RN Telehealth Full-time
Aledade

Registered Nurse (ACCESS Program), Remote

As an Aledade Registered Nurse supporting ACCESS, you'll play a behind-the-scenes but mission-critical role in transforming how we manage chronic disease at scale. ACCESS (Advancing Chronic Care with Effective, Scalable Solutions) is built to close the gap between clinical data and real patient outcomes, and you'll be at the center of that work — reviewing patient charts, verifying eligibility, establishing baseline tracking, and releasing standing lab orders for cardio-kidney-metabolic (CKM) conditions. Your clinical judgment and precision directly shape whether patients get the right diagnostic path at the right time. And as the program grows, so does the role: you'll have the opportunity to expand into active patient and provider outreach through our telephony platform, Five9, deepening your impact from behind-the-scenes coordination to direct engagement.     Candidates should be comfortable working remotely from anywhere within the US, across all US time zones.        

 

Primary Duties:

Clinical Coordination

  • Review patients entering the ACCESS program using integrated lab data to identify missing baseline tests, verify clinical indications, diagnosis codes, and elapsed time against standing orders for specific tracks (eCKM vs. CKM).
  • Release standing lab orders in the EHR under the Regional ACCESS Director's authority while documenting medical necessity and ordering intent to meet Medicare clinical laboratory billing requirements.
  • Manage daily order queues with speed, precision, and high clinical accuracy to maintain strict turnaround targets and prevent enrollment delays. 

Continuous Improvement & Program Partnership

  • Act as a subject matter expert on lab ordering processes and workflows while providing clinical expertise to support the interdisciplinary care team
  • Proactively identify friction, error-prone steps, and automation opportunities to directly optimize initial operations
  • Partner and act as a collaborative thought partner with key stakeholders to test workflows, resolve clinical blockers, and drive operational improvements
  • Other duties as assigned

Minimum Qualifications:

  • Associate Degree in Nursing (ADN) from an accredited nursing program
  • Minimum of 2 years clinical nursing experience
  • Active, unrestricted multistate Registered Nurse license through the Nurse Licensure Compact (NLC), with willingness to obtain additional individual state licenses as program needs expand — specifically: California, Alaska, Arkansas, Hawaii, Illinois, Massachusetts, Minnesota, Nevada, New York, and Oregon.
  • Experience with protocol-driven or standing-order work (i.e. Releasing orders, executing physician-delegated tasks, or working from clinical protocols rather than case-by-case)
  • Proven reliability in high-volume, repetitive, and detail-critical work
  • Ability to review and synthesize patient records, validate lab history, and identify outstanding diagnostic requirements.
  • Working knowledge of common laboratory panels and their clinical indications, including lipid panels, HbA1c, eGFR, and uACR.
  • Proficiency with electronic health records (EHRs) and order entry.
  • Strong attention to detail and documentation, ensuring accuracy for compliance and billing
  • Ability to adapt and demonstrate resilience in a fast-paced, evolving healthcare setting
  • Ability to work both independently and as part of a multidisciplinary team

Preferred Qualifications:

  • Bachelor of Science in Nursing (BSN)
  • Experience in Value Based Care Organizations
  • Active, unrestricted Registered Nurse (RN) license in Tennessee, New Jersey, Texas, Oregon, Mississippi, Kentucky, or Utah
  • Experience with athenaOne/Athena EHR
  • Experience working with diverse and underserved populations

Physical Requirements:

  • Prolonged periods of sitting at a desk and working on a computer
  • Ability to maintain sustained attention and focus during high-volume clinical chart reviews
Who We Are: Aledade PBC, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of health plans, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.   What Does This Mean for You? At Aledade PBC, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.   In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:   Flexible work schedules and the ability to work remotely are available for many roles Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners Robust time-off plan (21 days of PTO in your first year) Two paid volunteer days and 11 paid holidays 12 weeks paid parental leave for all new parents Six weeks paid sabbatical after six years of service Educational Assistant Program and Clinical Employee Reimbursement Program 401(k) with up to 4% match Stock options And much more!   At Aledade PBC, we don’t just accept differences, we celebrate them! We strive to attract, develop and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit, qualifications, performance and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.    

Share this job

Share to FB Share to LinkedIn Share to Twitter

Related Jobs

Children's Health

High-Cost Therapy Liaison RN

Job Title & Specialty Area: High-Cost Therapy Liaison RN Department: Utilization Management Location: Children's Health- Trinity Towers Shift: Monday through Friday 8:00a to 5:00p Job Type: Remote, but there will be an expectation to come onsite 2x a month as well as any events that will require onsite attendance Why Children's Health? At Children's Health, our mission is to Make Life Better for Children, and we recognize that their health plays a crucial role in achieving this goal. Through our cutting-edge treatments and affiliation with UT Southwestern, we strive to deliver an extraordinary patient and family experience, ensuring that every moment, big or small, contributes to their overall well-being. Our dedication to promoting children's health extends beyond our organization and encompasses the broader community. Together, we can make a significant difference in the lives of children and contribute to a brighter and healthier future for all. Summary: A specialized clinical and reimbursement-focused role responsible for coordinating and managing complex, high-cost medication authorizations to support timely patient access to therapy. Leveraging advanced clinical knowledge and expertise in specialty medications, payer policies, medical necessity requirements, and FDA-approved indications, this role conducts comprehensive reviews of clinical documentation to develop and support authorization, denial, and appeal submissions.Working collaboratively with providers, pharmacists, clinical teams, payers, and manufacturers, the High-Cost Therapy Liaison RN serves as a subject matter expert on high-cost therapies and complex authorization requirements. This position applies critical thinking and nursing judgment to navigate coverage barriers, interpret evolving payer guidelines, identify approval risks, and recommend strategies to optimize authorization outcomes. The role requires a high level of strategic problem-solving abilities, attention to detail, and specialized knowledge of reimbursement processes to ensure compliant, accurate, and efficient access to high-cost and specialty medications. Responsibilities: * Serve as a subject matter expert on specialty and high-cost therapies by interpreting payer policies, medical necessity criteria, clinical guidelines, FDA-approved indications, and reimbursement requirements to support coverage determinations and authorization outcomes * Review and evaluate complex clinical documentation, including medical records, treatment history, laboratory results, and diagnostic information, to support high-cost medication authorization requests * Collaborate with physicians, pharmacists, and clinical staff to obtain and develop supporting documentation, including letters of medical necessity, treatment plans, and evidence-based medical research publications. * Develop and maintain relationships with pharmaceutical manufacturers to ensure timely authorization and administration of medication therapies. * Coordinate and manage prior authorizations for specialty, infusion, and other high-cost therapies across multiple payer types to ensure timely patient access to treatment and accurate payment of claims in support of organizational goals. * Supports the coordination of payer, financial, and operational processes related to high-cost therapies to ensure appropriate access and reimbursement. * Utilize clinical judgment and critical thinking to assess complex cases, resolve non-routine authorization challenges, and escalate issues to other stakeholders to assist with resolution as appropriate * Manage authorization denials, reconsideration, and appeal activities by reviewing payer determinations, coordinating peer-to-peer discussions, obtaining supporting clinical documentation, and facilitating timely submissions. * Maintain accurate and compliant documentation of authorization activities, payer communications, determinations, and appeal outcomes within designated systems. * Maintains advanced knowledge of specialty medications, reimbursement practices, payer policies, and regulatory requirements affecting high-cost therapies. * Develop and maintain relationships with pharmaceutical manufacturers to ensure timely authorization and administration of medication therapies. * Acts as a preceptor and mentor for new employees, ensuring a smooth onboarding experience through education on workflows, policies, procedures, and departmental * Maintains performance in accordance with departmental productivity and quality metrics, ensuring timely and accurate authorization processing to support continuity of care and maximize claim reimbursement. * Educates providers and office staff on payer requirements, formulary restrictions, and authorization processes. and reimbursement considerations to improve access to therapy. How You’ll Be Successful: WORK EXPERIENCE * At least 2 years clinical or healthcare-related experience in acute care, ambulatory care, specialty pharmacy, infusion services, case management, utilization management, and/or population health. Required and * At least 1 year experience in medication prior authorizations, specialty medications, high-cost therapies, reimbursement activities, or payer-related functions involving commercial, Medicare, Medicaid, and other insurance coverage determinations, denials, and appeals. Required EDUCATION * BSN in Nursing Essential BSN * Masters Degree Preferred LICENSES AND CERTIFICATIONS * Registered Nurse-1N-RN Essential Current license to practice professional nursing in the State of Texas - Time Frame: Upon Hire A Place Where You Belong We put our people first. We welcome, value, and respect the beliefs, identities and experiences of our patients and colleagues. We are committed to delivering culturally effective care, creating meaningful partnerships in the communities we serve, and equipping and developing our team members to make Children’s Health a place where everyone can contribute. Holistic Benefits – How We’ll Care for You: · Employee portion of medical plan premiums are covered after 3 years. · 4%-10% employee savings plan match based on tenure · Paid Parental Leave (up to 12 weeks) · Caregiver Leave · Adoption and surrogacy reimbursement As an equal opportunity employer, Children's Health does not discriminate against employees or applicants because of race, color, religion, sex, gender identity and expression, sexual orientation, age, national origin, veteran or military status, disability, or genetic information or any other Federal or State legally-protected status or class. This applies to all aspects of the employer-employee relationship including but not limited to recruitment, hiring, promotion, transfer pay, training, discipline, workforce adjustments, termination, employee benefits, and any other employment-related activity.
Oak Street Health

Registered Nurse - Bilingual Spanish

$72,627 - $155,538 / year
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Registered Nurse Company: Oak Street Health Role Description: The purpose of a Registered Nurse at Oak Street Health is to build strong relationships with Oak Street Health patients by coordinating their care and providing a seamless experience to patients and their support team. At Oak Street Health you will use an integrated approach toward achieving desired patient outcomes by utilizing standards, guidelines and pathways for care delivery. Through clinical assessment, intervention and education you will ensure our patients are provided competent nursing care in a timely manner. Our Registered Nurses drive quality care, it is of vital importance that our nurses incorporate data and information to improve care and enhance our patient outcomes. You will work to create an engaging and welcoming environment through team communication and delegation to empower other members of the care team to deliver the best care to our patients. Our Registered Nurses report to the Practice Manager or Nurse Supervisor (where applicable). Core Responsibilities: Provide competent nursing care by displaying proficiency in this role and executing job responsibilities in a safe and consistent manner Respond to incoming telephonic requests in a dependable manner, ensuring we are responsive to their needs and exceeding expectations Provide clinically competent triage and symptom management to patients who may or may not be physically present Utilize standardized protocols for medication management, prescription refills and prior authorizations. Conduct thorough and accurate reviews of patient medications and update as needed Provide comprehensive education and direct patient care, particularly around chronic conditions; may occur in person, over the phone or in group settings Actively collaborate and monitor the implementation and progress of the care plan for patients on multiple provider panels Form relationships with patients and their caregivers to support preventative care and ED/hospital diversion where appropriate Create a welcoming and engaging environment to meet the needs of our patients, communities, families and teams where they are Delegation of activities to other clinical care team members to support the needs of our patients Participate in care team meetings to discuss patient care and clinic operations Deliver an exceptional patient experience through service, responsiveness and respectful care Perform point of care testing, procedures and specimen collection (including phlebotomy) as needed Performs other related duties as assigned What we're looking for Required Qualifications: Active Registered Nurse (RN) Licensure in good standing with the applicable state BLS Certification Electronic Medical Record (EMR) experience Ability to maintain patient confidentiality and process information in a confidential manner US work authorization Ability to assess patients without face-to face interaction, strong communication and assessment skill Strongly Preferred Qualifications: Ability to collaborate and communicate with members of an interdisciplinary care team Excellent computer skills with ability to read, interpret and analyze data from various computer systems Effective problem solving and prioritization skills 2+ years of healthcare experience, working as an RN Preferred Qualifications: Previous experience in clinic setting Ability to work independently Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $72,627.00 - $155,538.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments . We anticipate the application window for this opening will close on: 01/01/2027 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Penn Medicine

Full-Time Clinical Documentation Review Specialist-RN -Days-Fully Remote

Description Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines. Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work? Summary: The Clinical Documentation Review Specialist is responsible for collaborating with clinicians to assure accurate completion of documentation and development of effective plans of care to assure appropriate utilization and promote appropriate quality patient care and positive patient outcomes. Responsibilities: Documentation Improvement: Reviews clinical documentation for compliance with state, federal, and TJC regulations. Follows up with team for clarification if documentation is unclear. Identifies and documents delays. Collaborates with clinicians to assure accurate completion of documentation and development of effective plans of care. Elevates issues appropriately. Utilization Management: Collects and submits data as indicated. Quality Improvement and Risk Management: Reviews clinical reports for compliance with state, federal, and TJC regulations. Collects and submits data as indicated. Communicates with service line and clinical effectiveness team members. Works with department leadership to develop and implement solutions to issues identified. Credentials: RN (Required) Must have Pennsylvania RN Education or Equivalent Experience: Bachelor of Arts or Science (Required) Education Specialization: Must have BSN from an accredited school of nursing Equivalent Experience: •And 2+ years In Medicare regulations for OASIS, compliance, and coding and/or experience in home care criteria and processes. We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives. Live Your Life's Work We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.
Telecare Corporation

Full-Time M-F Registered Nurse - Mental Health 425

$41.41 - $51.15 / hour
Registered Nurse RN - Mental Health 425 “They made it easier for me to live, breathe, eat, and stay clean. Without them, I’d be waiting somewhere, waiting for someone to give me a chance to live...” - Client from Telecare What You Will Do to Change Lives The Registered Nurse (RN) provides recovery-focused services related to the safe and appropriate administration of medical treatment (including medications) as prescribed by the physician. *This role involves driving your personal vehicle throughout Yuma, AZ to provide psychiatric care to our members. Member transportation in personal vehicles may occur* Shifts Available: Full-Time| 8:00am-5:30pm | Monday-Friday Expected starting wage range is $41.41 - $51.15. Telecare applies geographic differentials to its pay ranges. The pay range assigned to this role will be based on the geographic location from which the role is performed. Starting pay is commensurate with relevant experience above the minimum requirements. What You Bring to the Table (Must Have) Licensure as a Registered Nurse in the state of program operations Valid and current driver’s license, and personal vehicle insurance with your name listed as a driver. Willingness to use your personal vehicle to drive clients to appointments and groups, etc. (weekly mileage reimbursement at the IRS rate) What’s In It For You* Paid Time Off: Eligible employees (20+ hours/week) earn PTO each pay period for vacation and personal needs, with pro-rated accrual for part-time schedules and annual carryover up to set caps. Nine Paid Holidays & Shift differentials for hourly staff (6% for PM Shift, 10% for NOC Shift). Weekend Shift differentials for hourly staff (5% for Weekend AM Shift, 11% for Weekend PM Shift, 15% for Weekend NOC Shift) Free CEUs, free Supervision for BBS Associate License, coaching, and mentorship Online University Tuition Discount and Company Scholarships Medical, Vision, Dental Insurance, 401K, Employee Stock Ownership Plan For more information visit: https://www.telecarecorp.com/benefits Join Our Compassionate Team Telecare's mission is to deliver excellent and effective behavioral health services that engage individuals in recovering their health, hopes, and dreams. Telecare continues to advance cultural diversity, humility, equity, and inclusion at all levels of our organization by hiring mental health peers, BIPOC, LGBTQIA+, veterans, and all belief systems. Telecare Yuma ACT is an Assertive Community Treatment (ACT) program for 50 adults, ages 18+, diagnosed with a serious mental illness. EOE AA M/F/V/Disability *May vary by location and position type Full Job Description will be provided if selected for an interview. If job posting references any sign-on bonus internal applicants and applicants employed with Telecare in the previous 12 months would not be eligible.
Telecare Corporation

Full-Time M-F Registered Nurse - Mental Health 427

$41.41 - $51.15 / hour
Registered Nurse RN - Mental Health 427 “They made it easier for me to live, breathe, eat, and stay clean. Without them, I’d be waiting somewhere, waiting for someone to give me a chance to live...” - Client from Telecare What You Will Do to Change Lives The Registered Nurse (RN) provides recovery-focused services related to the safe and appropriate administration of medical treatment (including medications) as prescribed by the physician. *This role involves driving your personal vehicle throughout Sierra Vista, AZ to provide psychiatric care to our members. Member transportation in personal vehicles may occur* Shifts Available: Full-Time| 8:00am-5:30pm | Monday-Friday Expected starting wage range is $41.41 - $51.15. Telecare applies geographic differentials to its pay ranges. The pay range assigned to this role will be based on the geographic location from which the role is performed. Starting pay is commensurate with relevant experience above the minimum requirements. What You Bring to the Table (Must Have) Licensure as a Registered Nurse in the state of program operations Valid and current driver’s license, and personal vehicle insurance with your name listed as a driver. Willingness to use your personal vehicle to drive clients to appointments and groups, etc. (weekly mileage reimbursement at the IRS rate) What’s In It For You* Paid Time Off: Eligible employees (20+ hours/week) earn PTO each pay period for vacation and personal needs, with pro-rated accrual for part-time schedules and annual carryover up to set caps. Nine Paid Holidays & Shift differentials for hourly staff (6% for PM Shift, 10% for NOC Shift). Weekend Shift differentials for hourly staff (5% for Weekend AM Shift, 11% for Weekend PM Shift, 15% for Weekend NOC Shift) Free CEUs, free Supervision for BBS Associate License, coaching, and mentorship Online University Tuition Discount and Company Scholarships Medical, Vision, Dental Insurance, 401K, Employee Stock Ownership Plan For more information visit: https://www.telecarecorp.com/benefits Join Our Compassionate Team Telecare's mission is to deliver excellent and effective behavioral health services that engage individuals in recovering their health, hopes, and dreams. Telecare continues to advance cultural diversity, humility, equity, and inclusion at all levels of our organization by hiring mental health peers, BIPOC, LGBTQIA+, veterans, and all belief systems. Telecare Sierra Vista ACT serves 50 adults, ages 18+, diagnosed with a serious mental illness. Most services are community-based. EOE AA M/F/V/Disability *May vary by location and position type Full Job Description will be provided if selected for an interview. If job posting references any sign-on bonus internal applicants and applicants employed with Telecare in the previous 12 months would not be eligible.