RN Telehealth Full-time
Molina Healthcare

Care Manager (RN) - Must Live in Illinois

Molina Healthcare IL
$27.73 - $54.06 / hour
JOB DESCRIPTION Opportunity for Illinois licensed RN to join Molina as a Case Manager working with our Medicare members who reside in Illinois. You will complete assessments needed for determining the types of services we will provide to them. While this role is telephonic, there may be times that you will have to meet with the member face-to-face. Preference will be given to those candidates with previous experience working with the Medicare population within a managed care organization (MCO) like Molina. Hours are Monday – Friday, 8 AM – 5 PM CST working from home. Solid experience with Microsoft Office Suite is necessary, especially with Outlook, Excel, and Teams as well as being confident in moving between different programs to complete the necessary forms and documentation. Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. • Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. • Conducts telephonic, face-to-face or home visits as required. • Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. • Maintains ongoing member caseload for regular outreach and management. • Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. • Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration. • Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. • Assesses for barriers to care, provides care coordination and assistance to member to address concerns. • May provide consultation, resources and recommendations to peers as needed. • Care manager RNs may be assigned complex member cases and medication regimens. • Care manager RNs may conduct medication reconciliation as needed. • 25-40% estimated local travel may be required (based upon state/contractual requirements). Required Qualifications • At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and unrestricted in state of practice. • Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. • Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA). • Demonstrated knowledge of community resources. • Ability to operate proactively and demonstrate detail-oriented work. • Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. • Ability to work independently, with minimal supervision and self-motivation. • Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. • Ability to develop and maintain professional relationships. • Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. • Excellent problem-solving, and critical-thinking skills. • Strong verbal and written communication skills. • Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications • Certified Case Manager (CCM). 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: $27.73 - $54.06 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
RN Manager/Supervisor Telehealth Full-time
Houston Methodist

Virtual Care Night Nurse Manager

Houston Methodist Houston, TX
At Houston Methodist, the Manager Nursing position is responsible for 24-hour comprehensive operational responsibility for the delivery and quality of patient care provided in the designated areas(s) of responsibility. This registered nurse position fosters interdepartmental/interprofessional collaboration. The Manager, Nursing position participates in committees, representing unit and Nursing in a positive manner. The position assists with developing and implementing performance initiatives, ensuring optimal patient safety, outcomes and customer satisfaction. This position demonstrates leadership qualities and critical thinking through self-direction, initiative, effective interpersonal skills and oral/written communication skills. The manager position responsibilities include managing the daily work activities of the work unit/department staff, ensuring quality, productivity, functional excellence and efficiency while assisting management in accomplishing strategic and operational objectives. In addition, this position provides guidance to staff and is responsible for staffing, budget compliance, contributing to staffing decisions such as hiring and terminating employment, coaching and counseling employees on work related performance, and assisting in the development and implementation of policies and procedures to ensure a safe and effective work environment. This position also implements training, monitoring and operations initiatives that secure compliance with ethical and legal business practices and accreditation/regulatory/government regulations. FLSA STATUS Exempt QUALIFICATIONS EDUCATION Bachelor’s degree or higher from an accredited school of Nursing EXPERIENCE Three years’ experience in nursing, one year in a progressive leadership role in healthcare; for HM internal, two years’ experience in nursing which includes HM performance that demonstrates leadership abilities, i.e. charge nurse responsibilities LICENSES AND CERTIFICATIONS Required RN - Registered Nurse - Texas State Licensure - Texas Board of Nursing_PSV Compact Licensure – Must obtain permanent Texas license within 60 days (if establishing Texas residency) and BLS - Basic Life Support or Instructor (AHA) - American Heart Association and Magnet - ANCC Recognized Leadership Certification (ANCC) within 1 year KNOWLEDGE AND ABILITIES Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through ongoing skills, competency assessments, and performance evaluations Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security Ability to effectively communicate through a variety of channels with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles; engages the recipient(s) and helps them understand and retain the message Demonstrates the ability to interact with others in a way that gives them confidence in one’s intentions and those of the organization Ability to use appropriate interpersonal styles and techniques to gain acceptance of ideas or plans; modifying one’s own behavior to accommodate tasks, situations and individuals involved Demonstrates leadership qualities and critical thinking through self-direction initiative and effective interpersonal skills and oral/written communication skills Ability to identify and understand issues, problems and opportunities, comparing data from different sources to draw conclusions; using effective approaches for choosing a course of action or developing appropriate solutions; taking action that is consistent with available facts, constraints and probable consequences Ability to work effectively in a fast paced environment Demonstrates flexibility and adaptability in the workplace Demonstrates problem solving skills to include investigation, identification of cause(s) and development of corrective action ESSENTIAL FUNCTIONS PEOPLE ESSENTIAL FUNCTIONS Performs management responsibilities of selection, scheduling, supervision, retention, and evaluation of employees in the department. Provides development and mentoring of staff. Meets or exceeds threshold goal for department turnover. Develops direct reports to perform these same functions. Provides fair and consistent leadership and communication to maintain a competent and engaged employee group by conducting regular department meetings to review policies and procedures and operational matters, rounding on all employees, completing performance appraisals, conducting new hire feedback sessions, coaching/corrective counseling, and providing recognition/commendations to achieve desired outcomes. Provides timely guidance and feedback to help others strengthen specific knowledge/skill areas needed to accomplish a task or solve a problem. Facilitates and promotes effective team dynamics and teambuilding strategies within and between departments; participates and/or leads and facilitates department process improvements as needed. Meets or exceeds threshold goal for department and/or system metrics on employee engagement indicators: action readiness score, tier level. Establishes effective, two-way communication with staff, demonstrating active listening, requesting and acknowledging feedback, making equitable decisions, providing rationale when appropriate, and supporting organizational goals. Coaches staff to use efficient and effective communication to establish and maintain a team environment, and to include the patient and family as a part of the team regarding their plan of care. Assists staff with stress management practices. SERVICE ESSENTIAL FUNCTIONS Plans and organizes day-to-day department operations, schedule and activities. Sets priorities and functional standards, giving direction to staff as necessary to ensure the best possible delivery of service and high customer/patient satisfaction. Drives department service standards and activities to impact department and/or system score for patient/customer-based satisfaction, through role modeling and fostering accountability. Serves and actively participates on various entity committees as a voice for the department. Serves as role model to staff, reinforcing principles of service orientation and ensuring that the focus is always on improving patient care and/or services, effectively resolve concerns, complaints or conflict with patients, families, physicians and other interprofessional health care team members, taking appropriate action and channeling concerns according to appropriate procedures. Maintains ongoing interactions with patients, families, physicians, and staff on how to improve patient care and service provided. QUALITY/SAFETY ESSENTIAL FUNCTIONS Ensures a safe and effective working environment; monitors and/or revises the department safety plan and/or any specific accreditation/regulatory required safety guidelines, including infection control principles. Monitors and confirms staff maintain their required credentials that demonstrate competency per accrediting agency or department guidelines as applicable. Uses and optimizes information systems to enhance operations; supports entity-specific performance improvement and data management/analysis functions. Employs a proactive approach in the optimization of safe outcomes by monitoring and improving the department workflow, using peer-to-peer accountability, reporting near misses and/or adverse events immediately and identifying solutions via collaboration. Adopts lean principles in driving process improvements. Role models situational awareness, using teachable moments to improve safety. Monitors self and employee compliance with policies, procedures, and System HR Standards of Practice and performs associated actions upon non-compliance (i.e., focal point review requirements, disaster plan, in-services, influenza immunization, wage and hour, standard hours, timely termination submission, timely timecard approval, etc.). Prepares measurable goals and objectives that are consistent with Houston Methodist priorities, and develops action plans for achieving goals, incorporating collaborative efforts when appropriate. FINANCE ESSENTIAL FUNCTIONS Assists in the development of department budget and ensures that the department operates in a cost-effective manner. Manages/audits department expenses within approved budget parameters, ensuring that the department meets the budgeted/flex revenue and/or expense targets on a monthly and annual basis. Develops staffing plans and schedules to meet department/patient care needs that reflect understanding of the importance of cost-effectiveness. Implements department strategies to achieve financial target and staffing needs, developing others to do the same, through optimizing productivity, supply/resource efficiency, minimizing incidental overtime and overtime percentage, and other areas according to department specifications. Plans coverage of unit to maximize presence of management and staff. Develops staffing plans and schedules to meet department/patient care needs that reflect understanding of the importance of cost-effectiveness. GROWTH/INNOVATION ESSENTIAL FUNCTIONS Identifies and implements innovative solutions for practice or workflow changes to improve department operations or other department-specific measures by leading unit projects and/or other department/system directed shared governance activities. Supports change initiatives, maintaining effectiveness when experiencing major changes in work responsibilities or environment; adjusts effectively to work within new work structures, processes, requirements or cultures. Proactively evaluates processes; recommends and implements action plan(s) for change; follows through to ensure effective, sustainable change. Participates in the development and implementation of new procedures and the review and revision of existing procedures. Identifies opportunities and takes action to build strategic relationships between one’s area and other areas, teams, departments, and units to achieve business goals. Seeks opportunities to identify developmental needs of self and staff and takes appropriate action. Ensures own career discussions occur with appropriate management. Completes and updates the individual development plan (IDP) on an ongoing basis. Conducts conversations with staff on their development and IDP. SUPPLEMENTAL REQUIREMENTS WORK ATTIRE Uniform: No Scrubs: Yes Business professional: Yes Other (department approved): No ON-CALL* *Note that employees may be required to be on-call during emergencies (ie. Disaster, Severe Weather Events, etc) regardless of selection below. On Call* Yes TRAVEL** **Travel specifications may vary by department** May require travel within the Houston Metropolitan area Yes May require travel outside Houston Metropolitan area No QUALIFICATIONS EDUCATION Bachelor’s degree or higher from an accredited school of Nursing EXPERIENCE Three years’ experience in nursing, one year in a progressive leadership role in healthcare; for HM internal, two years’ experience in nursing which includes HM performance that demonstrates leadership abilities, i.e. charge nurse responsibilities LICENSES AND CERTIFICATIONS Required RN - Registered Nurse - Texas State Licensure - Texas Board of Nursing_PSV Compact Licensure – Must obtain permanent Texas license within 60 days (if establishing Texas residency) and BLS - Basic Life Support or Instructor (AHA) - American Heart Association and Magnet - ANCC Recognized Leadership Certification (ANCC) within 1 year
RN Telehealth Full-time
Renown Health

Registered Nurse_ Sierra Med/Tele

Renown Health Reno, NV
Position Purpose This position provides optimal patient care utilizing knowledge and skills within the context of the nursing process. The incumbent is accountable for individualized patient outcomes over an entire episode of care. The incumbent provides comprehensive nursing services to adolescent, adult and geriatric patients, including their families/caregivers. Nature and Scope This position is challenged to diagnose and treat human responses to health problems. The incumbent must provide optimal patient/resident care through assessment, planning, implementation, and evaluation of adolescent, adult, and geriatric residents and families. Demonstrates the cognitive and psychosocial needs specific to the population to be served and meets standards of quality as measured by the unit/department age specific competency standards. This position requires a scientific knowledge base and ongoing growth and learning. When possible the family or those significant to the family are considered as part of the assessment, planning, intervention and evaluation efforts of the Registered Nurse (RN). The RN coordinates care between other professionals as needed. Intensive continuous mental effort is required to provide optimal safe patient care and the same mental effort is required when interacting with internal and external contacts, exercising judgments and making decisions. This position does provide patient care Disclaimer The foregoing description is not intended to be, and should not be construed as, an exhaustive list of all responsibilities, skills, efforts, or working conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job. Minimum Qualifications Requirements - Required and/or Preferred Name Description Education: Ability to read, write, speak, and understand English sufficiently to perform job duties safely and effectively. Appropriate education to obtain and maintain Registered Nursing licensure in the State of Nevada. Experience None License(s) Ability to obtain and maintain a State of Nevada Registered Nurse license. State of Nevada Point of Care Analyst POCA license required within 120 days of hire: 200208, 200255, 209256, 200266, 400255, 400266. State of Nevada Point of Care Analyst POCA license required within six (6) months of hire: 200201 Certification(s) Current BLS certification by The American Heart Association standards. Other Specific Department Required Certificates: Employees will obtain the extra certifications within six months, unless otherwise specified, of being hired or transferring into the department that requires the additional certificates. ACLS per The American Heart Association Standards Required for Departments: 200112, 200114, 200119, ,200132, 200150, 200151, 200155, 200179, 200201,200202, 200205, 200206, 200208, 200251, 200253, 200255, 200261, 200265, 200266, 200276, 200322, 200323, 200325, 200329, 200340, 200341, 209256, 400111, 400125, 400151, 400201, 400202, 400208, 400251, 400253, 400255, 400266, 400276, 400329, 400340, 900256 ACLS per The American Heart Association Standards Required for Departments: 200326 and 200329 within 3 months of being hired. ACLS and PALS per The American Heart Association Standards Required for Department: 400326 within 3 months of being hired. PALS per The American Heart Association Standards Required for Departments: 200178, 200179, 200202, 200205, 200208, 200324, 200341, 400202, 400340 (Pre-Op and PACU RNs only), 400341, 900256. PALS per The American Heart Association Standards Required for Department: 200322, 200323 within 6 months of being hired. NRP Required for Departments: 200171, 200174, 200206 additions to BLS & RN STABLE certification required for 200174 within 6 months of being hired or transferring. ENLS (Emergency Neuro Life Support) Required for Department 200150 within 18-24 months of being hired or transferred to the department. ENPC per The Emergency Nurse's Association or PALS per The American Heart Association Standards Required for Departments: 200255, 200268, 200276, 209256 within one year of being hired or transferring to the department in addition to ACLS, BLS & RN. ENPC per The Emergency Nurse's Association or PALS per The American Heart Association Standards required within 3 months of being hired or transferring to the department: 200326. ENPC per The Emergency Nurse's Association Required for Departments: 200323 within 12 months of being hired. ENPC or PALS preferred for 200266 TNCC Required for Departments: 200323, 200326 within 18 months of being hired or transferring to the department. TNCC or TCAR Required for Departments: 200202 within 18 months of being hired or transferring to the department. TNCC and ENPC preferred: 400326. APHON Chemotherapy and Biotherapy Provider Required for Departments: 200178, 200179, 200324 within 24 months of being hired or transferring into the department. OCN certification preferred. If does not hold the OCN certification, incumbent is required to complete at least 12 cancer-related continuing education nursing contact hours upon completion of first year of employment and on an annual basis thereafter. If certified, incumbent must maintain minimum qualifications in order to maintain certification: 200113. Chemotherapy Immunotherapy training per ASCO standards within 1 year of hire required for department: 200113. RNFA: RN may perform in the capacity of a first assist if he or she is a graduate of an accredited school of Nursing, Completion of a RNFA program that includes didactic and supervised clinical practice, is based on AORN's core curriculum for the RNFA 200201, 200340, 400201, 400340. Computer / Typing Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel, Teams, and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.
RN Telehealth Other
Duke Health

Virtual Nursing (RN) PRN

Duke Health Durham, NC
At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. About Duke University Hospital Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States. The largest of the four Duke Healthhospitals with 1062 patient beds, it features comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more. Duke Nursing Highlights: Duke University Health System is designated as a Magnet organization Nurses from each hospital are consistently recognized each year as North Carolina's Great 100 Nurses. Duke University Health System was awarded the American Board of Nursing Specialties Award for Nursing Certification Advocacy for being strong advocates of specialty nursing certification. Duke University Health System has 6000 + registered nurses Quality of Life: Living in the Triangle! Relocation Assistance (based on eligibility) VIRTUAL NURSE CLINICAL NURSE The Virtual Nurse will deliver exemplary nursing care virtually, in collaboration with the care team. This virtual care will be provided in collaboration with the care team to inpatients at Duke University Hospital, Duke Regional Hospital, Duke Raleigh Hospital, and Duke Lake Norman Hospital. This position will provide nursing care in a virtual setting in accordance with the medical and nursing plans of care and established policies and procedures accordance with the scope of the RN as defined by the North Carolina Board of Nursing. Supports nursing tasks virtually as admission questionnaires, discharge education, patient education, nurse mentoring, and other tasks as needed. This care will be provided using the EMR and telehealth technology using two-way audio and video to provide patient care. The virtual nurse will practice within the guidelines of the standards of nursing care to inpatient acute level patient populations from a remote Virtual Care Center in collaboration with the bedside patient care team. Utilizes patient EMR to support patient admission, education, discharge planning, identify and interpret trends and acute changes in patient physiology, monitor compliance of care bundles and protocols, and collaborates with the bedside multidisciplinary health care team using effective communication and clinical decision-making skills. Serves as a resource for inpatient support for novice nurses who are developing their clinical competencies and decision-making skills. Provides guidance and assistance while giving additional support in the assessment, evaluation, and intervention responsibilities with patients. Duties and Responsibilities: Supports the bedside staff for a large patient ratio to monitor comprehensive compliance of best practice protocols and care bundles aimed at reduction of Mortality, Length of Stay, Hospital Readmissions, and Patient Safety Events. Provides patient education and support virtually including verbal and written instructions. Assess the patient/family ability to receive education and uses appropriate tools and techniques. Takes initiative to problem solve and demonstrates critical thinking skills. Skilled and comfortable with various technologies to coordinate patient care, including multiple software applications, computerized clinical guidelines, specialized telephone technology, video and image transmission, and more. Supports the bedside care team in patient care activities within the guidelines of the standards of nursing care using the nursing process, clinical judgment, and decision support materials. Provides consultation and second opinion virtually to assist with clinical decision making, including managing inpatient patients whose condition may be deteriorating or who may require transfer to a higher level of care. Assists nurses with an appropriate plan of care related to a change of condition. Ability to work in a constant state of alertness and in a safe manner is an essential function of this job. Virtually support the plan, provide, supervise and document professional nursing care utilizing the nursing process for patients in accordance with physician orders and established policies and procedures in collaboration with the care nurse. Use professional nursing judgment to individualize the plan of care in collaboration with the care nurse based on assessment of the patient's baseline needs and response to care. Participate in own professional development by maintaining required competencies, identifying learning needs and seeking appropriate assistance or educational offerings. Identifying appropriate patients for Remote Safety Observation (RSO) Placement. Supporting care nurse with monitoring of unit dashboard and notifying the nurse with tasks needing attention. Act as Charge Nurse and Preceptor in oversite of RSO staff and escalating to unit leadership when appropriate. Act as preceptor and support the development of other staff and formal learners. Participate in the identification of clinical or operational performance improvement opportunities and in performance improvement activities. Perform other related duties incidental to the work described herein What you will need: Experience: Preceptor and Charge Nurse Experience is required. Minimum Requirements 3-5 years appropriate inpatient clinical experience is required. Preferred Requirements 5-10 + year’s appropriate inpatient clinical experience is required.At a manager's discretion, employees with less than the above experience who are exceptional performers may be eligible for this level. Degrees, Licensure, and/or Certification: Must have current or compact RN licensure in the state of North Carolina. BLS required. Education: Graduation from an accredited Bachelor’s Degree in Nursing (or higher) OR Associate's Degree in Nursing OR Nursing Diploma program. Twelve months of appropriate clinical experience is required for Experienced Registered Nurses. All registered nurses without a Bachelor's degree in Nursing (or higher) will be required to enroll in an appropriate BSN program within two years of their start date and to complete the program within seven years of their start date. Knowledge, Skills, and Abilities: Knowledge of scope of the registered nurse, licensed practical nurse and NCA Knowledge of and appropriate application of the nursing process Knowledge of professional theory, practice and procedure Ability to excel with computer technology and learn new software programs Ability to troubleshoot computer technology Ability to assess nursing needs of acute and chronically ill patients and their families using virtual technology Ability to independently seek out resources and work collaboratively Ability to excel in communication skills through asynchronous technology and telephone Ability to establish and maintain effective working relationships in the virtual environment Ability to communicate clearly with patients, families, visitors, healthcare team, physicians, administrators, leadership and others through virtual technology Ability to teach patients and families in accordance with the nursing plan of care through virtual technology Ability to use sensory and cognitive functions to process and prioritize information, treatment, and follow-up Ability to use fine motor skills Competent in BLS and/or other specialized life support requirements designated by work area Ability to record activities, document assessments, plan of care, interventions, evaluation and re-evaluation of patient status through virtual technology Able to document and communicate pertinent information using computer and/or paper documentation tools Ability to navigate to provide virtual clinical care for patients Ability to remain focused and organized Working knowledge of procedures and techniques involved in administering routine and special treatments to patients Working knowledge of infection control procedures and safety precautions Working knowledge and completion of appropriate JCAHO and other regulatory requirements Pre-employment Physical Capacity Testing Required Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status. Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values. Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
RN Telehealth
BestMed

Triage RN (Remote)

BestMed Eugene, OR
Position Summary: The Triage RN is responsible for using discretion and independent judgment in coordinating the delivery of quality patient care. This position requires skill in planning and organizing care. This position applies advanced nursing clinical skills in maintaining patient records within an electronic medical record, preparing written reports, teaching other nursing-related skills, and maintaining effective working relationships with others. Essential Functions and Responsibilities: 1. Analytical ability to solve clinical nursing issues and conduct quality improvement research utilization projects. 2. Ability to effectively delegate appropriate patient care activities. 3. Effective verbal and written communication skills appropriate to the patient populations served. 4. Ability to multitask. 5. Basic computer proficiency inclusive of ability to access, enters, and interpret computerized data/information. 6. Effective interpersonal skills to facilitate communication with various members of the health care team, patients, and families. 7. Organizational skills to set priorities and efficiently complete assigned work. 8. Ability to effectively manage stress due to critical issues related to patient care, changing organizational climate and personnel issues. 9. Perform other duties as assigned. Requirements and Qualifications: • Education: Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN). • Certificate/License: Active State of Oregon Registered Nurse (RN) license. • Experience: A minimum of five (5) years of nursing experience is required. Primary Care experience preferred. • Location: Candidates must currently live in OR and preferably reside in either Lane, Marion, Polk or Yamhill County or the Portland Metro area. Relocation assistance is not provided for this role, and we are unable to consider out-of-state applicants at this time. Working Conditions and Physical Demands: • Requires prolonged sitting, frequent standing, bending, stooping and occasional lifting of up to 25 pounds. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, telephone, photocopier, calculator and other office equipment. Requires normal range of hearing and eye sight to record, prepare and communicate appropriate reports. Requires residency in the state of Oregon and an uninhibited driver’s license to accommodate travel to off-site meetings and workgroup sessions. Out-of-State applicants will not be considered. Community Care Partners is an Equal Opportunity Employer (EEO). #LPN
RN Telehealth Full-time
Banner Health

RN, Case Manager

Banner Health Phoenix, AZ
$35.43 - $59.05 / hour
Department Name: Maternal Child Health Work Shift: Day Job Category: Clinical Care Better Than Ever for Nurses. When we make things better than ever for nurses at Banner Health, we make things better than ever for all of us. This means investing in the holistic health and happiness of our nurses—through better pay, better benefits, better opportunities and a better community. Join Banner University Family Care's Maternal Child Health team as a Pediatric RN, Case Manager , where you'll provide telephonic complex case management and make a meaningful difference in the lives of children and their families. In this role, you'll partner with members, caregivers, providers, and community resources to coordinate care, address barriers, and support the management of complex medical needs. Through assessment, advocacy, and care planning, you'll help families navigate the healthcare system and access the right services at the right time. As a trusted clinical resource and advocate, you'll facilitate seamless transitions across the continuum of care, ensuring members receive high-quality, evidence-based, and family-centered support. If you're passionate about improving pediatric health outcomes, building strong relationships with families, and collaborating with interdisciplinary teams to deliver whole-person care, you'll find a rewarding opportunity to create lasting impact while helping children achieve their best possible health and quality of life. The RN, Case Manager will be onsite for training at Banner Corporate Mesa or Banner Corporate Tucson, a minimum of three months. After completing training, it is a remote position with a work schedule of Monday - Friday 8am - 5pm. Candidates must live in the state of AZ to be considered. Your pay and benefits (Total Rewards) are important components of your Journey at Banner Health. Banner Health offers a variety of benefit plans to help you and your family. We provide health and financial security options, so you can focus on being the best at what you do and enjoying your life. Banner Plans & Networks (BPN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BPN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs. POSITION SUMMARY This position provides comprehensive care coordination for patients as assigned. This position assesses the patients plan of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through their care, facilitating options and services to meet the patients health care needs. The intensity of care coordination provided is situational and appropriate based on patient need and payer requirements. This position is accountable for the quality of clinical services delivered by both them and others and identifies/resolves barriers which may hinder effective patient care. CORE FUNCTIONS 1. Manages individual patients across the health care continuum to achieve the optimal clinical, financial, operational, and satisfaction outcomes. 2. Acts in a leadership function with process improvement activities for populations of patients to achieve the optimal clinical, financial, operational, and satisfaction outcomes. 3. Acts in a leadership function to collaboratively develop and manage the interdisciplinary patient discharge plan. Effectively communicates the plan across the continuum of care. 4. Evaluates the medical necessity and appropriateness of care, optimizing patient outcomes. Assesses patient admissions and continued stay utilizing standard criteria. Identifies issues that may delay patient discharge and facilitates resolution of these issues. 5. Establishes and promotes a collaborative relationship with physicians, payers, and other members of the health care team. Collects and communicates pertinent, timely information to payers and others to fulfill utilization and regulatory requirements. 6. Educates internal members of the health care team on case management and managed care concepts. Facilitates integration of concepts into daily practice. 7. May supervise other staff. 8. Has freedom to determine how to best accomplish functions within established procedures. Confers with supervisor on any unusual situations. Positions are entity based with no budgetary responsibility. Internal customers: All levels of nursing management and staff, medical staff, and all other members of the interdisciplinary health care team. External Customers: Physicians and their office staff, payers, community agencies, provider networks, and regulatory agencies. MINIMUM QUALIFICATIONS Must possess knowledge of case management or utilization review as normally obtained through the completion of a bachelor's degree in case management or health care. Requires current Registered Nurse (R.N.) license in state worked. For assignments in an acute care setting, Basic Life Support (BLS) certification is also required. Requires a proficiency level typically achieved with 3-5 years clinical experience. Must have a working knowledge of care management, acute care and/or home care environments, community resources and resource/utilization management. Must demonstrate critical thinking skills, problem-solving abilities, effective communication skills, and time management skills. Must demonstrate ability to work effectively in an interdisciplinary team format. For assignments in an acute care setting, must be able to work flexible hours and take rotating call after hours. Banner Registry and Travel positions require a minimum of one year experience in an acute care hospital and/or home care setting. Experience must include working in an acute care and/or home care setting within the past 12 months as a Case Manager in the specialty area. PREFERRED QUALIFICATIONS Certification for CCM (Certified Case Manager) preferred. Additional related education and/or experience preferred. Estimated Pay Range: $35.43 - $59.05 / hour Banner Health is committed to pay equity and transparency. The posted compensation range is a reasonable estimate that extends from the lowest to the highest pay Banner Health in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. This range is based on possible base salaries and does not include the value of our total rewards package. Actual pay determined at offer will be based on years of relevant work experience, education, certifications, skills, and geographic location, along with a review of current employees in similar roles to ensure pay equity is achieved and maintained. EEO Statement: EEO/Disabled/Veterans Our organization supports a drug-free work environment. Privacy Policy: Privacy Policy
RN Mother-Baby Pediatric Telehealth Full-time
UnitedHealthcare

Maternal Child RN Care Manager - Remote in NC

UnitedHealthcare Raleigh, NC
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together . You push yourself to reach higher and go further. Because for you, it's all about ensuring a positive outcome for members. In this role, you'll work in the field and coordinate the care needs for members in the local community. And at every turn, you'll have the support of an elite and dynamic team. Join UnitedHealth Group and our family of businesses and you will use your diverse knowledge and experience to make health care work better for our members. In this Care Manager role, will be an essential element of an Integrated Care Model by relaying the pertinent information about the member needs and advocating for the best possible care available, and ensuring they have the right services to meet their needs. If you reside in North Carolina, you will have the flexibility to work remotely* as you take on some tough challenges Primary Responsibilities Assess, plan and implement care management interventions that are individualized for each member and directed toward the most appropriate, least restrictive level of care Identify and initiate referrals for both healthcare and community-based services; including but not limited to financial, psychosocial, community and state supportive services Develop and implement care plan interventions throughout the continuum of care as a single point of contact Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members Advocate for members and families as needed to ensure the member's needs and choices are fully represented and supported by the health care team Ability to provide field-based visits to members locally (up to 25%), up to 120 miles round trip (60 miles one way) (includes mileage reimbursement) You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications Unrestricted RN license in the state of North Carolina Must be a resident of NC 4+ years of experience working within the pediatric/maternity community setting or 2+ years of experience providing community-based care management to pediatric/maternity members The ability to travel in assigned region to visit Medicaid members in their homes and/or other settings, including community centers or providers' offices Intermediate skills in Microsoft Office Suite Willing to work with both pediatric and maternity populations Driver's License and access to a reliable transportation Preferred Qualifications Bachelor of Science in Nursing (BSN) CCM certification Experience in managing populations with complex medical or behavioral needs Experience working with both maternity and pediatric populations Experience working with members in community and home-based settings Fluent in Spanish All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $29.00 to $52.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
RN Telehealth Full-time
Honest

Registered Nurse (RN) Care Manager - Future Opportunities (OR, WA, & AK)

Honest OR
$84,260 - $97,790 / year
This is not an active opening. We’re building a talent community of experienced RN Care Managers for future opportunities supporting patients in Oregon , Washington , and Alaska . If you’re interested in being considered as positions become available in these markets, we’d love for you to apply. Who You Are You’re a collaborative professional, driven by the potential to make a meaningful impact in healthcare. The challenges of healthcare don’t deter you—instead, you see them as opportunities to find innovative solutions that benefit the partners, people, and communities we serve. Honest Health’s commitment to purpose, innovation, communities, and kindness resonates with you, inspiring you to bring commitment, creativity, and compassion into your work. You’re ready to join a team focused on reimagining primary care for a healthier future that benefits all. Does this sound like you? Let’s connect. Who We Are At Honest Health, we believe in purpose and partnership to lead the transformation in primary care. Our team of healthcare experts and clinicians collaborates with a range of stakeholders—from health systems, physician organizations, and payers to providers, practices, and patients — to deliver innovative solutions that elevate care, control costs, and support long-term health. Guided by our core values, we’re creating a value-driven model that creates lasting benefits for everyone, now and into the future. For us, that’s just an Honest day’s work. Your Role You will manage patients’ specialized needs based on their individual condition(s) and/or reason for recent utilization in collaboration with physicians, advanced practice providers, and care coordination team members. Your job duties will include taking full ownership of assigned patients with complex chronic conditions, serious illness, advanced frailty, or recent healthcare utilization with the goal of avoiding preventable admissions, reducing unnecessary healthcare use, and optimizing patient outcomes. Through standardized assessments and workflows you will work with the patient to identify needs based on their values, goals and preferences. From this assessment, and in partnership with the patient and provider, you will develop an effective, and comprehensive nursing care plan for each member. These care plans will be used to coordinate patient care delivery with network providers, contracted vendors, and community-based services. This work takes place remotely, but you must be licensed in the state(s) where the role is based: Washington, Oregon, and/or Alaska Primary Functions of the Nurse Care Manager Include: Quickly build empathetic relationships with patients and families. Evaluate and identify patients’ needs based on their respective values, goals, and preferences, then translate these needs into clinical needs. Interface with primary care physicians, advanced practice providers (APP), specialists, and various disciplines on the development of case management plans/programs. In conjunction with the physician/APP, implement care/treatment plans by coordinating access to health services across multiple providers/ disciplines. Refer patients to internal Honest team members for care management activities as outlined by defined procedures. Monitor care and identify cost-effective measures, including recommendations for alternative levels of care and utilization of resources. In partnership with Honest team members, effectively coordinate patient admissions and discharges from hospitals or skilled nursing facilities via coordination with respective facility clinicians and case managers. Build relationships across network hospitals, SNFs, home health companies, and DME vendors within the respective community. Monitor and evaluate the effectiveness of the nurse care plans based on quality and cost drivers and modify as necessary. Coordinate the interdisciplinary approach to providing continuity of care, including transfer coordination, discharge planning and obtaining all authorizations/approvals/transfers as needed for outside services for patients/families. Act as a patient advocate and educator to assure that the patient has the knowledge to care for his/her condition and patient is educated and empowered to be responsible for participating in the plan of care. Develop individualized patient/family education plan focused on self-management and deliver patient/family education specific to a disease state. Engage internal resources to identify and respond to social determinants of health such as lack of transportation, stable housing, or food resources. Participate in data collection and analysis of clinical outcomes of care and customer satisfaction standards. Participate in the formulation and implementation and monitoring of action strategies and outcomes of care or customer service. Ensure that accurate records are maintained of the care associated with each patient. Actively participate in huddles, interdisciplinary team (IDT) sessions, and patient case conferences. Commendably represents Honest to patients, their families, and the community. Perform other related responsibilities as assigned. How You Qualify You reviewed the Who You Are section of this job posting and immediately felt the need to read on. This makes you a match for our innovative culture. You accept things change quickly in a startup environment and are willing to pivot quickly on priorities. ​​ Must have reliable access to high-speed internet to ensure seamless remote work communication and productivity Active Registered Nurse license is required in the state(s) where the role is based: Washington, Oregon, and/or Alaska Willing and able to obtain additional state nursing license(s) as business needs dictate, with support from Honest leadership and reimbursement for required fees Experience and high level of comfort with engaging patients virtually using different technologies including phone, text, video, etc. is required Bachelor’s of Science in Nursing preferred Certified Case Manager (CCM) credential preferred 3+ years of clinical practice in a hospital, clinic, home care, or nursing home setting highly preferred Case management experience with a senior population preferred Disease management and/or physician office experience highly preferred Prior experience with electronic health records or health registries required Microsoft Office skills, including Excel, Word, PowerPoint, Outlook required. Experience with PowerPoint preferred The base pay range for this role is $84,260 - $97,790. Compensation takes into account several factors including but not limited to a candidate’s experience, education, skills, licensure and certifications, and organizational needs. Base pay is just one piece of the total rewards program offered by Honest. Eligible roles also qualify for short-term incentives and a comprehensive benefits package. Honest Health is committed to ensuring fairness, opportunity, strong teams, and full integration of team members into the organization. We take proactive steps to ensure all applicants are considered for employment based on merit, without regard to race, color, religion, sex, national origin, disability, Veteran status, or other legally-protected characteristics. Honest Health is committed to working with and providing reasonable accommodations to job applicants with physical or mental disabilities. Applicants with a disability who require a reasonable accommodation for any part of the application or hiring process should email talent@Honesthealth.com for assistance. Reasonable accommodation will be determined on a case-by-case basis.
RN Telehealth Full-time
HCA Healthcare

Clinical Nurse Coordinator RN Virtual Care Center

HCA Healthcare Pearland, TX
** This is an onsite position – Location Address: 12620 W. Airport Blvd, Sugar Land, TX 77478 ** As the nation’s largest private employer of Registered Nurses, we’re honored by the trust of over 100,000 nurses and committed to supporting safe, high-quality care for which they can practice. That’s why more than 80% of our hospitals earn an A or B Leapfrog safety grade, rank in the top 5% nationally for patient outcomes through Health Grades , or are recognized as Magnet or Pathway to Excellence facilities. Join us! Job Summary and Qualifications The Clinical Nurse Coordinator (CNC) drives the strategic vision and day-to-day operations of the virtual care center. The CNC ensures and delivers high quality, patient-centered care and coordination of all functions in the unit/department during the designated shift. In collaboration with other members of the management team, the CNC directs, monitors, and evaluates nursing care in accordance with established policies/procedures, serves as a resource person for staff, and models a commitment to the organization’s vision/mission/values to support an unparalleled patient experience and clinical outcomes that contribute to overall departmental performance. We are an amazing team that works hard to support each other, and we are seeking a phenomenal addition who feels patient care is as meaningful as we do. What you will do in this role: Collaborates with a multidisciplinary team to coordinate, evaluate, customize, and deliver high quality patient- centered care. Exercises judgement and provides direction regarding patient care assignments using established policies/procedures. Operationalizes evidence-based practices to enhance patient safety and quality outcomes. Supports the achievement of internal/external benchmarks, accreditations, and designations. Ensures compliance with all policies, procedures and regulatory standards. Ensures equipment maintenance is performed regularly and according to regulatory and/or accreditation standards. Assists with admission and discharge processes to ensure efficient throughput and high quality, patient-centered care. Participates in the ongoing assessment of the quality of patient care services provided in the unit, in collaboration with other members of the management team. Collaborates with subject matter experts and other leaders to create an environment of teamwork that supports improved outcomes and service Responsible for payroll duties for Virtual Care Center staff Assists with staffing scheduling. Manages all practical aspects of staff labor in accordance with patient care needs and established productivity guidelines. What qualifications you will need: Basic Cardiac Life Support (RN) Registered Nurse Associate Degree or Bachelors Degree BSN highly preferred 2+ years RN Critical Care experience in an acute care setting 1+ years as a Charge Nurse or Clinical Nurse Coordinator Benefits HCA Houston Healthcare, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services Wellbeing support, including free counseling and referral services Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence Savings and retirement resources , including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts Learn more about Employee Benefits Note: Eligibility for benefits may vary by location. "There is so much good to do in the world and so many different ways to do it." - Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder HCA Gulf Coast Division is an affiliation of hospitals serving greater Houston area and South Texas. We share a mission, a commitment to the communities we serve and a standard of excellence for providing compassionate patient care. Serving such a large and diverse region requires HCA Gulf Coast Division to offer a range of programs that meets the needs of people of all ages with conditions ranging from acute to chronic illnesses. With 16 acute care and specialty hospitals, freestanding emergency rooms, ambulatory surgery centers, and more than 16,000 employees, HCA Gulf Coast Division offers patients access to a circle of care that is unique in the region. We bring comprehensive care close to home, including advanced medical care, education, and community outreach. By joining together as a network, hospitals are able to focus on improving outcomes and enhancing services for their own communities, while pooling resources for other functions like staffing and systems management. HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated 3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. Be a part of an organization that leverages our size to make a real impact in our industry! Our Talent Acquisition team is reviewing applications for our Clinical Nurse Coordinator RN Virtual Care Center opening. Submit your application today and help advance the practice of nursing. We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
RN Telehealth Full-time
Honest

Registered Nurse (RN) Care Manager - Future Opportunities (OR, WA, & AK)

Honest OR
$84,260 - $97,790 / year
This is not an active opening. We’re building a talent community of experienced RN Care Managers for future opportunities supporting patients in Oregon , Washington , and Alaska . If you’re interested in being considered as positions become available in these markets, we’d love for you to apply. Who You Are You’re a collaborative professional, driven by the potential to make a meaningful impact in healthcare. The challenges of healthcare don’t deter you—instead, you see them as opportunities to find innovative solutions that benefit the partners, people, and communities we serve. Honest Health’s commitment to purpose, innovation, communities, and kindness resonates with you, inspiring you to bring commitment, creativity, and compassion into your work. You’re ready to join a team focused on reimagining primary care for a healthier future that benefits all. Does this sound like you? Let’s connect. Who We Are At Honest Health, we believe in purpose and partnership to lead the transformation in primary care. Our team of healthcare experts and clinicians collaborates with a range of stakeholders—from health systems, physician organizations, and payers to providers, practices, and patients — to deliver innovative solutions that elevate care, control costs, and support long-term health. Guided by our core values, we’re creating a value-driven model that creates lasting benefits for everyone, now and into the future. For us, that’s just an Honest day’s work. Your Role You will manage patients’ specialized needs based on their individual condition(s) and/or reason for recent utilization in collaboration with physicians, advanced practice providers, and care coordination team members. Your job duties will include taking full ownership of assigned patients with complex chronic conditions, serious illness, advanced frailty, or recent healthcare utilization with the goal of avoiding preventable admissions, reducing unnecessary healthcare use, and optimizing patient outcomes. Through standardized assessments and workflows you will work with the patient to identify needs based on their values, goals and preferences. From this assessment, and in partnership with the patient and provider, you will develop an effective, and comprehensive nursing care plan for each member. These care plans will be used to coordinate patient care delivery with network providers, contracted vendors, and community-based services. This work takes place remotely, but you must be licensed in the state(s) where the role is based: Washington, Oregon, and/or Alaska Primary Functions of the Nurse Care Manager Include: Quickly build empathetic relationships with patients and families. Evaluate and identify patients’ needs based on their respective values, goals, and preferences, then translate these needs into clinical needs. Interface with primary care physicians, advanced practice providers (APP), specialists, and various disciplines on the development of case management plans/programs. In conjunction with the physician/APP, implement care/treatment plans by coordinating access to health services across multiple providers/ disciplines. Refer patients to internal Honest team members for care management activities as outlined by defined procedures. Monitor care and identify cost-effective measures, including recommendations for alternative levels of care and utilization of resources. In partnership with Honest team members, effectively coordinate patient admissions and discharges from hospitals or skilled nursing facilities via coordination with respective facility clinicians and case managers. Build relationships across network hospitals, SNFs, home health companies, and DME vendors within the respective community. Monitor and evaluate the effectiveness of the nurse care plans based on quality and cost drivers and modify as necessary. Coordinate the interdisciplinary approach to providing continuity of care, including transfer coordination, discharge planning and obtaining all authorizations/approvals/transfers as needed for outside services for patients/families. Act as a patient advocate and educator to assure that the patient has the knowledge to care for his/her condition and patient is educated and empowered to be responsible for participating in the plan of care. Develop individualized patient/family education plan focused on self-management and deliver patient/family education specific to a disease state. Engage internal resources to identify and respond to social determinants of health such as lack of transportation, stable housing, or food resources. Participate in data collection and analysis of clinical outcomes of care and customer satisfaction standards. Participate in the formulation and implementation and monitoring of action strategies and outcomes of care or customer service. Ensure that accurate records are maintained of the care associated with each patient. Actively participate in huddles, interdisciplinary team (IDT) sessions, and patient case conferences. Commendably represents Honest to patients, their families, and the community. Perform other related responsibilities as assigned. How You Qualify You reviewed the Who You Are section of this job posting and immediately felt the need to read on. This makes you a match for our innovative culture. You accept things change quickly in a startup environment and are willing to pivot quickly on priorities. ​​ Must have reliable access to high-speed internet to ensure seamless remote work communication and productivity Active Registered Nurse license is required in the state(s) where the role is based: Washington, Oregon, and/or Alaska Willing and able to obtain additional state nursing license(s) as business needs dictate, with support from Honest leadership and reimbursement for required fees Experience and high level of comfort with engaging patients virtually using different technologies including phone, text, video, etc. is required Bachelor’s of Science in Nursing preferred Certified Case Manager (CCM) credential preferred 3+ years of clinical practice in a hospital, clinic, home care, or nursing home setting highly preferred Case management experience with a senior population preferred Disease management and/or physician office experience highly preferred Prior experience with electronic health records or health registries required Microsoft Office skills, including Excel, Word, PowerPoint, Outlook required. Experience with PowerPoint preferred The base pay range for this role is $84,260 - $97,790. Compensation takes into account several factors including but not limited to a candidate’s experience, education, skills, licensure and certifications, and organizational needs. Base pay is just one piece of the total rewards program offered by Honest. Eligible roles also qualify for short-term incentives and a comprehensive benefits package. Honest Health is committed to ensuring fairness, opportunity, strong teams, and full integration of team members into the organization. We take proactive steps to ensure all applicants are considered for employment based on merit, without regard to race, color, religion, sex, national origin, disability, Veteran status, or other legally-protected characteristics. Honest Health is committed to working with and providing reasonable accommodations to job applicants with physical or mental disabilities. Applicants with a disability who require a reasonable accommodation for any part of the application or hiring process should email talent@Honesthealth.com for assistance. Reasonable accommodation will be determined on a case-by-case basis.
RN Telehealth Full-time
Cooper University Health Care

PRACTICE RN-FULL TIME

Cooper University Health Care Camden, NJ
About us At Cooper University Health Care , our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols. We have a commitment to our employees to provide competitive rates and compensation programs. Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement. We also provide attractive working conditions and opportunities for career growth through professional development. Discover why Cooper University Health Care is the employer of choice in South Jersey. Short Description The Registered RN is a professional care-giver who, as a member of a multidisciplinary health care team, assumes responsibility and accountability for a group of patients for a designated time frame and who provides care to these patients utilizing the nursing process including the therapeutic use of self. Position Summary The RN Triage Nurse serves as the clinical triage and care coordination resource for the Population Health at Home program. This role is responsible for assessing patient concerns, reviewing clinical information, coordinating care, managing test results, providing patient education, and escalating urgent issues to ensure safe, timely, and effective patient care. Essential Duties & Responsibilities • Provide telephonic and electronic clinical triage, assessing patient symptoms and determining the appropriate level of care. • Utilize evidence-based protocols and clinical judgment to manage urgent concerns, escalate high-risk situations, and facilitate timely interventions. • Review and communicate laboratory, diagnostic, and provider results, ensuring appropriate follow-up and patient understanding. • Coordinate care across providers and interdisciplinary teams to support seamless patient management and transitions of care. • Identify and engage eligible patients for Population Health at Home programs, promoting preventive care, chronic disease management, and improved health outcomes. • Serve as a clinical resource for complex patient issues, ensuring concerns are resolved efficiently and safely. • Deliver patient education and self-management support to enhance engagement and adherence to care plans. • Maintain accurate and timely documentation in the electronic medical record while adhering to regulatory, quality, and organizational standards. Experience Required 1-3 Years of experience Education Requirements BSN Required NJ RN License Required License/Certification Requirements American Heart Association BLS
RN Telehealth Full-time
Methodist Healthcare System

Registered Nurse RN Surgical Tele

Methodist Healthcare System Shavano Park, TX
Introduction Methodist Hospital Landmark is committed to investing in the latest technology enabling nurses to work more efficiently. Are you passionate about delivering patient-centered care? Submit your application for Registered Nurse RN Surgical Tele position and spend more time at the bedside with the patient. Benefits Methodist Hospital Landmark, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. Free counseling services and resources for emotional, physical and financial wellbeing 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) Employee Stock Purchase Plan with 10% off HCA Healthcare stock Family support through fertility and family building benefits with Progyny and adoption assistance. Referral services for child, elder and pet care, home and auto repair, event planning and more Consumer discounts through Abenity and Consumer Discounts Retirement readiness, rollover assistance services and preferred banking partnerships Education assistance (tuition, student loan, certification support, dependent scholarships) Colleague recognition program Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence) Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income. Learn more about Employee Benefits Note: Eligibility for benefits may vary by location. You contribute to our success let us contribute to yours! Whether you choose to focus on bedside care, a leadership or C-suite role, shape business and operational outcomes, or work to deliver clinical excellence behind the scenes in data science, case management or transfer centers. Unlock your potential at Methodist Hospital Landmark! Job Summary and Qualifications As a Registered Nurse, you will be responsible for delivering high-quality, patient-centered care in line with the requirements of the department and the standards of practice for the relevant state and specialty. Collaborating with medical providers and the care team, you will provide personalized, comprehensive, and compassionate care, following established nursing models such as "Assess, Perform, Teach, and Manage." You will also act as an advocate for patients, families, and caregivers, embodying the organizations vision, mission, and values to ensure an outstanding patient experience and positive clinical outcomes. What you will do in this role: Assess the patients condition during admission and each scheduled shift, promptly identifying and reporting any changes in patient status. Perform procedures, monitoring, or other functions as ordered by the medical provider(s), and ensure thorough and timely documentation of care administration in the patients medical record. - Administer prescribed medications, monitor the patient for therapeutic response, and take appropriate action in the event of an unintended response to the medication. Provide exceptional care by responding promptly to patient requests, proactively anticipating patient needs, and resolving them. Educate patients, families, and caregivers about the patients medical condition, treatment plan, medications, possible side effects, and follow-up measures, ensuring complete understanding by translating complex medical terminology. What qualifications you will need: Graduate of an accredited diploma, associates, or baccalaureate degree registered nursing program. Minimum of six (6) months of clinical experience as a licensed Registered Nurse Current Registered Nurse License in the State of Texas or Multi-State Compact License (Employees with RN Compact License are required to obtain Texas RN License within 60 days of hire date) Current American Heart Association BLS Certification Join a family that cares about every stage in your career! We are interviewing candidates for our Registered Nurse RN Surgical Tele opening. Apply today and a member of our Talent Acquisition team will reach out. We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
RN Telehealth Full-time
HCA Healthcare

Clinical Nurse Coordinator RN Virtual Care Center

HCA Healthcare Pearland, TX
** This is an onsite position – Location Address: 12620 W. Airport Blvd, Sugar Land, TX 77478 ** As the nation’s largest private employer of Registered Nurses, we’re honored by the trust of over 100,000 nurses and committed to supporting safe, high-quality care for which they can practice. That’s why more than 80% of our hospitals earn an A or B Leapfrog safety grade, rank in the top 5% nationally for patient outcomes through Health Grades , or are recognized as Magnet or Pathway to Excellence facilities. Join us! Job Summary and Qualifications The Clinical Nurse Coordinator (CNC) drives the strategic vision and day-to-day operations of the virtual care center. The CNC ensures and delivers high quality, patient-centered care and coordination of all functions in the unit/department during the designated shift. In collaboration with other members of the management team, the CNC directs, monitors, and evaluates nursing care in accordance with established policies/procedures, serves as a resource person for staff, and models a commitment to the organization’s vision/mission/values to support an unparalleled patient experience and clinical outcomes that contribute to overall departmental performance. We are an amazing team that works hard to support each other, and we are seeking a phenomenal addition who feels patient care is as meaningful as we do. What you will do in this role: Collaborates with a multidisciplinary team to coordinate, evaluate, customize, and deliver high quality patient- centered care. Exercises judgement and provides direction regarding patient care assignments using established policies/procedures. Operationalizes evidence-based practices to enhance patient safety and quality outcomes. Supports the achievement of internal/external benchmarks, accreditations, and designations. Ensures compliance with all policies, procedures and regulatory standards. Ensures equipment maintenance is performed regularly and according to regulatory and/or accreditation standards. Assists with admission and discharge processes to ensure efficient throughput and high quality, patient-centered care. Participates in the ongoing assessment of the quality of patient care services provided in the unit, in collaboration with other members of the management team. Collaborates with subject matter experts and other leaders to create an environment of teamwork that supports improved outcomes and service Responsible for payroll duties for Virtual Care Center staff Assists with staffing scheduling. Manages all practical aspects of staff labor in accordance with patient care needs and established productivity guidelines. What qualifications you will need: RN Registered Nurse Graduate of an accredited school of professional nursing is required Associate Degree or Bachelor’s Degree BSN highly preferred 2+ years of RN Critical Care experience in an acute care setting 1+ years as a Charge Nurse or Clinical Nurse Coordinator Benefits HCA Houston Healthcare, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services Wellbeing support, including free counseling and referral services Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence Savings and retirement resources , including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts Learn more about Employee Benefits Note: Eligibility for benefits may vary by location. "There is so much good to do in the world and so many different ways to do it." - Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder HCA Gulf Coast Division is an affiliation of hospitals serving greater Houston area and South Texas. We share a mission, a commitment to the communities we serve and a standard of excellence for providing compassionate patient care. Serving such a large and diverse region requires HCA Gulf Coast Division to offer a range of programs that meets the needs of people of all ages with conditions ranging from acute to chronic illnesses. With 16 acute care and specialty hospitals, freestanding emergency rooms, ambulatory surgery centers, and more than 16,000 employees, HCA Gulf Coast Division offers patients access to a circle of care that is unique in the region. We bring comprehensive care close to home, including advanced medical care, education, and community outreach. By joining together as a network, hospitals are able to focus on improving outcomes and enhancing services for their own communities, while pooling resources for other functions like staffing and systems management. HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated 3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. Be a part of an organization that leverages our size to make a real impact in our industry! Our Talent Acquisition team is reviewing applications for our Clinical Nurse Coordinator RN Virtual Care Center opening. Submit your application today and help advance the practice of nursing. We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
RN Manager/Supervisor Telehealth Full-time
Commonwealth of Kentucky

Nurse Manager

Commonwealth of Kentucky KY
$90,811.68 - $104,373.84 / year
Advertisement Closes 9/15/2026 (11:59 PM ET) 2604569 Nurse Manager Pay Grade 19 Salary $90,811.68 - $104,373.84 Annually Employment Type EXECUTIVE BRANCH | FULL TIME | INELIGIBLE FOR OVERTIME PAY | 18A | 37.5 HR/WK Click here for more details on state employment. Hiring Agency Cabinet for Health & Family Services | Department for Public Health Location Location Varies Description The agency may authorize the selected candidate to telecommute. The agency may terminate or modify the telecommuting arrangement at any time. Looking for a fulfilling career working for an agency that is making positive changes in the community? Interested in working with a highly motivated team of professionals? A job that qualifies for the federal public service student loan forgiveness (PSLF) program? The Office for Children with Special Health Care Needs is seeking a Nurse Manager for Clinical Services in the East Region. The Office for Children with Special Health Care Needs provides comprehensive services for children and youth with special health care needs through newborn hearing screening, early intervention, pediatric specialty clinics, care coordination, case management, therapy services, and family support. The Office for Children with Special Health Care Needs collaborates with community stakeholders across the Commonwealth to ensure comprehensive service delivery. The Nurse Manager administers the Nursing Services Program for children with special health care needs. Oversees and coordinates a regional team of Nurse Program Administrators and other health professionals to provide direct clinical services and indirect case management and care coordination while maintaining quality assurance of clinical practices for children with special health care needs and children with medical complexity. The Cabinet for Health and Family Services (CHFS) does not discriminate on the basis of race, color, religion, sex, national origin, sexual orientation or gender identity, ancestry, age, disability, political affiliation, genetic information, or veteran status in accordance with state and federal laws. Job Duties Include But Are Not Limited To Supervises and evaluates operations and services provided at specified regional offices across the state. Monitors and provides guidance as needed in relation to caseloads, patient acuity, clinic schedule coverage, and collaboration between clinic office locations. Monitors budget and approve expenditure requests. Travels to regional offices to provide training and support for clinic operations. Responsible for quality assurance and program audits of direct clinical care and indirect case management and care coordination. Prepares and monitors reports related to utilization review and outcome data specific to Clinic Programs and OCSHCN initiatives. Conducts and/or coordinates training and professional development specific to the identified quality assurance measures. Conducts and coordinates training and technical assistance for staff. Collaborates with the other nursing leadership to review, write, update, and develop clinical and agency processes in alignment with agency procedures and state regulation and in compliance with the various grant requirements. Responsible for staff development to meet certification requirements. Prepares annual Performance Evaluations of supervisors and conducts quarterly coaching sessions, if needed, to ensure fair and equitable treatment of all employees. Initiates and follows up on any disciplinary actions and performance improvement plans and follows personnel guidelines. Assists supervisors with defining goals and tasks to meet quality improvement initiatives. Interviews and recruits for open positions in accordance with the hiring process, for assigned region. Orients new Nurse Program Administrators and promotes ongoing training for all staff as assigned. Facilitates communication between community partners regarding referrals and student internships. Participates in the Eligibility Committee, monitors compliance with provider contracts; Facilitates Referrals. Conducts outreach activities, participates in agency wide committees, work groups, and special projects. Performs other duties as assigned. Preferred Skills Include But Are Not Limited To Highly self-motivated with the ability to work under pressure. Demonstrates flexibility and critical thinking. Ability to multi-task and delegate. Strong verbal and written communication skills, time management and organizational skills are necessary. Experience in performance and operations management Proficiency in Microsoft Office CHFS also participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in U.S. CHFS will only use E-Verify once you have accepted a job offer and completed the Form I-9. For more information on E-Verify, or if you believe that CHFS has violated its E-Verify responsibilities, please contact Department of Homeland Security (DHS) at 888-897-7781 or https://www.e-verify.gov/ . Minimum Requirements EDUCATION: Graduate of a college or university with a bachelor's degree in nursing. EXPERIENCE, TRAINING, OR SKILLS: Must have five years of experience as a Registered Nurse two years of which must be as a supervisor of nursing in long term care, acute care, or public/community health setting. Substitute EDUCATION for EXPERIENCE: A master's degree in nursing will substitute for one year of the non-supervisory experience. Substitute EXPERIENCE for EDUCATION: Experience as a Registered Nurse will substitute for the required education on a year-for-year basis. SPECIAL REQUIREMENTS (AGE, LICENSURE, REGULATION, ETC.): Must be licensed in Kentucky as a Registered Nurse or possess a valid work permit issued by the Kentucky Board of Nursing. https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=52116 http://www.kbn.ky.gov Must maintain any required licensure(s), certification(s), or other credentials for the length of employment in this job classification. Employing agency is responsible for ensuring employee possesses and maintains required licensure(s), certification(s) or other credentials. Working Conditions Works with patients, residents, or employees who may have been exposed to infectious diseases which requires compliance with safety procedures. Probationary Period This job has an initial and promotional probationary period of 6 months, except as provided in KRS 18A.111. If you have questions about this advertisement, please contact Michelle Marra at michelle.marra@ky.gov or 502-564-1357. An Equal Opportunity Employer M/F/D
RN Telehealth Other
MaineHealth

Registered Nurse (RN) - Access Center

MaineHealth Westbrook, ME
$34.35 - $46.46 / hour
Description Medical Group Practices Nursing Req #: 91759 The ideal candidate for this position resides in Maine or New Hampshire. For a limited time MaineHealth is offering a $10,000 Sign on bonus for all eligible Registered Nurses with up to 2 years of RN experience and $20,000 for Registered Nurses with greater than 2 years of RN work experience! Eligible candidates are hired (offer accepted) into a Full or Part time RN position. Bonus amount prorated for Part time hires, per diem hires are ineligible. Current MaineHealth member employees are ineligible; former MaineHealth Members are ineligible until greater than 6 months’ separation from employment. Desired Registered Nurse will have phone triage experience and in a high-volume call setting. Knowledge of my chart (preferred but not required) and live in the state of Maine or New Hampshire. This is a clinical call setting open Monday - Friday, 8am-5pm. Option to be HYBRID (work from home) after in-person training. On call, Weekends and major holidays are not required to work. Summary The MH Registered Nurse - Ambulatory Care role provides high quality care to patients and families calling or presenting for care through assessment, planning, implementation, and evaluation, and performs a wide variety of patient care services to assist physicians/advanced practice practitioners in delivering excellent care to patients of the practice. MH RN II: This level is competent in their clinical role and has demonstrated the ability to care for most patients assigned. Though not able to care for every patient type within their area of hire, demonstrates how to obtain the appropriate resources to develop required skills and knowledge over time. This level included automatic advancement after 1 year as a RN I – must be in good standing and meets RN I requirements. Required Minimum Knowledge, Skills, And Abilities (KSAs) Education: Graduate of an accredited School of Nursing required; BSN preferred. License/Certifications: Current applicable state(s) license as a Registered Professional Nurse required. Current BLS certification required or must obtain within 30 days of start date. Experience: One year of recent RN experience required. Automatic advancement from RN I level if all onboarding requirements are complete, including the New Grad Residency (where available). Additional Information MaineHealth is committed to fostering a supportive, inclusive environment where care team members can thrive while making a meaningful impact in the communities we serve across Maine and New Hampshire. We offer competitive benefits including paid parental leave, flexible work options, student loan assistance, professional development opportunities, and well-being resources—so you can grow your career while feeling supported both personally and professionally. We recognize the value each team member brings to our organization. Any offer of employment will depend on qualifications such as skills, relevant experience, education, certifications, and other job-related factors. The base range is an estimate and does not reflect the full value of our total compensation package. The pay range for this position is $34.35 to $46.46 per hour. Compensation for part-time positions is determined on a prorated basis consistent with the scheduled hours and applicable full-time equivalent (FTE). In addition to base pay, MaineHealth offers comprehensive benefits, recognition programs, career growth opportunities, and, where applicable, shift differentials or other incentives. If you have questions about this role, please contact samantha.gonzales@mainehealth.org Hiring Scam Alert MaineHealth will never request financial information during the interview or pre-hiring process. All legitimate communications will come from an email address ending in @mainehealth.org. If you suspect fraudulent activity, please report it immediately to mhcareers@mainehealth.org. Notice Regarding Maine Employer Surveillance Statute: Pursuant to Maine's Employer Surveillance Statute, prospective care team members are notified that MaineHealth may monitor, collect, record, review, or retain information related to the use of its systems, networks, applications, files, data, communications platforms (including notified recordings), smart badges, building access, company vehicle GPS data, business calls, and workplace security cameras. Information collected may be used for legitimate business purposes, including security, safety, compliance, investigations, training, quality assurance, and operational management.
RN Manager/Supervisor Telehealth Full-time
VNS Health

Clinical Evaluation Manager, Registered Nurse

VNS Health New York, NY
$85,000 - $106,300 / year
Overview Assesses member needs and identifies solutions that promote high quality and cost-effective health care services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical determinations in accordance with healthcare policies as well as applicable state and federal regulations. Delivers timely notification detailing clinical decisions. Coordinates with management, subject matter experts, physicians, member representatives, and discharge planners in utilization tracking, care coordination, and monitoring to ensure care is appropriate, timely and cost effective. Works under general supervision. What We Provide Referral bonus opportunities Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life Disability Employer-matched retirement saving funds Personal and financial wellness programs Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care Generous tuition reimbursement for qualifying degrees Opportunities for professional growth and career advancement Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities What You Will Do Conducts comprehensive review of all components related to requests for services which includes a clinical record review and interviews with members, clinical staff, medical providers, paraprofessional staff, caregivers and other relevant sources as necessary. Examines standards and criteria to ensure medical necessity and appropriateness of admissions, treatment, level of care and lengths of stay. Performs prior authorization and concurrent reviews to ensure extended treatment is medically necessary and being conducted in the right setting. Reviews requests for outpatient and inpatient admission; approves services or consults with medical directors when case does not meet medical necessity criteria. Ensures compliance with state and federal regulatory standards and VNS Health policies and procedures. Participates in case conferences with management. Identifies opportunities for alternative care options and contributes to the development of patient focused plan of care to facilitate a safe discharge and transition back into the community after hospitalization. Reviews covered and coordinated services in accordance with established plan benefits, application of evidenced based medical criteria, and regulatory requirements to ensure appropriate authorization of services and execution of the plan’s fiduciary responsibilities. Identifies and provides recommendations for improvement regarding department processes and procedures. Maintains current knowledge of organizational or state-wide trends that affect member eligibility and the need for issuance of Determination Notices Improves clinical and cost-effective outcomes such as reduction of hospital admissions and emergency department visits through on-going member education, care management and collaboration with IDT members. Provides input and recommendations for design and development of, processes and procedures for effective member case management, efficient department operations, and excellent customer service. Maintains accurate record of all care management. Maintains written progress notes and verbal communications according to program guidelines. Participates in approval for out-of-network services when member receives services outside of VNS Health network services. Provides case direction and assistance ensuring quality and appropriate service delivery. Keeps current with all health plan changes and updates through on-going training, coaching and educational materials. Assesses, plans, facilitates and advocates for options and services to effectively manage an individual’s health needs. Promotes quality and cost-effective outcomes at all times. Provides telephonic case management to members, balancing clinical, social, and environmental concerns. Provides analysis of initial health evaluation and comprehensive assessment of the member/family psychosocial status and case management needs. Participates in the development, coordination and implementation of the care plan to address specific needs of the member/family including thorough transitions between settings of care. Coordinates with community providers to ensure efficient and effective transitions and delivery of care in the home and community. Consults with the member, family, and members of the inter-disciplinary team to coordinate the treatment plan, education, self-care techniques and prevention strategies. Verifies that all aspects of the clinical record are in agreement with the member’s clinical and functional status. Utilizes VNS Health and state approved assessment and documentation as well as interviews with members, family, and care providers in decision-making. Performs annual clinical co-visits for nurses as well as two initial co-visits during the first six months for new hires as follows: one within first three weeks and a second within the first six months. Provides feedback to therapist and management; assists in development of plans to address improvement needs as appropriate. Participates in special projects and performs other duties as assigned. Qualifications Licenses and Certifications: Current license to practice as a Registered Professional Nurse in New York State required Certified Case Manager preferred Education: Associate's Degree in Nursing required Bachelor's Degree or Master’s degree in nursing preferred Work Experience: Minimum two years of experience with strong cost containment /case management background or two years acute inpatient hospital experience in chronic or complex care required Must have experience and qualifications demonstrating knowledge of working with the LTSS eligible population. preferred Knowledge of Medicare and Medicaid regulations required Excellent organizational and time management skills, interpersonal skills, verbal and written communication skills. Working knowledge of Microsoft Excel, Power-Point, and Word and strong typing skills required Knowledge of Medicaid and/or Medicare regulations required Knowledge of Milliman criteria (MCG) preferred Pay Range USD $85,000.00 - USD $106,300.00 /Yr. About Us VNS Health has been committed to meeting the needs of New Yorkers for over 130 years. We’re one of the largest nonprofit home- and community-based health care organizations in the country, and today, more than 11,500 team members work together to make a difference in the lives of more than 99,000 patients and members on any given day.
RN Telehealth Full-time
UTHealth East Texas

Charge RN / Virtual Care

UTHealth East Texas Tyler, TX
Overview Join our team as a night shift, full-time, Virtual Care Charge Nurse in Tyler, TX. This position works onsite in Tyler, Texas Why Join Us? Thrive in a People-First Environment and Make Healthcare Better Thrive: We empower our team with career growth opportunities, tuition assistance , and resources that support your wellness, education, and financial well-being. People-First: We prioritize your well-being with paid time off, comprehensive health benefits, and a supportive, inclusive culture where you are valued and cared for. Make Healthcare Better: We use advanced technology to support our team and enhance patient care. Get to Know Your Team: Ardent Health is a leading provider of healthcare in growing mid-sized urban communities across the U.S. With a focus on people and investments in innovative services and technologies, Ardent is passionate about making healthcare better and easier to access. Through its subsidiaries, Ardent delivers care through a system of 30 acute care hospitals, 24,000+ team members and more than 280 sites of care with over 1,800 affiliated providers across six states. Learn About A Day in the Life of a Virtual Nurse: Responsibilities The Virtual Care Charge Nurse provides real-time coordination and administration for the Virtual Care Program. This role serves as the primary escalation point for virtual nurses, virtual PSAs (Patient Safety Attendants), and Surveillance Monitoring Staff. Using multiple virtual care and monitoring platforms, the Virtual Care Charge Nurse oversees staffing, workflow prioritization, and patient safety escalations to support safe, efficient, and compliant virtual care delivery across assigned departments. Maximizes the effectiveness of virtual nurses, virtual PSAs, and surveillance monitoring staff during the assigned shift. Serve as a resource for patient safety concerns, workflow issues, and technology-related barriers from virtual and bedside teams. Manage staffing and patient assignments for virtual admissions, discharges, rounding, observation, and remote monitoring activities. Adjust virtual care coverage in response to census changes, call-ins, admissions, discharges, and surge capacity needs. Prioritize patients and virtual care tasks based on acuity, safety risk, and active alerts. Ensure escalations and interventions follow established facility algorithms, policies, and documentation standards. Maintain clear and timely communication with bedside charge nurses, unit leadership, providers, and clinical managers. Participate in shift hand-offs by communicating staffing status, high-risk patients, unresolved escalations, and operational concerns. Collaborate with IT, vendors, and clinical leadership to escalate and troubleshoot virtual care and remote monitoring system issues. Support adherence to regulatory, organizational, and departmental policies related to virtual care. Serve as a clinical and operational resource for virtual staff, providing guidance on workflows and best practices. Participate in quality improvement initiatives and operational projects related to the Virtual Nursing Program. Assists the Management Team in maintaining staff competencies and other tasks that may be assigned to them. Qualifications Job Requirements: Registered Nurse from an accredited school of professional nursing Current Multistate Compact RN License BLS certification must be obtained within 14 days of hire or transfer into the role and prior to providing direct patient care Comply with regulatory requirements, guidelines, and organizational policies Strong clinical judgment and ability to manage multiple workflows in a fast-paced virtual environment Effective verbal and written communication skills, including remote communication technologies Preferred Job Requirements: Minimum of 3-5 years of inpatient or acute care nursing experience Prior charge nurse, virtual nursing, or telehealth experience Experience supporting remote patient monitoring or virtual observation programs Proficiency in EMR systems and multiple virtual care and monitoring platforms
RN Pediatric Telehealth Full-time
TriHealth

Practice Telephonic Triage Registered Nurse - Peds

TriHealth Mason, OH
Job Description Join Our Team as a Practice Telephonic Triage Registered Nurse! At TriHealth, we are driven by a shared commitment to excellence and innovation in healthcare. We believe that every test, analysis, and result plays a vital role in our mission to provide the highest standard of care to our patients. Join us in our mission to advance healthcare and improve lives. Apply today and be part of a team that is passionate about making a difference. We offer career growth opportunities , and a comprehensive benefits package. Location: TriHealth Peds – at 6010 S Mason Montgomery Rd In person position Work Schedule Full - Time (80 hours bi-weekly) Day shift Weekend rotation Incentives & Benefits We offer a comprehensive benefits package, including medical, dental, vision, paid time off, retirement plans, and tuition reimbursement. https://careers.trihealth.com/what-we-offer/benefits Job Requirements Associate's Degree in Nursing (Required) 2 - 3 years Clinical Nursing (Required) Acute Care Strong Computer Skills Ability to type and talk at the same time Knowledge, judgment, and skills derived from the principles of Biological, Physical, Behavioral, Social, and Nursing sciences. Registered Nurse RN - Registered Nurse - State Licensure and/or Compact State Licensure Upon Hire Required Basic Life Support (BLS) Upon Hire Required Job Overview The Telephonic Triage RN is responsible for providing nursing care services to assigned practice(s)/specialty(s). Completes bio-psychosocial telephonic assessment using approved clinical protocols to triage patient needs and provide best course of action or patient disposition. This role serves as a patient/caregiver advocate and acts as a communication link between the patient/caregiver, physician, pharmacy, and or hospital using approved system platforms for communication. This role has a strong working knowledge of patient needs that are emergent and require immediate attention, urgent, and non-urgent. This role utilizes best practices in documentation to ensure communication is efficient, concise, and timely. The goal is to provide first call resolution. This role understand the needs of the organization and supports the mission, values, and management of TriHealth Physician Practices. Job Responsibilities Coaching/Development: Promotes a positive work environment by working collaboratively with team members, recognizing colleagues for excellence, and participating in peer to peer coaching Interdisciplinary Collaboration: Manages In-Basket messages received in a timely manner. Responds to and addresses patient concerns, first call resolution, when in scope. When applicable, ensures all messages sent to providers have complete and accurate information. Implements changes in nursing practice/patient care that have resulted from quality of care activities. Operations Management: Operating in "Ready" mode during work hours with minimum utilization of "AUX/Not Ready". Goal is
RN Telehealth Part-time
UTHealth East Texas

Charge RN / Virtual Care

UTHealth East Texas Tyler, TX
Overview Join our team as a night shift, part-time, Virtual Care Charge Nurse in Tyler, TX. This position works onsite in Tyler, Texas Why Join Us? Thrive in a People-First Environment and Make Healthcare Better Thrive: We empower our team with career growth opportunities, tuition assistance , and resources that support your wellness, education, and financial well-being. People-First: We prioritize your well-being with paid time off, comprehensive health benefits, and a supportive, inclusive culture where you are valued and cared for. Make Healthcare Better: We use advanced technology to support our team and enhance patient care. Get to Know Your Team: Ardent Health is a leading provider of healthcare in growing mid-sized urban communities across the U.S. With a focus on people and investments in innovative services and technologies, Ardent is passionate about making healthcare better and easier to access. Through its subsidiaries, Ardent delivers care through a system of 30 acute care hospitals, 24,000+ team members and more than 280 sites of care with over 1,800 affiliated providers across six states. Learn About A Day in the Life of a Virtual Nurse: Responsibilities The Virtual Care Charge Nurse provides real-time coordination and administration for the Virtual Care Program. This role serves as the primary escalation point for virtual nurses, virtual PSAs (Patient Safety Attendants), and Surveillance Monitoring Staff. Using multiple virtual care and monitoring platforms, the Virtual Care Charge Nurse oversees staffing, workflow prioritization, and patient safety escalations to support safe, efficient, and compliant virtual care delivery across assigned departments. Maximizes the effectiveness of virtual nurses, virtual PSAs, and surveillance monitoring staff during the assigned shift. Serve as a resource for patient safety concerns, workflow issues, and technology-related barriers from virtual and bedside teams. Manage staffing and patient assignments for virtual admissions, discharges, rounding, observation, and remote monitoring activities. Adjust virtual care coverage in response to census changes, call-ins, admissions, discharges, and surge capacity needs. Prioritize patients and virtual care tasks based on acuity, safety risk, and active alerts. Ensure escalations and interventions follow established facility algorithms, policies, and documentation standards. Maintain clear and timely communication with bedside charge nurses, unit leadership, providers, and clinical managers. Participate in shift hand-offs by communicating staffing status, high-risk patients, unresolved escalations, and operational concerns. Collaborate with IT, vendors, and clinical leadership to escalate and troubleshoot virtual care and remote monitoring system issues. Support adherence to regulatory, organizational, and departmental policies related to virtual care. Serve as a clinical and operational resource for virtual staff, providing guidance on workflows and best practices. Participate in quality improvement initiatives and operational projects related to the Virtual Nursing Program. Assists the Management Team in maintaining staff competencies and other tasks that may be assigned to them. Qualifications Job Requirements: Registered Nurse from an accredited school of professional nursing Current Multistate Compact RN License BLS certification must be obtained within 14 days of hire or transfer into the role and prior to providing direct patient care Comply with regulatory requirements, guidelines, and organizational policies Strong clinical judgment and ability to manage multiple workflows in a fast-paced virtual environment Effective verbal and written communication skills, including remote communication technologies Preferred Job Requirements: Minimum of 3-5 years of inpatient or acute care nursing experience Prior charge nurse, virtual nursing, or telehealth experience Experience supporting remote patient monitoring or virtual observation programs Proficiency in EMR systems and multiple virtual care and monitoring platforms
RN Telehealth Part-time
BJC HealthCare

Clinical Nurse - After Hours Answer Line

BJC HealthCare St. Louis, MO
Additional Information About the Role Answer Line Overview The Answer Line After Hours Service provides after-hours exchange and nurse triage services for over 300 subscribing community pediatricians in the St. Louis and surrounding areas. Answer Line RNs utilize triage guidelines, critical thinking skills, and physician preferences to determine the most appropriate plan of care for each patient. These services are provided Monday-Friday from 4:30pm – 8:00am and 24/7 on weekends. Location Almost all staff work remote, though we do have office space at BJC @ The Commons, 5th floor (4249 Clayton Ave, St. Louis, MO 63110). Staff are expected to work their shift in the call center if experiencing connectivity issues at home. Minimum 2-5 years of nursing experience in a variety of the following areas: Emergency Department, NICU, PICU, telephone triage, pediatric primary care office, or pediatric General Medicine Every other weekend (Saturday and Sunday) Part-time; 8hr shifts Days or evenings, depending on staffing needs: Days: 7am-3pm, 8am-4pm, 10am-6pm (this shift is only on Saturdays) Evenings: 12pm-8pm, 1pm-9pm, 2pm-10pm, 3pm-11pm, 4pm-12am, 4:30pm - 12:30am Holiday rotation BJC Nursing Career Ladder The BJC Registered Nurse Career Ladder differentiates BJC as the place for nurses to work in the greater St. Louis area. This is a tool to empower nurses to work at the top of their license and own their career progression. The BJC Registered Nurse Career Ladder promotes professional development, leadership, collaboration, education and service excellence and gives staff the opportunity to continue doing what they do best - caring for patients - while having the opportunity to advance to the next step in their career. Moves to higher ladder levels will result in a percentage increase of current pay that aligns with the new job description. Additional Preferred Requirements Prior pediatric experience Computer/typing skills Overview St. Louis Children’s Hospital is dedicated to improving the health and lives of children. As one of the top-ranked children’s hospitals in the country, St. Louis Children’s provides care in more than 50 specialty areas through a dedicated team of physicians, nurses, staff and volunteers. Along with inpatient and outpatient medical care, the hospital offers education, wellness and injury-prevention programs to fulfill its mission to “do what’s right for kids.” Providing comprehensive, high-quality care and serving as an advocate for children has been St. Louis Children’s commitment since its inception in 1879. Today, the hospital serves patients and families across a 300-mile service area, and has seen patients from all 50 states and more than 80 countries. St. Louis Children’s consistently ranks among America’s Best Children’s Hospitals by U.S.News & World Report in all surveyed categories. In 2021, St. Louis Children’s was one of eight children’s hospitals to rank in the top 25 of all 10 specialties. The hospital’s academic and physician partner, Washington University School of Medicine, is one of the top-ranked medical schools in the United States. Since 2005, St. Louis Children’s has been designated as a Magnet® hospital for nursing excellence from the American Nurses Credentialing Center® (ANCC). Preferred Qualifications Role Purpose Provides direct patient care activities including assessment, diagnosis, planning implementation, and evaluation within the guidelines of the standards of nursing care. Responsibilities Promotes patient and family centered care in a healing environment. Educates patients and their families on how to manage their illness or injury, including post treatment home care needs and medication administration. Participates in activities that promote patient safety, quality and regulatory compliance. Participates in professional development. Develops, implements, and documents individual plans of care with defined goals in collaboration with other members of the interprofessional team and patient, family or caregiver in accordance with the established guidelines and standards of nursing care. Proactively plans and ensures communication of the plan of care across the continuum of care. Uses critical nursing skills to assess and evaluate physical, psychosocial, and emotional needs according to standards of care. Assess patient preferences and barriers to involvement in care, including their values, emotional, spiritual, cultural, and population-specific needs. BJC has determined this is a safety-sensitive position. The ability to work in a constant state of alertness and in a safe manner is an essential function of this job. Minimum Requirements Education Nursing Diploma/Associate's - Nursing Experience No Experience Supervisor Experience No Experience Licenses & Certifications RN Preferred Requirements Education Bachelor's Degree - Nursing Experience
RN Telehealth
Paradigm

Telephonic Nurse Case Manager

Paradigm TN
$85,000 - $92,000 / hour
We are seeking a full-time, benefitted Telephonic Case Manager with compact RN license to work Monday – Friday in Eastern time zone. As a Telephonic Case Manager (TCM), you will provide remote medical case management services to injured individuals, many of whom were industrially injured. This position will assist consumers in their recovery so that they may return to the highest level of function as possible. The TCM ensures that medical services are coordinated and assessed frequently, vocational options are explored with the injured worker and their employers, and pre-injury employment or alternate employment is secured. In the role of TCM, this position works with all parties to the claim including: the injured person, the claim’s examiner, employer, attorneys (plaintiff and defense) and medical providers. At Paradigm, People Come First It's more than a job. It's a passion. Work at Paradigm, and you’ll find deep satisfaction knowing you’re making a profound difference in people’s lives. Meaningful work : better outcomes for all isn’t just our tagline. It’s what guides us to do our best—every day. At Paradigm, you’ll find an authentic connection between the work you do and your passion for making a difference in the world. Exceptional people : You'll work alongside smart people who share a commitment to excellence and a dedication to service. We're not here just for a "job." We're here to transform lives. Collaborative culture: At Paradigm, a spirit of collaboration and care is evident in everything we do. We promote a culture of inclusivity and value diversity of all kinds including thought, knowledge, and experience. No matter the team, everyone works together toward a common goal to deliver exceptional outcomes. Qualifications: Unencumbered compact RN license required National certification required (CCM, CRRN, CDMS, COHN). Case Managers may also need regional or national certifications and must adhere to the standards of practice outlined by the specific national certifying body or the jurisdictionally accepted standards of practice. Professional licenses or certifications required to meet qualifications for this position must be current, unrestricted and allow for practice within a state or territory of the United States (TN BWC, GA Rehab Supplier, NC QRP, MD RN WCCM / MCRSP.)
RN Telehealth Full-time
Moffitt Cancer Center

Sarcoma RN Advisor

Moffitt Cancer Center Tampa, FL
$35.91 - $54.55 / hour
Working at Moffitt is both a career and a mission: to contribute to the prevention and cure of cancer. As the only National Cancer Institute-designated Comprehensive Cancer Center based in Florida, Moffitt employs some of the best and brightest minds from around the world. Join a dedicated team of nearly 11,000 who are shaping the future we envision. Moffitt has been recognized as a Best and Brightest Company to Work For in the Nation and is continually named one of the Tampa Bay Times’ Top Workplaces. Summary The RN Advisor uses the nursing process to effectively plan and manage patient care by providing individualized, quality nursing care to cancer patients and family members over the phone, in accordance with established Cancer Center guidelines, nursing care standards, and Moffitt Clinic policies. Using the concepts of Duffy's Quality Caring Model, ensures calls are answered promptly and accurately while assessing patient's urgent signs and symptoms. Provides nursing interventions and acts as a liaison with the clinical team. Documents assessment and interventions in the EHR. Moffitt Cancer Center’s Sarcoma Oncology Program specializes in the diagnosis and treatment of over 70 different types of Sarcoma. Sarcoma is a very rare tumor, only about 1 % of all cancers. Our Sarcoma Oncology Program Is Based On a Collaboration Of a Number Of Experienced Specialists, Including Medical Oncologists, Radiation Oncologists, Pathologists, Orthopedic Surgeons And General Surgeons. This Diverse Team Provides a Comprehensive Range Of Services. Our Sarcoma Oncology Clinic Cares For 60 Patients a Day, Where Patients Can Access Diagnostic and staging tests, including pathology and imaging services with results interpreted by radiologists who specialize in sarcoma readings Chemotherapy, including oral and intravenous options and innovative drug combinations including numerous clinical trials. Radiation therapy Surgery Supportive care, including nutrition consultations, pain management, physical therapy and social services. Our Sarcoma Oncology Clinic is currently looking for an RN Advisor to join our team. Position Highlights The RN Advisor uses the nursing process to effectively plan and manage patient care by providing individualized, quality nursing care to cancer patients and family members over the phone, in accordance with established Cancer Center guidelines, nursing care standards, and Moffitt Clinic policies. Using the concepts of Duffy's Quality Caring Model, the RN Advisor ensures calls are answered promptly and accurately while assessing patient's urgent signs and symptoms. The RN Advisor provides nursing interventions, acts as a liaison with the clinical team and documents assessment and interventions in the EHR. The Ideal Candidate The ideal candidate will have the following qualifications: At least 2 years of experience in Oncology as a Registered Nurse At least 2 years of experience in Sarcoma as a Registered Nurse OCN or ACON certification Call center experience Responsibilities Answer calls using Moffitt Promise Guidelines (AIDET), the quality caring factors, and the nursing process to assess the patient's issue, plan and properly evaluate the care. Complete, accurate and timely nursing documentation. Exercise clinical judgment and decision making. Recognizes emergencies and takes appropriate action. Identify, document and provide accurate and appropriate patient education. Participate in evidence based improvement activities related to area of practice. Participate in professional development based on the nursing professional standards, regulatory requirements and job expectations. Credentials And Qualifications BSN from an ACEN or CCNE accredited institution with at least one year of relevant experience or ASN from an ACEN or CCNE accredited institution with 1 year of relevant experience FL RN License BLS Certification An applicant for this position, who will be or is seeking Florida licensure by endorsement, must not have any National Practitioner Data Bank (NPDB) reports, unless the applicant has successfully appealed to have their name removed from the NPDB. An applicant is encouraged to conduct a NPDB Self-Query before proceeding with an employment application: https://www.npdb.hrsa.gov/pract/howToGetStarted.jsp Salary Range $35.91 - $54.55 Salary ranges posted for this position represent the expected base pay range for the role. Actual compensation may vary based on location and a variety of job-related factors, including experience, skills, education, and internal equity among Team Members in similar positions. We are committed to maintaining fair and equitable pay practices and regularly review compensation to ensure alignment across our workforce. Moffitt Career Site If you have the vision, passion, and dedication to contribute to our mission, then we have a place for you! Equal Employment Opportunity Moffitt Cancer Center is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, or protected veteran or disabled status. We seek candidates whose skills, and personal and professional experience, have prepared them to contribute to our commitment to diversity and excellence. Reasonable Accommodation Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment. Moffitt endeavors to make moffitt.org/careers accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact one of the Human Resources receptionists by phone at 813-745-7899 or by email at HRReceptionists@moffitt.org. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications. Read more information about your EEO rights under the law. Transparency in Coverage Rule
RN Telehealth Full-time
Geisinger

RN - Registered Nurse Navigator Triage - Population Health

Geisinger Danville, PA
The RN Nurse Navigator Triage provides nursing triage services and health advice for patients over the phone and in person if applicable. Assesses and determines the patients’ acuity level and the need for medical support. Provides results and education related to diagnostic testing to ensure continuity and quality of care. Responsible for accurate, appropriate and timely telephone and electronic messaging. Provides protocol-driven clinical advice. Hours: This is a day/night position. 36 hours per week. Hours will fall between 7am and 7:30pm or 7:00 p.m.- 7:30 a.m. Shifts may be 12, 8, 6, or 4 hours in length. Schedules are made based on patient needs. Weekends and Holidays : Every other weekend rotation and holiday rotation. Travel: Less than 25%- Travel may be required for orientation/training, meetings, or other business needs. Experience: BSN preferred. 5yrs nursing experience preferred. ICU/ED experience preferred. Specialty certification preferred. Proficient computer skills. Proficient with Microsoft products such as Word, Excel, PowerPoint, SharePoint, Windows, & TEAMs. Benefits at Geisinger: We offer a comprehensive benefits package starting on day one, including: Health, dental, and vision insurance Three medical plan choices , including expanded network options Pre-tax savings plans (FSA & HSA) Company-paid life, short-term, and long-term disability insurance 401(k) with automatic Geisinger contributions Generous PTO that accrues quickly Up to $5,000 in tuition reimbursement per calendar year MyHealth Rewards wellness program with financial incentives Family-friendly support : adoption/fertility assistance, parental leave, military leave, and Care.com membership Employee Assistance Program (EAP) : mental health, legal guidance, childcare/eldercare referrals, and more Voluntary benefits : accident, critical illness, hospital indemnity, identity theft protection, pet insurance, and more Job Duties: Performs a patient assessment via phone and documents patient chief complaint, patient reported symptoms, relevant history, and pharmacy and contact information using established protocols. Initiates and coordinates emergency treatment when necessary. Prioritizes incoming high priority telephone calls addressing urgent patient needs while reporting all pertinent information to the triage provider for decision making. Provides education to patients and families. Schedules, or facilitates scheduling of emergency appointments. Coordinates patient care and requests across departments, specialties and sites. Assists with orientation of new personnel to ensure that they are appropriately trained to support patients and providers. Executes and documents ongoing patient and customer communication, prioritizes communication to providers, and promptly responds to patient and customer needs. Reviews and reinforces instructions as directed by provider, to ensure patient's understanding of, and compliance with, treatment plan. Explains medical conditions. Manages patient concerns following documented clinical protocols with the goal of patient satisfaction while utilizing service recovery techniques. Ensures that all patient documentation is completed and routed in a timely manner. Suggests issues of improvement and offers solutions to the issues. Assists in coordination of care and services with external organizations including, but not limited to, insurance companies, home health, and other medical facilities.
RN Telehealth
UnitedHealthcare

Senior Clinical Quality of Care RN - Arizona

UnitedHealthcare Phoenix, AZ
$72,800 - $130,000 / year
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together The Senior Clinical Quality of Care RN will be responsible for conducting quality of care (QOC) investigation, review and management of the regulatory Incident/Accident/Death (IAD) portal, documenting and communicating findings from these reviews, and preparing reports or summaries for internal and external customers. This position collaborates with the Chief Medical Officer or other Medical Directors to review QOC and other investigations and ensures that QOC investigations comply with all applicable State, Federal, and regulatory requirements. These activities are used to ensure care and services provided to our members are timely, adequate, and compliant with regulatory and professional standards and guidelines. These QOC investigations are specific to Arizona Medicaid and Medicare members. This position is an Arizona based remote position with the option of working 40% in-office. There is travel up to 25% of the time based on business needs. In-office may be required based on performance metrics. The office is located at 1 East Washington Street in Phoenix. If you reside in Arizona and be able to travel 25% of the time, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities: Perform clinical documentation review of inpatient and outpatient care delivered to adults and children with Medicaid, Medicare health care benefits through Arizona United Health Care Community Plans for peer review and internal investigations of Quality of Care concerns Create professionally written case investigation summaries for Peer Review, present case summaries at the Provider Advisory Committee as applicable Review plans of correction from providers in response to a substantiated QOC occurrence Effectively interface with external customers, facilities and providers to resolve quality of care concerns, obtain medical records and other information Conduct delegated oversight reviews of contractors that perform work on behalf of UnitedHealthcare. This includes reviewing samples of contractor work against an audit tool or information found in medical charts Collaborate internally with Medical Directors and staff in other UHCCP departments Manage multiple tasks and projects and changing priorities; prioritize work products effectively Maintain timeliness for deliverables and regulator requests Must have the ability to work independently, good critical thinking skills, excellent verbal and written communication skills Occasional on-site provider visits may be required for potential Quality of Care concerns You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: Active, unrestricted RN license in the state of Arizona 5+ years of experience working as a Registered Nurse 2+ years of hospital experience as a Registered Nurse Experience evaluating and auditing medical records Proven intermediate skills in Microsoft Office, Word, and Excel ability to work with multiple data bases to retrieve and enter information Ability to travel up to 25% within the state of Arizona Driver's license and access to reliable transportation Reside within the state of Arizona Preferred Qualifications: Quality Management experience in a healthcare setting Experienced with Behavioral Health Services Experience analyzing information and preparing written summaries Experience working in a deadline driven environment prioritizing responsibilities Knowledge of Medicare/Medicaid regulations Experience with medical record review and identification of quality of care concerns *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. #UHCPJ At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
RN Utilization Review Telehealth
L.A. Care Health Plan

Utilization Management Nurse Specialist RN II

L.A. Care Health Plan CA
$88,854 - $142,166 / year
Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically necessary referrals that meet established criteria. Assures timely and accurate determination and notification of referrals and reconsiderations based on the referral determination status. Generates approval, modification and denial communications, to include member and provider notification of referral determination. Actively monitors for admissions in any inpatient setting. Performs telephonic and/or onsite admission and concurrent review, and collaborates with onsite staff, physicians, providers, member/family interaction to develop and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service and retrospective claims medical review. Monitors and oversees the collection and transfer of data (medical records) and referral requests by Providers. Acts as a department resource for medical service requests /referral management and processes. Receives incoming calls from providers, professionally handles complex calls, researches to identify timely and accurate resolution steps. Follows up with caller to provide response or resolution steps. Answers all inquiries in a professional and courteous manner. Duties Promote and support team engagements, programs and activities to create and ensure a positive and productive workplace environment. Perform telephonic and/or onsite admission and concurrent review, and collaborates with onsite staff, physicians, providers, the member and significant others to develop and implement a successful discharge plan. Process, finalize and facilitate inbound requests that are received from providers. Generate appropriate member and provider communication for all determinations within the required timelines as defined by the most current department policy. Facilitate/review requests for Higher level of care or skilled nursing/discharge planning needs. Research for appropriate facilities, specialty providers and ancillary providers to utilize for all lines of business. Identification of potential areas of improvement within the provider network. Identify and initiate referrals for appropriate members to the various L.A. Care programs/processes and external community based programs or Linked and Carve Out Services (e.g. DDS/CCS/MH). Potential quality of care/potential fraud issues are identified and documented per L.A. Care policy. High risk/high cost cases and reports are maintained and referred to the Physician Advisor/UM Director. Document in platform/system of record. Utilize designated software system to document reviews and/or notes. Receive incoming calls from providers, professionally handle complex calls, research to identify timely and accurate resolution steps. Follow up with caller to provide response or resolution steps. Answer all inquiries in a professional and courteous manner. Perform other duties as assigned. Duties Continued Education Required Associate's Degree in NursingEducation Preferred Bachelor's Degree in NursingExperience Required: At least 5 years of varied RN clinical experience in an acute hospital setting. At least 2 years of Utilization Management/Case Management experience in a hospital or HMO setting . Preferred: Managed Care experience performing UM and CM at a medical group or management services organization. Experience with Managed Medi-Cal, Medicare, and commercial lines of business. Skills Required: Must be computer literate, with expertise in Outlook, Word, Excel, PowerPoint. Effectively utilizes computer and appropriate software and interacts as needed with L.A. Care Information System. Knowledge of personal computer, keyboarding, and appropriate software to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment. Prepare clear, comprehensive written and oral reports and materials. Provision of excellent customer service required due to frequent communication with providers and other members of the interdisciplinary team Excellent time management and priority-setting skills. Maintains strict member confidentiality and complies with all HIPAA requirements. Strong verbal and written communication skills. Preferred: Knowledge of National Committee for Quality Assurance (NCQA) requirements for Utilization Management or Care Management (CM). Knowledge of Department of Health Care Services (DHCS) or Centers for Medicare and Medicaid Services(CMS) requirements for health plan compliance with UM or CM. Licenses/Certifications Required Registered Nurse (RN) - Active, current and unrestricted California LicenseLicenses/Certifications Preferred Certified Case Manager (CCM)Required Training Physical Requirements LightAdditional Information May work on occasional weekends and some holidays depending on business needs. Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. L.A. Care offers a wide range of benefits including Paid Time Off (PTO) Tuition Reimbursement Retirement Plans Medical, Dental and Vision Wellness Program Volunteer Time Off (VTO)