedural Technology (CPT) coding and Healthcare Common Procedure Coding (HCPC). Experience working within applicable state, federal, and third-party regulations. Analytic, problem-solving, and decision-making skills. Organizational and time-management skills. Attention to detail. Critical-thinking and active listening skills. Common look proficiency. Effective verbal and written communication skills. Microsoft Office suite and applicable software program(s) proficiency. PREFERRED QUALIFICATIONS: Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), or other health care certifications. Nursing experience in critical care, emergency medicine, medical/surgical or pediatrics. Billing and coding experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $29.05 - $67.97 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Job Description Advantmed is a leading provider of risk adjustment, quality improvement and value-based solutions to health plans and providers. We drive market leading performance with integrated technology, service, and program solutions that optimize the risk and quality performance of our partners. Our solutions focus on identifying, managing, and documenting risk and quality performance, and the proactive clinical engagement of high acuity populations. The building B.L.O.C.K.S. of our team's success! Bring the fun Leverage together for better Outperform yourself Care at every touchpoint Keep your word. Keep it real Stay curious & listen well Primary Purpose: We are proud of the quality care we provide members, and our team is rapidly expanding to meet the demands of our growing business; we are seeking a highly skilled and compassionate certified Nurse Practitioner to join our Advantmed provider network. In this role, you will be responsible for conducting in-home wellness risk adjustment assessments for Medicare members and other at-risk populations. Your primary objective will be to assess the overall health and well-being of member beneficiaries to ensure accurate and comprehensive risk adjustment coding, leading to greater value-based care. This role is 1099 (PRN) and offers tremendous flexibility and opportunity for those who are balancing competing priorities. Learn more about our primary purpose here Follow us on LinkedIn: ****************************************** NP Responsibilities: In-home Clinical Assessments Travel to members' homes and conduct comprehensive health evaluations Conduct Annual Wellness Visits and health assessments for members with chronic conditions. Perform: Medical history and physical examinations Review of systems Vital signs collection Medication review and reconciliation Possible preventive health screenings Hemoglobin A1C Spirometry KED (Kidney Health Evaluation) DRE (Diabetic Retinal Exam) FIT Patient Education & Engagement Deliver preventive health education and counseling opportunities. Educate patients on ongoing health monitoring, medication adherence, and chronic condition management. Support informed decision-making and ensure true, informed consent. Engage in goals of care discussions when appropriate. Care Coordination & Quality Support Identify clinically relevant diagnoses for care management and risk adjustment documentation. Communicate findings used to generate post visit summaries for the primary care provider. Identify and help close quality care gaps (e.g., screenings, labs, follow-ups). Collaborate enthusiastically with the broader care team to enhance clinical quality and patient experience. Compliance & Professional Standards Adhere to HIPAA regulations and safeguard protected health information (PHI). Maintain accurate, timely, and compliant EMR documentation. Perform additional duties as assigned in alignment with organizational goals. An enthusiastic collaborator contributing to the enhancement of care delivery Providers are expected to commit a minimum of 30 hours per month Locations: Davis County, Utah Requirements Travel Requirements Daily travel expectations remain within a 55-mile radius of the assigned home location. NP Qualifications: Must have a valid unencumbered NP License for the state you will be working in This role requires travel up to a maximum 55-mile radius originating in the assigned job posting county Preference is given to weekday schedules Preference is given to standard working hour schedules Previous in-home risk assessment experience preferred Previous 1099 (PRN) experience is preferred but not required 3 years patient care experience preferred (primary care/adult/geriatric, EMR) May be requested to obtain additional NP licensure supported by Advantmed Access to reliable transportation that will enable you to travel to members' homes within a designated area Strong ability to work within our EMR system Ability to work independently Bilingual is a plus Benefits Advantmed offers: Competitive compensation of ~$100 per completed in-home health assessment Paid mileage Flexible work schedule, choose your own schedule No on call Visits ready to be scheduled immediately Appointment confirmation support Dedicated coordinator support Advanced member scheduling coverage State of art technology

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA This position is responsible for providing patient care under the supervision of a Registered Nurse. Providing direct contact with patients and their families as well as the performance of indirect patient care activities necessary to support patients and their environment. Once the incumbent successfully passes nursing board exams and is licensed as a Registered Nurse in the State of Utah, the incumbent must apply for a Clinical Nurse position to be promoted. Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, quality standards and overall patient experience. Our five hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes. Responsibilities Works under the supervision of a registered nurse to assess, plan, implement and re-evaluate interventions for solving patient care problems. Formulates care plans for specific patients, consults with supervising nurse for oversight, and documents the nursing process in patient's record. Works under the guidance of the supervising nurse to develop and participate in educating patients, their families, or significant others about post discharge care programs. Keeps current on advances in nursing care by participating in educational programs. Participates in total quality management to positively affect patient and system outcomes to improve care. Assists the patient with Activities of Daily Living (ADL). Assists with indirect patient care activities such as providing a clean, efficient and safe patient care environment, companion care, chaperoning the physician during patient examinations/procedures, housekeeping, transporting, stocking and maintenance tasks. Performs unit specific duties as required. Accepts delegated tasks as appropriate to training and certification. Performs as an integral component of the health care team. At the discretion of department operational and patient care needs, this position is required to work rotating schedules, which may include variable hours, weekends, nights, and holidays to meet the staffing and patient care demands of a 24/7 complex health system. Regular, reliable, and punctual attendance during assigned shifts is considered an essential function of the role. Knowledge / Skills / Abilities Demonstrated availability to work variable and rotating shifts, including nights, weekends, and holidays, in a 24/7 patient care environment. Demonstrated ability to perform the essential functions as outlined above. Ability to provide care to the population served. Demonstrated knowledge of the principles of life span growth and development and the ability to assess data regarding the patient's status and provide care as described in the department's policies and procedures manual. Demonstrated human relations and effective communication skills. Qualifications QualificationsLicenses Required Current RQI Healthcare Provider eCredential through the University of Utah Health RQI system. The eCredential is to be obtained within 30 days of hire. One of the following Current license to practice as a Temporary Graduate Nurse in the State of Utah Current license to practice as a Temporary RN Apprentice in the State of Utah * Additional license requirements as determined by the hiring department. Qualifications (Preferred) Working Conditions and Physical Demands Employee must be able to meet the following requirements with or without an accommodation. This position involves intensive work that may exert up to 100 pounds and may consistently require lifting, carrying, pushing, pulling or otherwise moving objects, such as medical equipment, or patients while providing medical care. Workers in this position may be exposed to infectious diseases and may be required to function around prisoners and behavioral health patients. Physical Requirements Carrying, Climbing, Color Determination, Crawling, Far Vision, Lifting, Listening, Manual Dexterity, Near Vision, Non Indicated, Pulling and/or Pushing, Reaching, Sitting, Speaking, Standing, Stooping and Crouching, Tasting or Smelling, Walking