ChristianaCare

Nurse Practitioner, Women's Health Practice, Wilmington, DE

$111,278 - $140,485 / year
Job Details ChristianaCare is looking for a full-time Nurse Practitioner who has a passion for Women’s Health. The Advanced Practice Clinician (APC) will evaluate, manage, and provide care to women seeking obstetrical and gynecologic care including family planning and prenatal services. Position Overview: The APC will be responsible, but not limited to, the following duties: Provides direct management and ambulatory health care to adolescent, adult and geriatric women seeking OB/GYN services. Responsible for ambulatory health care to women seeking OB/GYN services – women’s health care in the areas of health screening, health education, family planning, screening for sexually transmitted diseases, obstetrical care, and prenatal care of pregnant women. Assess the female patient by performing a comprehensive health history and physical examination. Performs, obtains, and/or orders appropriate laboratory tests to assist in screening and diagnostic evaluation and follow-up. Prescribes all forms of contraceptives including LARC. Monitors progress of prenatal patients and assesses risk status. Perform evaluation of normal and high-risk obstetrical patients. Performs limited OB and GYN ultrasounds. Formulate an assessment and diagnosis. Performs endometrial biopsy. Seeing patient both in-person and virtually. Recommended skills: colposcopy, vulvar biopsy. Center for Women’s & Children’s Health Highlights: Eight-story, 400,000 square foot tower at Christiana Hospital in Newark State-of-the-art NICU, featuring private rooms with sleep-in space for families. It’s one of the only hospitals in the United States to provide “couplet care.” New and expanded labor and delivery suites. ChristianaCare was rated number 24 in the country for gynecology by US News and World Report due to large volume of obstetrical and gynecologic patients and the scope of subspecialists. ChristianaCare is a tertiary care center for the entire region receiving the most acute and complicated patients. Over 6,000 deliveries a year and is consistently in the top centers in volume of gynecologic care and surgery. Nationally recognized and accredited Obstetrics and Gynecology Residency program with 28 residents Academic affiliation with Sidney Kimmel Medical College at Thomas Jefferson University We have an established division of research and are a recognized site with the NICHD’s Maternal Fetal Medicine Units Network Strong commitment to improving care. Compensation and Benefits Competitive Base Salary plus Annual Quality Incentive Bonus Generous CME Paid Time and Allowance Six weeks of Paid Time Off 12 weeks Paid Protected Parental Leave Opportunities for Career Growth 403(b) and Defined Contribution Plan Retirement Options with Employer Match Position Qualifications Completion of a master's degree program and board certification as a Women's Health Nurse Practitioner License or license eligible in the State of Delaware. Minimum of two years clinical experience preferred. Experience in in-office GYN procedures including IUD and Nexplanon insertion and removal, I&D of abscess, Endometrial biopsy, Vulvar biopsy, Wound care preferred. Prescriptive Authority, DEA registration, BLS Required About ChristianaCare : ChristianaCare is one of the country's most dynamic health systems, centered on improving health outcomes, making high-quality care more accessible and lowering health care costs. ChristianaCare includes an extensive network of outpatient services, home health care, medical aid units, three hospitals (1,300 beds), a Level I trauma center and a Level III neonatal intensive care unit, a comprehensive stroke center and regional centers of excellence in heart and vascular care, cancer care and women's health. ChristianaCare is a not-for-profit teaching health system with more than 290 residents and fellows. We are continually ranked by US News & World Report as a Best Hospital, and named among Forbes Best Employer for Diversity & Inclusion in the U.S. With our unique, data-powered care coordination service and a focus on population health and value-based care, ChristianaCare is shaping the future of health care. ChristianaCare offers caregivers an excellent benefits package, including 12-weeks of paid parental leave. Benefits of living in the Delaware Valley: Working for ChristianaCare offers the best of urban and suburban living with multiple housing options, excellent restaurants and entertainment venues, quality public and private schools and a short driving distance to popular Delaware and New Jersey beaches. The location provides easy access to Washington, DC, Philadelphia, and New York City - all within a short drive or train ride from Newark, DE. When we lead with love, excellence is inevitable. #LI-CS1 Annual Compensation Range $111,278.00 - $140,485.00 This pay rate/range represents ChristianaCare’s good faith and reasonable estimate of compensation at the time of posting. The actual salary within this range offered to a successful candidate will depend on individual factors including without limitation skills, relevant experience, and qualifications as they relate to specific job requirements. Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law. Post End Date Jun 26, 2026 EEO Posting Statement ChristianaCare offers a competitive suite of employee benefits to maximize the wellness of you and your family, including health insurance, paid time off, retirement, an employee assistance program. To learn more about our benefits for eligible positions visit https://careers.christianacare.org/benefits-compensation/
St. Luke's University Health Network

Medical Assistant - Orthopedics, Upper Bucks Region

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care. The Medical Assistant, Practice Operations' primary responsibility is to assist in the delivery of healthcare support for the practice. The Medical Assistant is a professional member of the interdisciplinary team and consistently demonstrates and promotes the values of the organization. JOB DUTIES AND RESPONSIBILITIES: Conducts pre-visit planning by reviewing and updating the patient’s medical record prior to the appointment with recent test results and correspondence and determines needed services by conferring with the provider. Completes pre-charting of all value-based pieces up to five days prior to patient’s appointment. Sends messages to the Care Team, when warranted. Responsible for preparing patients for examination and escorting them into the exam room. Preparation includes the following: height, weight and vital signs; update medication list; update allergies in record; update personal, family and social history; inquire about smoking status; obtain the reason for the visit. Assists in capturing demographic information. Provides other patient care services as needed/directed: keeps exam rooms clean; maintains clinical supplies in exam rooms; cleans and autoclaves contaminated instruments; gives injections or immunizations within State guidelines. Communicates and coordinates with providers or Care Team regarding hospital discharge, Emergency Department visits, consulting physicians, community resources, disease management, patient self-management, patient and/or family education on chronic conditions, and labs or other testing as well as specialist visits. Actively participates in department activities; attends departmental meetings; actively participates as a team member in resolution of problems as they are identified; analyzes current procedures. Responsible to dispose Bio-Hazardous waste and regular waste per practice protocol. Maintains vaccine temperature logs, inventory and ordering of medical supplies (i.e.: vaccines, medications), disposing of expired sample medication, and stocking rooms to set par levels. Performs other administrative tasks (e.g. check-in and check-out functions, opening and closing office procedures, etc...) as needed. Brings suggestions for improvement to the attention of Practice Managers and Providers for consideration. Actively participates in maintaining and/or improving quality improvement initiatives. Other related duties as assigned. PHYSICAL AND SENSORY REQUIREMENTS: Requires sitting, standing and walking for extended periods of time (up to 8 hours at time). Occasional requirement to lift up to 25 pounds. Occasionally push wheelchairs with patients weighing up to 325 pounds. EDUCATION: High School degree or equivalent required. TRAINING AND EXPERIENCE: One year of clinical experience OR graduate of Medical Assistant program required. Two years of experience in similar healthcare setting is preferred. Customer service experience is strongly preferred. BLS/CPR: Current or within 60 days of hire; through the American Red Cross or American Heart Association. Where applicable, a 30/60/90 day on-boarding checklist will be completed during the on-boarding process for new or transferred employees to confirm mastery of skills relevant to the service line. This on-boarding checklist will be acknowledged by practice leadership or a provider when appropriate; records will be retained at the practice location. Please complete your application using your full legal name and current home address. Be sure to include employment history for the past seven (7) years, including your present employer. Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable. It is highly recommended that you create a profile at the conclusion of submitting your first application. Thank you for your interest in St. Luke's!! St. Luke's University Health Network is an Equal Opportunity Employer.
Temple Health

RN Clinical Nurse Manager - Ambulatory Care Clinic - Fox Chase Canter Center 8:30a-5p

Directs the nursing care provided to patients on a nursing unit. Maintains standards of service excellence and nursing practice. Develops evidenced based policies, procedures, and work processes to ensure provision of quality patient care. Responsible for staffing, budget, control of expenses,maintaining supplies and equipment, continuing development and education of staff, performance improvement, and human resource management. Supervises, evaluates, guides and counsels nursing staff in their work performance. National certification in Nursing or Healthcare related specialty preferred. Education Bachelor's Degree Nursing Required Master's Degree Nursing or Healthcare related field Required Other Graduate Of Accredited School Of Nursing Required Or Combination of relevant education and experience may be considered in lieu of degree Required Experience 5 years experience as a RN in a clinical specialty area Required 1 Year Experience In a Clinical Leadership Role Preferred Licenses Basic Life Support Required PA Registered Nurse License Required Multi State Compact RN License Required Or
DaVita Kidney Care

Registered Nurse

Posting Date 03/13/2026 235 W Chelten Ave, Philadelphia, Pennsylvania, 19144-3802, United States of America Make a real impact—every day. As a DaVita RN, you’ll ensure compassionate and professional delivery of all dialysis-related nursing services in an outpatient setting, ensuring the safety, comfort, and wellbeing of your patients. You’ll work in a fast-paced environment, collaborate with our professional team of clinicians, and use your critical thinking skills to solve problems and support patient care. Key Responsibilities: Deliver dialysis treatments and monitor patient status Assess, troubleshoot, and respond to clinical situations Educate patients and build meaningful relationships Work as part of a supportive care team Qualifications: Current RN license in state of practice CPR certification and basic EKG interpretation 2+ years’ experience with acutely ill patients (ICU, ER, Med/Surg preferred) Strong assessment, time management, and communication skills CNN certification a plus DaVita requires teammates to comply with Federal and State requirements related to vaccination against Covid-19. This includes being up to date with vaccinations or having a qualified exemption. For our teammates who work to support in-patient treatments in hospital or healthcare systems, there may be additional booster requirements prior to providing patient care services. What We Offer: Medical, dental, vision, 401(k) with match Paid time off and PTO cash out Parental leave, family support, and mental health tools Career growth and training through DaVita’s StarLearning platform Performance-based pay and advancement opportunities Start making a difference today. Apply now to join a team that values your skills and supports your career. #LI-DO1 At DaVita, we strive to be a community first and a company second. We want all teammates to experience DaVita as "a place where I belong." Our goal is to embed belonging into everything we do in our Village, so that it becomes part of who we are. We are proud to be an equal opportunity workplace and comply with state and federal affirmative action requirements. Individuals are recruited, hired, assigned and promoted without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, protected veteran status, or any other protected characteristic. This position will be open for a minimum of three days. For location-specific minimum wage details, see the following link: DaVita.jobs/WageRates Compensation for the role will depend on a number of factors, including a candidate’s qualifications, skills, competencies and experience. DaVita offers a competitive total rewards package, which includes a 401k match, healthcare coverage and a broad range of other benefits. Learn more at https://careers.davita.com/benefits Colorado Residents: Please do not respond to any questions in this initial application that may seek age-identifying information such as age, date of birth, or dates of school attendance or graduation. You may also redact this information from any materials you submit during the application process. You will not be penalized for redacting or removing this information.
Temple Health

RN-Staff/Clinical Nurse- Vascular Wound Care (40/hrs, Day Shifts) - Temple Faculty Practice

Provides professional nursing care at the proficient level which includes assessment, planning, implementation, and evaluation in accordance with care standards, under the direction of a licensed physician or other licensed medical professional. Contributes to a safe and therapeutic environment that is centered on the needs of the patients, caregivers and others demonstrating concern for the patient's privacy, comfort, and emotional state. Treats patient with consideration to age, race, gender, gender identity, sexual orientation, religion, socioeconomic background, and culture in a caring, ethical, and professional manner. Education Bachelor's Degree Preferred Other Graduate of an accredited school of nursing Required Experience 1 year experience in area of clinical specialty Preferred General Experience In An Outpatient / Ambulatory Setting Preferred General Experience with EPIC EMR Preferred Licenses PA Registered Nurse License Required Basic Life Support Required Multi State Compact RN License Required Or
Temple Health

RN-Staff/Clinical Nurse- Pediatrics-Primary Care (Temple Faculty Practice)

Provides professional nursing care at the proficient level which includes assessment, planning, implementation, and evaluation in accordance with care standards, under the direction of a licensed physician or other licensed medical professional. Contributes to a safe and therapeutic environment that is centered on the needs of the patients, caregivers and others demonstrating concern for the patient's privacy, comfort, and emotional state. Treats patient with consideration to age, race, gender, gender identity, sexual orientation, religion, socioeconomic background, and culture in a caring, ethical, and professional manner. Education Bachelor's Degree Preferred Other Graduate of an accredited school of nursing Required Experience 1 year experience in area of clinical specialty Preferred General Experience In An Outpatient / Ambulatory Setting Preferred General Experience with EPIC EMR Preferred Licenses PA Registered Nurse License Required Basic Life Support Required Multi State Compact RN License Required Or Schedule: M,W 9-5:30pm Tu, Th 10:30 AM- 7PM |Saturday 7:30 AM - 3 PM| Friday off
Albany Medical Center

Registered Nurse - Rheumatology Office

$83,200 - $128,960 / year
Department/Unit: HBD - Rheumatology Work Shift: Day (United States of America) Salary Range: $83,200.00 - $128,960.00 RN – Full Time Rheumatology Office – Albany, NY Work schedule: Monday – Friday Our Rheumatology outpatient practice is seeking an RN to join our team of dedicated healthcare professions that provide exceptional care! The Department of Rheumatology at Albany Medical Center includes providers who are experts in their field. They have extensive training and experience in the diagnosis and treatment of arthritis, certain autoimmune diseases, musculoskeletal pain disorders, osteoporosis, and other diseases of the joints, muscles, and bones. There are over 100 types of rheumatic diseases which can be serious and very difficult to diagnose and treat. Symptoms can vary from patient to patient and the experts at Albany Med work collectively to address each patient’s needs and provide the best possible care. Under the direction of the practice physician and/or advanced practice provider (APP) and the supervision of the Nurse Manager (RN) and/or Nurse Supervisor (RN), the RN may provide direct patient care, patient triage (in-person and telephonic), assessment, planning, directing and evaluating of a patient’s specific care plan and clinic visit. Able to work effectively within a team of multi-specialty professionals. Essential Duties and Responsibilities include: Obtains and accurately record patient’s vital signs; reports abnormal values to treating provider Obtains and documents a patient’s history (Medical, Surgical and Social) and focused physical assessment, related to the clinic visit and as dictated by clinic procedure Administers medications and treatments to patients in clinic, under the direction of a physician or APP Participates in in-office procedure, as related to clinic specialty, under the direction and supervision of a Physician or APP and documents results in EHR Performs review and triage of incoming test results, patient requests and pharmacy renewals; facilitates call-backs to patients as necessary Facilitates the utilization of resources to meet patient outcomes and contribute to Facility (AMC), New York State and National Quality data metrics Delegates tasks deemed appropriate per licensure of LPN and/or MA Adheres to AMC’s regulatory agency (The Joint Commission) and internal compliance policies Orientation and education of newly hired staff Completes continuous/annual education related to Clinic specialty to maintain knowledge base on current practices Provides education to patients related to their visit and overall health and wellness Minimum Qualifications: Associate’s degree of a state accredited Registered Nursing program is required NYS current RN licensure is required Previous nursing experience in an ambulatory care setting or at least 1 year nursing experience obtained outside an ambulatory care setting Thank you for your interest in Albany Med Health System!​ Albany Med Health System is an equal opportunity employer. This role may require access to information considered sensitive to Albany Med Health System, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that: Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Health System policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.
Virtua Health

RN Pulmonology Practice - FT

$36.14 - $56.23 / hour
At Virtua Health, we exist for one reason – to better serve you. That means being here for you in all the moments that matter, striving each day to connect you to the care you need. Whether that's wellness and prevention, experienced specialists, life-changing care, or something in-between – we are your partner in health devoted to building a healthier community. If you live or work in South Jersey, exceptional care is all around. Our medical and surgical experts are among the best in the country. We assembled more than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques to provide exceptional care close to home. A Magnet-recognized health system ranked by U.S. News and World Report, we've received multiple awards for quality, safety, and outstanding work environment. In addition to five hospitals, seven emergency departments, seven urgent care centers, and more than 280 other locations , we're committed to the well-being of the community. That means bringing life-changing resources and health services directly into our communities through our Eat Well food access program , telehealth, home health, rehabilitation, mobile screenings, paramedic programs, and convenient online scheduling. We're also affiliated with Penn Medicine for cancer and neurosciences, and the Children's Hospital of Philadelphia for pediatrics. Location: Moorestown - 401 Young Ave Remote Type: On-Site Employment Type: Employee Employment Classification: Regular Time Type: Full time Work Shift: 1st Shift (United States of America) Total Weekly Hours: 40 Additional Locations: Job Information: Summary: Provide Triage Assessments in person and on the telephone with patients to determine the appropriate level of care required. Prepare and assist clinical providers with patient examinations and procedures. Perform clinical tasks within the scope of their licensure. Leads team as appropriate and assists with assignment of tasks. Position Responsibilities: • Conducts Triage patient assessments incorporating psychosocial and physiological status as well as health behaviors, compliance with therapeutic regime and technical procedures. • Demonstrates a consistent ability to perform patient triage via telephone as well as in person. • Identifies and evaluates patient and family needs, abilities and readiness to learn via telephone or schedules appointments. Instruct when possible teaching needed via telephone. • Demonstrates complete knowledge of established standards for documentation. • Communicates effectively and professionally with staff, supervisor, clients, physicians and others involved in care. • Handles in office and telephone emergency situations. Stat lab/procedure follow-up. Facilitates medication refills per office policy. PT/INR follow up. Orders office medications/vaccines. • Prepares patients for exam by obtaining and documenting vital signs, chief complaint. • Administers vaccines per protocols and standing orders prior to physician exam. • Performs specimens for processing. • Assists with Minor surgical procedures and general medical treatment such as administering medication, applying appliances/dressings, performs first aid for injuries, lacerations, punctures, etc. in accordance with policy. • Administers and documents medications requiring calculation and follow up assessment as directed by the physician. • Performs diagnostic tests such as EKG, Pulmonary Function Testing, audiograms, vision screening. • Provides patient education such as diabetic teaching, use of inhalers. • Assists in the processing of abnormal lab studies as ordered by the physician. • Assists Residents and Medical Students in the delivery of patient care. • Participates in QI Projects. Position Qualifications Required / Experience Required: Minimum 6 months experience in a physicians practice/primary care. Knowledge of minor surgical procedures and sterile techniques. Required Education: Graduate of an approved RN School of Nursing. Training/Certifications/Licensure: Current NJ RN License. Current BLS certification through the American Heart Association Hourly Rate: $36.14 - $56.23 The actual salary/rate will vary based on applicant’s experience as well as internal equity and alignment with market data. Virtua offers a comprehensive package of benefits for full-time and part-time colleagues, including, but not limited to: medical/prescription, dental and vision insurance; health and dependent care flexible spending accounts; 403(b) (401(k) subject to collective bargaining agreement); paid time off, paid sick leave as provided under state and local paid sick leave laws, short-term disability and optional long-term disability, colleague and dependent life insurance and supplemental life and AD&D insurance; tuition assistance, and an employee assistance program that includes free counseling sessions. Eligibility for benefits is governed by the applicable plan documents and policies. For more benefits information click here .
Albany Medical Center

Medical Assistant - Rheumatology

$40,495.10 - $52,643.64 / year
Department/Unit: HBD - Rheumatology Work Shift: Day (United States of America) Salary Range: $40,495.10 - $52,643.64 The Medical Assistant (MA) performs assigned tasks of direct and indirect care in the ambulatory setting to meet the care needs of patients under the direct supervision of a Registered Nurse (RN), Licensed Practical Nurse (LPN), or Licensed Independent Practitioner (LIP). The Medical Assistant participates as a member of the health care team and accepts appropriate delegation from the RN, LPN or LIP in meeting needs of the patient/family. The Medical Assistant performs assigned tasks in accordance with the patient care plan, policies and procedures of the organization and principles of patient-centered care. The Medical Assistant carries out designated activities that are within those functions limited by NYS law to unlicensed health care personnel. Essential Duties and Responsibilities Documents information into patient record in an accurate and timely manner Obtains prior authorizations from insurance companies Generates medical renewals under the supervision of a licensed healthcare provider Assists LPN’s with obtaining information for pump/sensor/meter approvals Assists in clinical coverage as needed Adheres to AMC’s regulatory compliance issues Other responsibilities as assigned by manager Qualifications High School Diploma/G.E.D. - required 1-3 years Medical office experience - preferred Excellent interpersonal, written and verbal communication skills Ability to work within a team as well as individually Certified Medical Assistant with accreditation by the National Commission for Certifying Agencies (NCCA) Upon Hire - required Equivalent combination of relevant education and experience may be substituted as appropriate. Physical Demands Standing - Constantly Walking - Constantly Sitting - Rarely Lifting - Frequently Carrying - Frequently Pushing - Occasionally Pulling - Occasionally Climbing - Occasionally Balancing - Occasionally Stooping - Frequently Kneeling - Frequently Crouching - Frequently Crawling - Occasionally Reaching - Frequently Handling - Frequently Grasping - Frequently Feeling - Constantly Talking - Constantly Hearing - Constantly Repetitive Motions - Constantly Eye/Hand/Foot Coordination - Constantly Working Conditions Extreme cold - Rarely Extreme heat - Rarely Humidity - Rarely Wet - Rarely Noise - Constantly Hazards - Frequently Temperature Change - Rarely Atmospheric Conditions - Rarely Vibration - Rarely Thank you for your interest in Albany Medical Center! Albany Medical Center is an equal opportunity employer. This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that: Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Medical Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification. Thank you for your interest in Albany Medical Center!​ Albany Medical is an equal opportunity employer. This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that: Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.
Temple Health

RN-STAFF/CLIN NURSE- Otolaryngology- 40/hrs, Day Shifts (Temple Faculty Practice)

Provides professional nursing care at the proficient level which includes assessment, planning, implementation, and evaluation in accordance with care standards, under the direction of a licensed physician or other licensed medical professional. Contributes to a safe and therapeutic environment that is centered on the needs of the patients, caregivers and others demonstrating concern for the patient's privacy, comfort, and emotional state. Treats patient with consideration to age, race, gender, gender identity, sexual orientation, religion, socioeconomic background, and culture in a caring, ethical, and professional manner. Education Bachelor's Degree Preferred Other Graduate of an accredited school of nursing Required Experience 1 year experience in area of clinical specialty Preferred General Experience In An Outpatient / Ambulatory Setting Preferred General Experience with EPIC EMR Preferred Licenses PA Registered Nurse License Required Basic Life Support Required Multi State Compact RN License Required Or