NP Jobs in Middlefield, OH

NP Outpatient Outpatient Full-time
Cleveland Clinic

Advanced Practice Provider (NP/PA) - Neurosurgery Spine Inpatient and Outpatient III (Hillcrest)

Cleveland Clinic Mayfield Heights, OH
At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day. We all have the power to help, heal and change lives — beginning with our own. That’s the power of the Cleveland Clinic Health System team, and The Power of Every One. Job Title Advanced Practice Provider (NP/PA) - Neurosurgery Spine Inpatient and Outpatient III (Hillcrest) Location Mayfield Hts Facility Hillcrest Hospital Department Job Code T97895 Shift Day/Evening/Night/Weekend Schedule 7:00am-6:00pm Job Summary Job Details Cleveland Clinic’s Neurological Institute has an exciting career opportunity available in our nationally recognized spine program for a Nurse Practitioner or Physician Assistant with OR experience. Specialists are brought together from orthopedic surgery, neurosurgery and medical spine to provide patients with the latest and most innovative care options. Our services extend across the region including this opportunity based at Hillcrest Hospital . Duties to include: first assist in spine surgery, inpatient rounding weekday/weekend, on-call rotation, outpatient clinic. Work schedule 4 -10's. Dynamic team with significant flexibility Working at top of license with significant independence but also outstanding support from the professional staff Integrated team meetings and education If you are an energetic person with excellent clinical care skills, surgical experience, and a working knowledge of spinal disorders you are strongly encouraged to apply. Surgical experience is required, new graduates who have completed a surgical rotation are welcome to apply. Nationally certified Advanced Practice Provider who provides primary and/or specialty care in a variety of healthcare settings. Functions in collaboration with the health care team in accordance with certification and licensure. Practice emphasizes health promotion, disease prevention and the diagnosis and treatment of acute and chronic health problems. Responsible for dissemination of knowledge through instructing, leading and developing educational programs. Responsibilities: Conducts thorough medical histories, performs complete physical examinations (where indicated), initiates appropriate lab, radiology tests or other special tests required for evaluation of illness, and scrutinizes lab data to establish a record of the patient's current health status and to develop a working diagnosis and treatment plan. Works in collaboration with the health care team. Performs and interprets common laboratory, radiologic, cardiographic and other routine diagnostic procedures used to identify pathophysiologic processes as credentialed and privileged by the Medical Executive Committee and the Governing Body of the applicable hospitals. Performs routine and specialized procedures as credentialed and privileged by the Medical Executive Committee and the Governing Body of the applicable hospitals. May prescribe and monitor medications as allowed by license through applicable state board and Cleveland Clinic policies. Educates patients and answers questions regarding their disease, treatments, related drug and treatment side effects and hazards. Participates in medical team rounds; collaborates with nursing, medical and other healthcare team members regularly to ensure quality patient care. Refers patients to specialists as appropriate for consultation or for specialized health resources and treatment. Ensures continuity of care by serving as a liaison between patient and other members of the multi-disciplinary care team or with other specialty areas as necessary. Participates in quality monitoring thru the review of records and treatment plans for patient outcomes on a periodic basis to assure quality care. Facilitates appropriate length of stay, discharge planning and compliance with regulatory standards for inpatient management. Supports professional development of the health care team. Promotes translation of evidence-based practices, guidelines, and research. May conduct research studies. May assists in data collection and analysis. May serve as clinical preceptor for students. May onboard new caregivers. Other duties as assigned. Education: APRN Effective 05/01/2014: MSN required upon hire or within 3 years of hire for external hires and internal hires moving from a non-APRN licensed role to an APRN licensed role. Graduate of an accredited APRN program. If in neonatal care service area Master’s Degree is required upon hire. PA Graduate of an A.R.C. approved Physician Assistant Program. Master’s degree in Physician Assistant Studies and/or higher degree obtained from a program recognized by their practicing states Licensing Board. Languages: Oral and written communication in English Certifications: NP Currently licensed as a Nurse Practitioner in applicable state(s). Must be licensed as an RN in applicable state(s). National certification as a Nurse Practitioner by nationally accredited organization recognized by state Board of Nursing. Basic Life Support (BLS) through the American Heart Association (AHA) required. Advanced Cardiac Life Support (ACLS) or Pediatric Advanced Life Support (PALS) through the American Heart Association (AHA); or Neonatal Resuscitation Program (NRP) through the American Academy of Pediatrics (AAP) may be required based upon work setting. Must have arrangements with at least one physician in accordance with requirements set forth by the State Board of Nursing in applicable states. Must be credentialed and privileged by the Medical Executive Committee and the Governing Body of the applicable hospitals. PA Certification as a Physician Assistant through the NCCPA or successor organization recognized by their practicing states Licensing Board. License to practice and prescribe issued by their practicing states Licensing Board. Current DEA License or DEA designee as required by NCQA. Basic Life Support (BLS) through the American Heart Association (AHA) required. Advanced Cardiac Life Support (ACLS) or Pediatric Advanced Life Support (PALS) through the American Heart Association (AHA); or Neonatal Resuscitation Program (NRP) through the American Academy of Pediatrics (AAP); or Advanced Trauma Life Support (ATLS) American Heart Association may be required based upon work setting. If a candidate has held a license to prescribe within another jurisdiction and needs to obtain a master's degree in order to apply for prescribing privileges the candidate will be subject for review for eligibility for hiring within our system. Must have a Physician Supervision Agreement and signed addendum to Physician Supervision Agreement. Must be credentialed and privileged by the Medical Executive Committee and the Governing Body of the applicable hospitals. Complexity of Work: Excellent analytical and decision-making skills are required. Strong written and verbal communication skills. Ability to work as a member of a multi-disciplinary team. Demonstrated competency and the ability to perform advanced assessment and diagnosis. Demonstrated ability to utilize the electronic medical record. Demonstrates a high standard of moral and ethical behavior. Demonstrates compassion and professionalism and a commitment to excellent patient care. Requires critical thinking skills, decisive judgement, and the ability to work independently. Must be able to work in a stressful environment and take appropriate action. Work Experience: Related clinical experience preferred. Physical Requirements: Typical physical demands include the ability to walk and stand for long periods of time. Manual and finger dexterity and eye/hand coordination to perform physical examinations. Requires corrected vision and hearing to a normal range. Occasionally lifts and carries items weighing up to 50 pounds. May require exposure to communicable diseases and/or body fluids. Personal Protective Equipment: Follows standard precautions using personal protective equipment as required. The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our drug free environment. All offers of employment are followed by testing for controlled substances. Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption. Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility. If applying for a Florida position, please see the following website for more information on the background screening requirements required by the Agency of Health Care Administration: https://info.flclearinghouse.com/ Please review the Equal Employment Opportunity poster . Cleveland Clinic is pleased to be an equal employment opportunity employer.
NP Full-time
Cleveland Clinic

Advanced Practice Provider (NP/PA) - Hillcrest Hospital Medicine II

Cleveland Clinic Mayfield Heights, OH
At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day. We all have the power to help, heal and change lives — beginning with our own. That’s the power of the Cleveland Clinic Health System team, and The Power of Every One. Job Title Advanced Practice Provider (NP/PA) - Hillcrest Hospital Medicine II Location Mayfield Hts Facility Hillcrest Hospital Department Advanced Practice Medicine-Hillcrest Hospital Job Code T98104 Shift Days Schedule 7:00am-5:00pm Job Summary Nationally certified Advanced Practice Provider who provides primary and/or specialty care in a variety of healthcare settings. Functions in collaboration with the health care team in accordance with certification and licensure. Practice emphasizes health promotion, disease prevention and the diagnosis and treatment of acute and chronic health problems. Responsible for dissemination of knowledge through instructing, leading and developing educational programs. Job Details The Department of Hospital Medicine is looking to add a qualified Family/Adult-Geriatric/Acute Care Nurse Practitioner or Physician Assistant to join the Hospital Medicine team. In this role, the APRN/PA will work at the top of their license caring for patients at Hillcrest Hospital. This new role will require flexibility and includes both day coverage at our east side hospitals. Typical Hospital Medicine day shifts are 12hr (7am-7:30pm) & 8hr (7am-3:30pm) Responsibilities in these roles include independently rounding on Hospital Medicine patients, admissions, discharges, and cross-coverage. Ideal candidates would have at least 1 year of inpatient experience, but new graduates are encouraged to apply. Responsibilities: Conducts thorough medical histories, performs complete physical examinations (where indicated), initiates appropriate lab, radiology tests or other special tests required for evaluation of illness, and scrutinizes lab data to establish a record of the patient's current health status and to develop a working diagnosis and treatment plan. Works in collaboration with the health care team. Performs and interprets common laboratory, radiologic, cardiographic and other routine diagnostic procedures used to identify pathophysiologic processes as credentialed and privileged by the Medical Executive Committee and the Governing Body of the applicable hospitals. Performs routine and specialized procedures as credentialed and privileged by the Medical Executive Committee and the Governing Body of the applicable hospitals. May prescribe and monitor medications as allowed by license through applicable state board and Cleveland Clinic policies. Educates patients and answers questions regarding their disease, treatments, related drug and treatment side effects and hazards. Participates in medical team rounds; collaborates with nursing, medical and other healthcare team members regularly to ensure quality patient care. Refers patients to specialists as appropriate for consultation or for specialized health resources and treatment. Ensures continuity of care by serving as a liaison between patient and other members of the multi-disciplinary care team or with other specialty areas as necessary. Participates in quality monitoring thru the review of records and treatment plans for patient outcomes on a periodic basis to assure quality care. Facilitates appropriate length of stay, discharge planning and compliance with regulatory standards for inpatient management. Supports professional development of the health care team. Promotes translation of evidence-based practices, guidelines, and research. May conduct research studies. May assists in data collection and analysis. May serve as clinical preceptor for students. May onboard new caregivers. Other duties as assigned. Languages: Oral and written communication in English Education: APRN Effective 05/01/2014: MSN required upon hire or within 3 years of hire for external hires and internal hires moving from a non-APRN licensed role to an APRN licensed role. Graduate of an accredited APRN program. If in neonatal care service area Master’s Degree is required upon hire. PA Graduate of an A.R.C. approved Physician Assistant Program. Master’s degree in Physician Assistant Studies and/or higher degree obtained from a program recognized by their practicing states Licensing Board. Certifications: NP Currently licensed as a Nurse Practitioner in applicable state(s). Must be licensed as an RN in applicable state(s). National certification as a Nurse Practitioner by nationally accredited organization recognized by state Board of Nursing. Basic Life Support (BLS) through the American Heart Association (AHA) required. Advanced Cardiac Life Support (ACLS) or Pediatric Advanced Life Support (PALS) through the American Heart Association (AHA); or Neonatal Resuscitation Program (NRP) through the American Academy of Pediatrics (AAP) may be required based upon work setting. Must have arrangements with at least one physician in accordance with requirements set forth by the State Board of Nursing in applicable states. Must be credentialed and privileged by the Medical Executive Committee and the Governing Body of the applicable hospitals. PA Certification as a Physician Assistant through the NCCPA or successor organization recognized by their practicing states Licensing Board. License to practice and prescribe issued by their practicing states Licensing Board. Current DEA License or DEA designee as required by NCQA. Basic Life Support (BLS) through the American Heart Association (AHA) required. Advanced Cardiac Life Support (ACLS) or Pediatric Advanced Life Support (PALS) through the American Heart Association (AHA); or Neonatal Resuscitation Program (NRP) through the American Academy of Pediatrics (AAP); or Advanced Trauma Life Support (ATLS) American Heart Association may be required based upon work setting. If a candidate has held a license to prescribe within another jurisdiction and needs to obtain a master's degree in order to apply for prescribing privileges the candidate will be subject for review for eligibility for hiring within our system. Must have a Physician Supervision Agreement and signed addendum to Physician Supervision Agreement. Must be credentialed and privileged by the Medical Executive Committee and the Governing Body of the applicable hospitals. Complexity of Work: Excellent analytical and decision-making skills are required. Strong written and verbal communication skills. Ability to work as a member of a multi-disciplinary team. Demonstrated competency and the ability to perform advanced assessment and diagnosis. Demonstrated ability to utilize the electronic medical record. Demonstrates a high standard of moral and ethical behavior. Demonstrates compassion and professionalism and a commitment to excellent patient care. Requires critical thinking skills, decisive judgement, and the ability to work independently. Must be able to work in a stressful environment and take appropriate action. Work Experience: Related clinical experience preferred. Physical Requirements: Typical physical demands include the ability to walk and stand for long periods of time. Manual and finger dexterity and eye/hand coordination to perform physical examinations. Requires corrected vision and hearing to a normal range. Occasionally lifts and carries items weighing up to 50 pounds. May require exposure to communicable diseases and/or body fluids. Personal Protective Equipment: Follows standard precautions using personal protective equipment as required. The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our drug free environment. All offers of employment are followed by testing for controlled substances. Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with this program, which will include obtaining an influenza vaccination on an annual basis or obtaining an approved exemption. Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic Health System facility. If applying for a Florida position, please see the following website for more information on the background screening requirements required by the Agency of Health Care Administration: https://info.flclearinghouse.com/ Please review the Equal Employment Opportunity poster . Cleveland Clinic is pleased to be an equal employment opportunity employer.
NP Hospice Hospice Full-time
Affinity Care of Ohio

Nurse Practitioner NP Hospice & Palliative

Affinity Care of Ohio Warren, OH
Job Description Summary The Nurse Practitioner is a registered professional nurse with advanced graduate education and clinical training who provides comprehensive hospice services in compliance with the state Nurse Practice Act and under the supervision of a collaborating physician. He/She provides hospice care through the evaluation and assessment of the health history, health promotion, diagnosing medical conditions, management of health problems by directing and developing the plan of care, prescribing medications or treatments, coordinating and collaborating with patients, families and other healthcare practitioners. Under the supervision of a physician, the nurse practitioner visits patients, completes physical assessments, performs face to face assessments and evaluates hospice eligibility as assigned in consultation with the hospice interdisciplinary team. The nurse practitioner builds from the resources of the community to plan and direct services to meet the need of individuals and families within their homes and communities. Essential Job Functions/Responsibilities Patient Care 1. Provides medical care, palliates and manages terminal illness in compliance with the state Nurse Practice Act under the supervision of a collaborating physician. 2. Completes history and physical examinations by evaluating the patient's medical condition and health history, ordering and interpreting results from laboratory and diagnostic tests or procedures, diagnosing health conditions and documents the findings in the patient's medical record. 3. Manages health conditions and terminal illnesses by developing an individualized plan of care, prescribing medications and / or treatments, obtaining consultations or making referrals and coordinating hospice care services. 4. Completes the hospice face to face visit requirements prior to the third and subsequent hospice benefit periods to assess hospice eligibility based on the hospice conditions of participation and the local coverage determinations. Provides clinical information to the hospice medical director for interpretation for eligibility for hospice recertification. 5. Makes recommendations to the hospice medical director regarding patient eligibility for certification and recertification for hospice care. 6. Reviews clinical information, coordinates and oversees patient care in consultation with the hospice interdisciplinary team and other healthcare practitioners. 7. Assures that patient receives appropriate measures to control symptoms, through collaboration with interdisciplinary team members. 1. Reviews and develops protocols for treatment and proposes options for interventions based on the literature in collaboration with the collaborating physician. 2. Consults the collaborating physician when the patient's plan of care is outside standardized practice and protocols. Communication 1. Communicates and collaborates with the interdisciplinary group to create, review and revise the patient's plan of care. 2. Consults with the patient's attending physician, the hospice medical director and other healthcare practitioners regarding the patient's eligibility for hospice care, ongoing care needs and medical management related to the patient's terminal condition. 3. Communicates with other community health practitioners to coordinate the plan of care. 4. Attends and participates in hospice interdisciplinary group meetings. 5. Completes, maintains and submits accurate and relevant clinical notes, physical examination notes, assessment visit notes, medical orders, collaboration notes and other documentation in the medical record. 6. Educates/counsels patients, families, and/or caregivers as to preventative care, medical problems, psychological problems, and spiritual problems in conjunction with the interdisciplinary team to meet the total needs of patients. 7. Provides and maintains a safe environment for the patient. 8. Assists the patient and family/caregiver and other team members in providing continuity of care. 9. Works in cooperation with the family/caregiver and hospice interdisciplinary group to identify the goals of care and meet the care needs of the patient and family/caregiver. 1 Serves as a nursing resource for consultation and educations to members of the interdisciplinary team and other healthcare practitioners in the community. 1 Establishes, builds and nurtures relationships with staff and community referral sources to facilitate program growth. Additional Duties 1. Maintains knowledge of and compliance with current Medicare/Medicaid, state/federal rules and regulations for hospice services 2. Ensures compliance with the Medicare conditions of participation and other state regulations govern the provision of healthcare. 3. Complies with all Health Insurance Portability and Accountability Act (HIPAA) requirements in accordance with federal, state and organizational policies. 1. Participates in organizational monitoring of the quality of medical services and quality improvement initiatives. 2. Assumes responsibility for personal growth. Develops, maintains and upgrades professional knowledge and practice skills through attendance at seminars, conferences and participation in continuing education and in-service classes. 3. Fulfills the obligation of requested and/or accepted assignments. 4. Demonstrate knowledge in communication and counseling patient/family in dealing with end-of-life issues. Position Qualifications 1. Graduation from an accredited School of Nursing and accredited Nurse Practitioner Program. 2. Has a current DEA license 3. Current nursing licensure in State and CPR certification. 4. Master's degree with a minimum of one (1) year Nurse Practitioner experience and a minimum of one (1) year hospice or palliative care experience. 5. Accreditation from an approved certifying body for advanced practice nursing as required by State. 6. Certification in a specialist area preferred; (e.g. Hospice and Palliative Nursing (CHPN), Pediatrics or Geriatrics) 7. Excellent observation, verbal and written communication skill, problem solving skills, mathematical skills; nursing skills per competency checklist. 8. Prolonged or considerable walking or standing. Able to lift, position and / or transfer patients. Able to lift supplies and equipment. Considerable reaching, stooping, bending, kneeling and/or crouching. Visual acuity and hearing to perform required nursing skills. 9. Must be a licensed driver with an automobile that is insured in accordance with state/or organization requirements and is in good working order.
NP Full-time
Altea Healthcare

Certified Nurse Practitioner

Altea Healthcare Lyndhurst, OH
$115,000 - $140,000 / year
Certified Nurse Practitioner (NP) – Post-Acute Care | Salary up to $140K Location: Lyndhurst, Ohio Compensation: $115,000 - $140,000 per year + Uncapped Bonus Potential Job Type: Full-time Launch or Grow Your Career in Post-Acute Care! Are you a Certified Nurse Practitioner (NP) looking for a rewarding and high-paying career with work-life balance? Whether you're an experienced provider or a recent graduate eager to learn , we provide the training, mentorship, and support you need to succeed in post-acute and skilled nursing care. ✅ New Graduates Welcome – Training & Support Provided! ✅ Flexible Scheduling – Achieve Work-Life Balance ✅ Competitive Pay + Bonus Potential At Altea Healthcare , we offer a collaborative team environment, cutting-edge technology, and ongoing education to ensure you thrive in your career. What You’ll Do: As a Certified NP , you will be a key clinical provider in a skilled nursing facility, diagnosing, treating, and guiding patients to better health. No two days are the same! Your daily responsibilities include: Performing physical exams and reviewing medical histories. Ordering and interpreting diagnostic tests (labs, imaging, etc.). Diagnosing and managing acute and chronic conditions. Prescribing medications and creating treatment plans. Collaborating with physicians, nurses, and facility staff. Educating patients and families on health conditions and preventive care. Documenting patient care accurately and efficiently. Who Should Apply? We welcome both experienced providers and motivated new graduates! ✅ NP License (or eligibility to obtain) ✅ All Experience Levels Welcome – Training & Mentorship Available! ✅ Passion for geriatrics, internal medicine, or primary care ✅ Strong team player with excellent communication skills ✅ Self-motivated with a patient-first approach What We Offer: Highly Competitive Pay ($115K - $140K Base Salary) + Uncapped Performance Bonuses Flexible Scheduling – Achieve the Work-Life Balance You Want Career Growth & Leadership Opportunities – Fast-Track Your Success Paid Time Off (PTO) – Because You Deserve It Full Benefits Package – Medical, Dental, Vision, Life Insurance & More 401(k) With Company Match – Invest in Your Future Ongoing Training & Mentorship – Support for New Grads & Experienced Providers Take the Next Step in Your Career! Don’t miss this opportunity to join a top-tier healthcare team, receive excellent pay, and make a lasting impact in post-acute care. Apply Today & Secure Your Spot!
NP Home Health Contract
Advantmed

Field Nurse Practitioner / Physician Assistant - Trumbull County, Ohio

Advantmed Warren, OH
$100 / visit
Field Nurse Practitioner / Physician Assistant Pay - ~$100 per completed assessment + paid mileage Schedule - Flexible weekdays | No evenings, weekends, or on‑call Work Model - 1099 Independent Contractor (PRN) Designed for NPs and PAs seeking reliable, ongoing PRN income with structure and support. About the Role Advantmed is seeking a licensed, dependable Nurse Practitioner (NP) or Physician Assistant (PA) to conduct structured, in-home wellness and risk adjustment assessments for diverse patient populations with varying healthcare needs This PRN role offers flexibility with consistent visit availability and strong operational support. It is best suited for clinicians who value autonomy, professionalism, and accountability, and are looking for steady supplemental income - not short-term or ad hoc work. Why Advantmed Partnering with 40+ health plans and supporting 1M+ providers nationwide 99% Provider Satisfaction and 97% Member Satisfaction 30%+ In Home Assessment completion rates, even in complex populations Clinically led, quality-first organization with standardized visits and strong QA Technology-enabled workflows and structured training from day one Why You’ll Like This Role Paid training and standardized onboarding ~$100 per completed visit + mileage reimbursement Most providers complete 4–5 visits per day, based on availability Visits ready to schedule immediately Choose your own weekday availability Dedicated coordinators, scheduling, and tech support Predictable workflows with clinical and operational support What You’ll Do Conduct in-home Annual Wellness Visits and chronic condition assessments Perform focused histories, physical exams, vitals, medication reviews, and screenings Complete screenings including: Hemoglobin A1C Spirometry KED (Kidney Health Evaluation) DRE (Diabetic Retinal Exam) FIT (Fecal Immunochemical Test) Educate members on preventive care and chronic disease management Document visits in the EMR to support value-based care and risk adjustment Operate within NP or PA scope of practice and state regulatory guidelines All assessments are standardized, with full training, equipment guidance, and EMR support provided. Important Role Expectations This is a 1099 PRN role requiring consistency and reliability: Maintain ongoing monthly availability Be responsive during onboarding and scheduling Honor confirmed visits and assignments Work independently and professionally in the field Minimum commitment: ~30 hours per month, ongoing (Not intended for casual or short-term engagement) Travel daily within a ~55-mile radius of the assigned county Adhere to state-specific supervision or collaboration requirements (for PAs where applicable) Qualifications Active, unencumbered NP or PA license in the applicable state Ability to practice within applicable state guidelines, including supervision / collaboration requirements (for PAs) 3+ years of patient care experience preferred Comfortable with EMR systems and independent field-based work In-home or risk adjustment experience preferred Willing to obtain additional licensure if needed (supported by Advantmed) What Advantmed Offers Competitive per-visit compensation Paid mileage Flexible, provider-driven scheduling Pre-scheduled appointments with confirmation support Dedicated coordinator and clinical escalation support Modern, technology-enabled documentation workflows