RN Telehealth Telehealth Full-time
MUSC

Virtual Care Access Concierge( RN )-Telehealth-2

MUSC Charleston, SC
Job Description Summary The Virtual Care Access Concierge – Registered Nurse (RN) reports to the Telehealth Nurse Manager of Telehealth Centralized Support/Virtual Specialty. Under general supervision and in collaboration with the interdisciplinary team, this concierge role ensures patients requiring escalation from a virtual visit receive a seamless transition to the appropriate next level of care without being lost during the handoff. This role removes friction from care transitions, reduces patient effort, and improves timely access while maintaining continuity of clinical information. Entity Medical University Hospital Authority (MUHA) Worker Type Employee Worker Sub-Type​ Regular Cost Center CC004953 SYS - Virtual First Teleconsultation Pay Rate Type Hourly Pay Grade Health-28 Scheduled Weekly Hours 40 Work Shift Job Description Job Responsibility: Utilize the nursing process to serve as a patient liaison to assist patients and caregivers in scheduling within the complex healthcare system. Success Criteria: • Function as a patient/family advocate demonstrating a care, compassionate approach. • Implement discharge plans and coordinate patient and clinical reminders, scheduling follow-up visits, and ensure warm hand-off of patient and clinical context to the next level of care. • Liaison with ambulatory clinics, Free Standing EDs (FSEDs), and other virtual services to improve the hand-off and scheduling processes for post-virtual care follow-up needs • Coordinate and manage care transitions by applying analytical reasoning, reflection, rational problem-solving skills, using evidence-based information and clinical judgment • Perform individualized education with patients and families, as needed, to reinforce understanding of their After Visit Summary (AVS) to achieve goals of care. • Identify potential and actual patient problems and utilize resources to address problems. • Utilize appropriate community resources to improve patient outcomes and family adaptation to patient care needs. • Accurately document all orders, care plans and interaction with the patient, family or interdisciplinary team members in the EMR to maintain current patient records.The Virtual Care Access Concierge – Registered Nurse (RN) reports to the Telehealth Nurse Manager of Telehealth Centralized Support/Virtual Specialty. Under general supervision and in collaboration with the interdisciplinary team, this concierge role ensures patients requiring escalation from a virtual visit receive a seamless transition to the appropriate next level of care without being lost during the handoff. This role removes friction from care transitions, reduces patient effort, and improves timely access while maintaining continuity of clinical information. Additional Job Description Minimum Requirements: Bachelor of Nursing degree preferred. RN staff hired on or after July 1, 2013 with an Associate or Diploma degree in nursing are required to be enrolled in an accredited BSN program within two years and successfully obtain a BSN degree within four years of the RN hire or reclassification date. Refer to policy A141 for more details. A minimum of one year of work experience as a registered nurse required. Licensure as a registered nurse by the South Carolina Board of Nursing or a compact state. Current American Heart Association (AHA) Basic Life Support (BLS) certification or American Red Cross BLS for Healthcare Providers certification is required. Physical Requirements: 1. Ability to stand or sit for extended periods of time. 2. Proficiency in manual dexterity and fine motor skills for tasks such as taking patient vitals, administering injections, or conducting physical exams. 3. Capacity to lift and move patients or medical equipment as needed. 4. Visual acuity and color perception to accurately read medical charts, documents, and monitors. 5. Auditory ability to effectively communicate with patients and colleagues, as well as to perceive important sounds such as alarms or patient instructions. 6. Stamina and resilience to handle the physical and emotional demands of providing patient care, including long shifts and potentially stressful situations. 7. Mobility to navigate clinical environments, including moving between patient rooms, offices, and other areas of the facility. 8. Compliance with infection control protocols and proper use of personal protective equipment to maintain a safe and healthy work environment. Physical Requirements Mobility & Posture Standing: Continuous Sitting: Continuous Walking: Continuous Climbing stairs: Infrequent Working indoors: Continuous Working outdoors (temperature extremes): Infrequent Working from elevated areas: Frequent Working in confined/cramped spaces: Frequent Kneeling: Infrequent Bending at the waist: Continuous Twisting at the waist: Frequent Squatting: Frequent Manual Dexterity & Strength Pinching operations: Frequent Gross motor use (fingers/hands): Continuous Firm grasping (fingers/hands): Continuous Fine manipulation (fingers/hands): Continuous Reaching overhead: Frequent Reaching in all directions: Continuous Repetitive motion (hands/wrists/elbows/shoulders): Continuous Full use of both legs: Continuous Balance & coordination (lower extremities): Frequent Lifting & Force Requirements Lift/carry 50 lbs. unassisted: Infrequent Lift/lower 50 lbs. from floor to 36”: Infrequent Lift up to 25 lbs. overhead: Infrequent Exert up to 50 lbs. of force: Frequent Examples: Transfer 100 lb. non-ambulatory patient = 50 lbs. force Push 400 lb. patient in wheelchair on carpet = 20 lbs. force Push patient stretcher one-handed = 25 lbs. force Vision & Sensory Maintain corrected vision 20/40 (one or both eyes): Continuous Recognize objects (near/far): Continuous Color discrimination: Continuous Depth perception: Continuous Peripheral vision: Continuous Hearing acuity (with correction): Continuous Tactile sensory function: Continuous Gross motor with fine motor coordination: Continuous Selected Positions: Olfactory (smell) function: Continuous Respirator use qualification: Continuous Work Environment & Conditions Effective stress management: Continuous Rotating shifts: Frequent Overtime as required: Frequent Latex-safe environment: Continuous If you like working with energetic enthusiastic individuals, you will enjoy your career with us! The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need. Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees
RN Telehealth Telehealth Full-time
MUSC

Virtual Care Access Concierge (RN)-Telehealth

MUSC Charleston, SC
Job Description Summary The Virtual Care Access Concierge – Registered Nurse (RN) reports to the Telehealth Nurse Manager of Telehealth Centralized Support/Virtual Specialty. Under general supervision and in collaboration with the interdisciplinary team, this concierge role ensures patients requiring escalation from a virtual visit receive a seamless transition to the appropriate next level of care without being lost during the handoff. This role removes friction from care transitions, reduces patient effort, and improves timely access while maintaining continuity of clinical information. Entity Medical University Hospital Authority (MUHA) Worker Type Employee Worker Sub-Type​ Regular Cost Center CC004953 SYS - Virtual First Teleconsultation Pay Rate Type Hourly Pay Grade Health-28 Scheduled Weekly Hours 25 Work Shift Job Description The Virtual Care Access Concierge – Registered Nurse (RN) reports to the Telehealth Nurse Manager of Telehealth Centralized Support/Virtual Specialty. Under general supervision and in collaboration with the interdisciplinary team, this concierge role ensures patients requiring escalation from a virtual visit receive a seamless transition to the appropriate next level of care without being lost during the handoff. This role removes friction from care transitions, reduces patient effort, and improves timely access while maintaining continuity of clinical information. Job Responsibility: Utilize the nursing process to serve as a patient liaison to assist patients and caregivers in scheduling within the complex healthcare system. Success Criteria: • Function as a patient/family advocate demonstrating a care, compassionate approach. • Implement discharge plans and coordinate patient and clinical reminders, scheduling follow-up visits, and ensure warm hand-off of patient and clinical context to the next level of care. • Liaison with ambulatory clinics, Free Standing EDs (FSEDs), and other virtual services to improve the hand-off and scheduling processes for post-virtual care follow-up needs • Coordinate and manage care transitions by applying analytical reasoning, reflection, rational problem-solving skills, using evidence-based information and clinical judgment • Perform individualized education with patients and families, as needed, to reinforce understanding of their After Visit Summary (AVS) to achieve goals of care. • Identify potential and actual patient problems and utilize resources to address problems. • Utilize appropriate community resources to improve patient outcomes and family adaptation to patient care needs. • Accurately document all orders, care plans and interaction with the patient, family or interdisciplinary team members in the EMR to maintain current patient records. Comments: Additional Job Description Minimum Requirements: Bachelor of Nursing degree preferred. RN staff hired on or after July 1, 2013 with an Associate or Diploma degree in nursing are required to be enrolled in an accredited BSN program within two years and successfully obtain a BSN degree within four years of the RN hire or reclassification date. Refer to policy A141 for more details. A minimum of one year of work experience as a registered nurse required. Licensure as a registered nurse by the South Carolina Board of Nursing or a compact state. Current American Heart Association (AHA) Basic Life Support (BLS) certification or American Red Cross BLS for Healthcare Providers certification is required. Physical Requirements: 1. Ability to stand or sit for extended periods of time. 2. Proficiency in manual dexterity and fine motor skills for tasks such as taking patient vitals, administering injections, or conducting physical exams. 3. Capacity to lift and move patients or medical equipment as needed. 4. Visual acuity and color perception to accurately read medical charts, documents, and monitors. 5. Auditory ability to effectively communicate with patients and colleagues, as well as to perceive important sounds such as alarms or patient instructions. 6. Stamina and resilience to handle the physical and emotional demands of providing patient care, including long shifts and potentially stressful situations. 7. Mobility to navigate clinical environments, including moving between patient rooms, offices, and other areas of the facility. 8. Compliance with infection control protocols and proper use of personal protective equipment to maintain a safe and healthy work environment. Physical Requirements Mobility & Posture Standing: Continuous Sitting: Continuous Walking: Continuous Climbing stairs: Infrequent Working indoors: Continuous Working outdoors (temperature extremes): Infrequent Working from elevated areas: Frequent Working in confined/cramped spaces: Frequent Kneeling: Infrequent Bending at the waist: Continuous Twisting at the waist: Frequent Squatting: Frequent Manual Dexterity & Strength Pinching operations: Frequent Gross motor use (fingers/hands): Continuous Firm grasping (fingers/hands): Continuous Fine manipulation (fingers/hands): Continuous Reaching overhead: Frequent Reaching in all directions: Continuous Repetitive motion (hands/wrists/elbows/shoulders): Continuous Full use of both legs: Continuous Balance & coordination (lower extremities): Frequent Lifting & Force Requirements Lift/carry 50 lbs. unassisted: Infrequent Lift/lower 50 lbs. from floor to 36”: Infrequent Lift up to 25 lbs. overhead: Infrequent Exert up to 50 lbs. of force: Frequent Examples: Transfer 100 lb. non-ambulatory patient = 50 lbs. force Push 400 lb. patient in wheelchair on carpet = 20 lbs. force Push patient stretcher one-handed = 25 lbs. force Vision & Sensory Maintain corrected vision 20/40 (one or both eyes): Continuous Recognize objects (near/far): Continuous Color discrimination: Continuous Depth perception: Continuous Peripheral vision: Continuous Hearing acuity (with correction): Continuous Tactile sensory function: Continuous Gross motor with fine motor coordination: Continuous Selected Positions: Olfactory (smell) function: Continuous Respirator use qualification: Continuous Work Environment & Conditions Effective stress management: Continuous Rotating shifts: Frequent Overtime as required: Frequent Latex-safe environment: Continuous If you like working with energetic enthusiastic individuals, you will enjoy your career with us! The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need. Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees
RN Telehealth Telehealth Full-time
MUSC

Virtual Care Access Concierge( RN )-Telehealth-1

MUSC Charleston, SC
Job Description Summary The Virtual Care Access Concierge – Registered Nurse (RN) reports to the Telehealth Nurse Manager of Telehealth Centralized Support/Virtual Specialty. Under general supervision and in collaboration with the interdisciplinary team, this concierge role ensures patients requiring escalation from a virtual visit receive a seamless transition to the appropriate next level of care without being lost during the handoff. This role removes friction from care transitions, reduces patient effort, and improves timely access while maintaining continuity of clinical information. Entity Medical University Hospital Authority (MUHA) Worker Type Employee Worker Sub-Type​ Regular Cost Center CC004953 SYS - Virtual First Teleconsultation Pay Rate Type Hourly Pay Grade Health-28 Scheduled Weekly Hours 40 Work Shift Job Description Job Responsibility: Utilize the nursing process to serve as a patient liaison to assist patients and caregivers in scheduling within the complex healthcare system. Success Criteria: • Function as a patient/family advocate demonstrating a care, compassionate approach. • Implement discharge plans and coordinate patient and clinical reminders, scheduling follow-up visits, and ensure warm hand-off of patient and clinical context to the next level of care. • Liaison with ambulatory clinics, Free Standing EDs (FSEDs), and other virtual services to improve the hand-off and scheduling processes for post-virtual care follow-up needs • Coordinate and manage care transitions by applying analytical reasoning, reflection, rational problem-solving skills, using evidence-based information and clinical judgment • Perform individualized education with patients and families, as needed, to reinforce understanding of their After Visit Summary (AVS) to achieve goals of care. • Identify potential and actual patient problems and utilize resources to address problems. • Utilize appropriate community resources to improve patient outcomes and family adaptation to patient care needs. • Accurately document all orders, care plans and interaction with the patient, family or interdisciplinary team members in the EMR to maintain current patient records.The Virtual Care Access Concierge – Registered Nurse (RN) reports to the Telehealth Nurse Manager of Telehealth Centralized Support/Virtual Specialty. Under general supervision and in collaboration with the interdisciplinary team, this concierge role ensures patients requiring escalation from a virtual visit receive a seamless transition to the appropriate next level of care without being lost during the handoff. This role removes friction from care transitions, reduces patient effort, and improves timely access while maintaining continuity of clinical information. Additional Job Description Minimum Requirements: Bachelor of Nursing degree preferred. RN staff hired on or after July 1, 2013 with an Associate or Diploma degree in nursing are required to be enrolled in an accredited BSN program within two years and successfully obtain a BSN degree within four years of the RN hire or reclassification date. Refer to policy A141 for more details. A minimum of one year of work experience as a registered nurse required. Licensure as a registered nurse by the South Carolina Board of Nursing or a compact state. Current American Heart Association (AHA) Basic Life Support (BLS) certification or American Red Cross BLS for Healthcare Providers certification is required. Physical Requirements: 1. Ability to stand or sit for extended periods of time. 2. Proficiency in manual dexterity and fine motor skills for tasks such as taking patient vitals, administering injections, or conducting physical exams. 3. Capacity to lift and move patients or medical equipment as needed. 4. Visual acuity and color perception to accurately read medical charts, documents, and monitors. 5. Auditory ability to effectively communicate with patients and colleagues, as well as to perceive important sounds such as alarms or patient instructions. 6. Stamina and resilience to handle the physical and emotional demands of providing patient care, including long shifts and potentially stressful situations. 7. Mobility to navigate clinical environments, including moving between patient rooms, offices, and other areas of the facility. 8. Compliance with infection control protocols and proper use of personal protective equipment to maintain a safe and healthy work environment. Physical Requirements Mobility & Posture Standing: Continuous Sitting: Continuous Walking: Continuous Climbing stairs: Infrequent Working indoors: Continuous Working outdoors (temperature extremes): Infrequent Working from elevated areas: Frequent Working in confined/cramped spaces: Frequent Kneeling: Infrequent Bending at the waist: Continuous Twisting at the waist: Frequent Squatting: Frequent Manual Dexterity & Strength Pinching operations: Frequent Gross motor use (fingers/hands): Continuous Firm grasping (fingers/hands): Continuous Fine manipulation (fingers/hands): Continuous Reaching overhead: Frequent Reaching in all directions: Continuous Repetitive motion (hands/wrists/elbows/shoulders): Continuous Full use of both legs: Continuous Balance & coordination (lower extremities): Frequent Lifting & Force Requirements Lift/carry 50 lbs. unassisted: Infrequent Lift/lower 50 lbs. from floor to 36”: Infrequent Lift up to 25 lbs. overhead: Infrequent Exert up to 50 lbs. of force: Frequent Examples: Transfer 100 lb. non-ambulatory patient = 50 lbs. force Push 400 lb. patient in wheelchair on carpet = 20 lbs. force Push patient stretcher one-handed = 25 lbs. force Vision & Sensory Maintain corrected vision 20/40 (one or both eyes): Continuous Recognize objects (near/far): Continuous Color discrimination: Continuous Depth perception: Continuous Peripheral vision: Continuous Hearing acuity (with correction): Continuous Tactile sensory function: Continuous Gross motor with fine motor coordination: Continuous Selected Positions: Olfactory (smell) function: Continuous Respirator use qualification: Continuous Work Environment & Conditions Effective stress management: Continuous Rotating shifts: Frequent Overtime as required: Frequent Latex-safe environment: Continuous If you like working with energetic enthusiastic individuals, you will enjoy your career with us! The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need. Medical University of South Carolina participates in the federal E-Verify program to confirm the identity and employment authorization of all newly hired employees. For further information about the E-Verify program, please click here: http://www.uscis.gov/e-verify/employees
RN Telehealth Full-time
University of Miami Health System

Nurse Navigator 1 - Site Disease Group - Full Time/Remote

University of Miami Health System
Current Employees: If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position, please review this tip sheet . Location: Remote CORE JOB FUNCTIONS Triages new patient appointments to the appropriate provider(s) and assures timely scheduling of initial appointments. Reviews outside medical records for appropriate scheduling. Assess barriers to care and refers to support services, local, and national organizations when needed. Educates on the treatment plan for patients based on diagnosis. Supports patients throughout the care continuum. Counsels individuals and patients on positive health practices. Collaborates with a multidisciplinary team of experts to outline best treatment for patients. Performs holistic evaluation of specialty population, making use of enhanced proven techniques and procedures to achieve better results. Implements the improvement of patient care, and healthcare policies and resources. Mentors other healthcare professionals by functioning as a preceptor or coordinating preceptors for visiting professionals, students, new graduates, and orienteers. Maintains professional knowledge by affiliating with professional and technical organizations, and participating in applicable continuing education programs, conferences, seminars, and workshops. Adheres to University and unit-level policies and procedures and safeguards University assets. This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary. CORE QUALIFICATIONS Education: Bachelor’s Degree Certification and Licensing: Registered Nurse Licensing (RN) Experience: Minimum 2-3 years of relevant work experience Knowledge, Skills and Attitudes: Ability to maintain effective interpersonal relationships Ability to communicate effectively in both oral and written form Skill in collecting, organizing and analyzing data Proficiency in computer software (i.e. Microsoft Office) and Electronic Medical Record system(s) Department Specific Functions Assess patient needs upon initial encounter and periodically throughout navigation, matching unmet needs with appropriate referrals and support services. Identifies potential and realized barriers to care and facilitates referrals as appropriate to mitigate barriers. Reviews, patients’ medical records, test results and any other documentation required for the first visit. Facilitates timely scheduling of appointments, diagnostic testing, and procedures to expedite the plan of care and to promote continuity of care. Participates in coordination of the plan of care with the multidisciplinary team, promoting timely follow-up on treatment and supportive care recommendations. Serves as a liaison for patients, families, caregivers, staff, and referring physicians Greet patients on the day of clinic and provide them with personalized schedule, education, and appropriate resources. Orients and educates patients, families, and caregivers to the cancer healthcare system, multidisciplinary team member roles and available resources. Help to explain treatment recommendations to patients and caregivers and appropriately answer questions. Work with referring physicians to understand their preferences for communication about patients’ test results, treatment progress and manage those communications Communicates with physicians as needed by phone, emails or in person for new patient referrals and scheduling priorities. Help eligible patient’s access appropriate clinical trials Track individual patients’ progress along care continuum; identify potential bottlenecks and perform appropriate interventions Work with oncology administrators to understand any changes in reporting metrics. Identify bottlenecks in the patient pathway and gaps in care; propose process improvement measures to address them Communicates with other staff to coordinate patient care activities. Participate with other members of the healthcare team to provide patients with supportive care services. Refers patients to local and national community support groups/services Coordination of Educational Activities : Identify and document individual patient’s barriers to learning Educate patients and families about disease process, treatment options, potential side effects Assist patients with treatment decision making; develop and use decision aids as appropriate Provide pre and post-operative education to all groups Educate patients about survivorship, set expectations for the post-treatment transition, remain available to patients and families for questions during the continuum of treatment and at survivorship. Assist with identification of survivors and delivery of the survivorship care plan. Advocate for patient and support with end-of-life/palliative care decisions Educate patients and families about diet, exercise, smoking cessation and other wellness and cancer prevention strategies Psychosocial Support Administer psychosocial screening at patients’ at time of intake; repeat screening at regular intervals or as needed Make referrals to social worker, financial counselor, or support services as needed; facilitate scheduling and monitor patients to ensure follow-though Check in with patients via phone on day prior to surgery and/or treatment start; ensure patients know exactly what to expect before, during and after procedure Facilitates shared decision making with the patients, caregivers, families, and care team. Supports a smooth transition of patients from active treatment into survivorship, chronic cancer management, and end-of life care. Promotes advances care planning by assisting patients in formulating a discussion with their care team. Multidisciplinary Clinical Support Help determine which patients are eligible for clinical trial participation. Facilitate new patient referrals into the clinical trials program. Attend Tumor Board Conference and be available for coordination of care recommended post conference. Maintain communication with the tumor registry when needed. Actively solicit and record feedback from referring physicians and their staff; develop recommendations for improving clinical operations to better meet their needs Meet with physicians who have the potential to become referral sources for the cancer program to provide information about the cancer center and its related programs. Track new patients throughout the care continuum through the EPIC and ensure key follow-up time points are met. Ensures documentation of patient encounter and provided services. Collaborate with marketing and communications departments in events as needed. Assist in developing patient education materials. Develop collaborative relationships with local individuals, agencies and organizations that provide cancer education and support for cancer patients Collaborate with community outreach programs designed to increase public awareness of cancer, cancer prevention and the importance or regular screening Leadership Responsibilities : Must be able to perform job duties as an independent professional and as a team player; organizational skills sufficient to set own priorities and facilitate work team progress. Contributes to the nurse navigator program and role development, implementation, and evaluation within the healthcare system and community. Orients new staff to their group and is cross trained to other groups Attends staff meetings and other meetings as needed Ensure compliance with mandatory in-services and employee health procedures. Actively supports and participates in performance improvement activities Ensures compliance with all facility policies and procedures and all HIPPA, ACHA, JCAHO, OSHA standards and regulations The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more. UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for. The University of Miami is an Equal Opportunity Employer. Applicants and employees are protected from discrimination based on certain categories protected by Federal law. Job Status: Full time Employee Type: Staff
RN Utilization Review Telehealth Full-time
Mass General Brigham

Utilization Management Nurse, Out of Network

Mass General Brigham Assembly Square, MA
$90,000 - $107,000 / year
Site: Mass General Brigham Health Plan Holding Company, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Job Summary Given equity, this position will pay somewhere between $90,000 to $107,000 annually. Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are at the forefront of transformation with one of the world’s leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage. Our work centers on creating an exceptional member experience – a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a welcoming and supportive environment that embraces their unique and varied backgrounds, experiences, and skills. We are pleased to offer competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more. The UM Nurse will support network adequacy review and authorization activities for members enrolled in ACO, HMO, and EPO products who require planned inpatient or outpatient services from out-of-network providers. Utilizing clinical knowledge, the UM Nurse will review prior authorization requests, assess medical necessity and benefit coverage, render approval decisions within scope, determine when physician review is required, and complete determinations following physician review. The ideal candidate will have prior authorization experience in a managed care setting and possess strong commercial health plan knowledge. Essential Functions: • Expertise in clinical review for prospective, concurrent, retrospective utilization management reviews utilizing Interqual ®, company policies and procedures, and other resources as determined by review, including physician reviews as needed for all lines of business as per departmental needs • Review authorization requests for medical services, including making initial eligibility and coverage determinations, screening for medical necessity appropriateness, determining if additional information is required, and referral to correct programs within Mass General Brigham Health Plan as needed. • Manage incoming requests for procedures and services including patient medical records and related clinical information. • Strong working knowledge of commercial, self-insured, fully insured, and limited network plans. • Adherence to program, departmental, and organizational performance metrics, including productivity. • Excellent verbal and written communication skills. • Excellent problem-solving and customer service skills. • Would need to be available for “on call” for a minimum of once per month with the possibility of that increasing depending on staff availability; Approximately 6 months after hire. • Must be self-directed and highly motivated with an ability to multitask. • Develop and maintain effective working relationships with internal and external customers • Hold self and others accountable to meet commitments. • Sound decision-making and time management skills. • Proactive in areas of professional development, personally and for the department. • Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise. • Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization. • Proficient with Microsoft Word, Excel, Outlook, McKesson InterQual ®, Outlook, SharePoint, PC based operating system, and web-based phone system. Qualifications Education Associate's Degree Nursing required or Bachelor's Degree Nursing preferred Licenses and Credentials Massachusetts Registered Nurse (RN) license required ​ Experience At least 2-3 years of utilization review experience is highly preferred Experience using Interqual or Milliman is highly preferred At least 1-2 years of experience in a payer setting is highly preferred At least 1-2 years of experience in an acute care setting is highly preferred Knowledge, Skills, and Abilities Demonstrate Mass General Brigham Health Plan’s core brand principles of always listening, challenging conventions, and providing value Strong aptitude for technology-based solutions. Embrace opportunities to take the complexity out of how we work and what we deliver. Listen to our constituents, learn, and act quickly in our ongoing pursuit of meaningful innovation Current in healthcare trends. Ability to inject energy, when and where it’s needed. Exercise self-awareness; monitor impact on others; be receptive to and seek out feedback; use self-discipline to adjust to feedback. Be accountable for delivering high-quality work. Act with a clear sense of ownership. Bring fresh ideas forward by actively listening to and working with employees and the people we serve. Communicate respectfully and professionally with colleagues Strong EQ; exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback. Knowledge, Skills, and Abilities Demonstrate Mass General Brigham Health Plan’s core brand principles of always listening, challenging conventions, and providing value Strong aptitude for technology-based solutions. Embrace opportunities to take the complexity out of how we work and what we deliver. Listen to our constituents, learn, and act quickly in our ongoing pursuit of meaningful innovation Current in healthcare trends. Ability to inject energy, when and where it’s needed. Exercise self-awareness; monitor impact on others; be receptive to and seek out feedback; use self-discipline to adjust to feedback. Be accountable for delivering high-quality work. Act with a clear sense of ownership. Bring fresh ideas forward by actively listening to and working with employees and the people we serve. Communicate respectfully and professionally with colleagues Strong EQ; exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback. Additional Job Details (if applicable) Working Conditions Would need to be available for “on call” for a minimum of once per month with the possibility of that increasing depending on staff availability; Approximately 6 months after hire. This is a remote role with occasional onsite team meetings in Somerville, MA. Monday through Friday, eastern business hours required Remote workdays require a stable, secure, quiet, and HIPAA-compliant workspace. This will be confirmed via Microsoft Teams video for all employees Given equity, this position will pay somewhere between $90,000 to $107,000 annually. Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $58,656.00 - $142,448.80/Annual Grade 98TEMP At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package. EEO Statement: 8925 Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.
RN Telehealth Full-time
McLaren Health Care

Care Coordinator Registered Nurse - Remote in Michigan

McLaren Health Care Flint, MI
Position Summary: As an advocate for the patient, the RN care manager will assess, plan, implement, coordinate, monitor, and evaluate the options and services required to meet an individual’s health needs, using clinical and community resources to promote quality, cost effective outcomes. Integrates evidenced based clinical guidelines, preventive guidelines, and protocols, in the development of individualized care plans that are patient centric. Provides targeted interventions to avoid hospitalization and emergency room visits. Essential Functions and Responsibilities: Provides telephonic and face-to-face comprehensive assessment and care management services to patients as part of an interdisciplinary team. Uses multi-dimensional assessment skills, risk assessment and screening tools to target high risk and vulnerable populations. Assesses over time the health care, educational, and psychosocial needs of the patient/caregiver.Uses standardized assessment tools such as depression screening, functionality, and health risk assessment. Provides follow up with patient/family when patient transitions from one setting to another.Completes timely post-hospital follow up: Medication reconciliation, PCP or specialist follow-up appointment, assess symptoms, teach warning signs, review discharge instructions, coordination of care, and problem solve barriers. Uses clinical judgment to determine level of care and collaborates with the PCP, patient and interdisciplinary team, including continuum of care settings and community. Responsible for developing a comprehensive individualized plan of care and targeted interventions.Continually monitors patient/family response to plan of care and revises the care plan as indicated. Provides patient self-management support with a focus on empowering the patient/caregiver to build capacity for self-care. Implements systems of care that facilitate close monitoring of high-risk patients to prevent and/or intervene early during acute exacerbations. Implements clinical interventions and protocols based on risk stratification and evidenced-based clinical guidelines. Coordinates patient care through ongoing collaboration with PCP, patient/caregiver, McLaren Health Care, community agencies, health plans, and other disciplinary team members. Fosters a team approach and includes patient/caregiver as active members of the team. Takes the lead in ensuring the continuity of care which extends beyond the practice boundaries. Serves as liaison to acute care hospitals, specialists, post-acute care services and community services. Demonstrates excellent written, verbal and listening communication skills, positive relationship building skills, and critical analysis skills. Maintains required documentation of all care management activities. Works with MPP Medical leadership to continuously evaluate process, identify problems, and propose/develop process improvement strategies to enhance care management and Patient Centered Medical Home delivery of care model. Reviews the current literature regarding effective engagement and communication strategies, care management strategies, and behavior change strategies and incorporates them into clinical practice. Other duties as assigned or when necessary to maintain efficient operations of the department and the Company as a whole. Required: RN with a valid unrestricted Michigan license. Three (3) years clinical nursing experience serving chronically ill patients and extensive knowledge of issues associated with chronic care and geriatrics. Preferred: RN, BSN. Three (3) years experience in a health plan or Physician Organization environment with care coordination, care management, and/or population health. Telephonic care management experience. Home care and/or hospice experience. Complex Care Management course completion or CCM. Additional Information Schedule: Full-time Requisition ID: 26004630 Daily Work Times: 8:00am-5:00pm Hours Per Pay Period: 80 On Call: No Weekends: No
RN Telehealth Full-time
Texas Health Resources

Virtual Care Registered Nurse - RN II - Full Time Nights

Texas Health Resources Dallas, TX
26008250 RN/ Registered Nurse - Virtual Patient Observation Program Bring your passion to Texas Health so we are Better + Together Work location: This position is located on site at Texas Health Dallas – 8200 Walnut Hill Lane, Dallas, Texas 75231 Work hours: Full Time, 36 hours a week. Nights 6:45pm- 7:15am 3 nights a week, rotating weekends Virtual Care Highlights Opportunity to innovate healthcare Professional advancement opportunities Strong teamwork and collaboration Here’s What You Need Diploma in Nursing required or Associate degree from an accredited Nursing program required BSN preferred 3 years RN experience required; 1 year in the last 3 years as a Registered Nurse in specialty area of acute care and patient population of position ( e.g. adults, geriatrcs) 8 years of acute care nursing experience is strongly preferred Certification in specialty fields such as acute care, oncology, or geriatrics is desirable. Critical Care or Med/surg experience preferred RN - Registered Nurse upon hire required CPR within 30 days of hire (maintained every 2 years) Able to promote patient safety and a positive patient experience Flexible and comfortable with a changing and dynamic work environment and schedule across all shifts and days Team player who also works well independently Participates in ongoing learning and continuing education to care for a variety of patient populations Collaborate, advocate and mentor others with a professional, non-condescending manner Model collaborative, respectful team relationships with colleagues and customers; lead by example Strong interpersonal, inter-professional communication and collaboration capabilities Ability to analyze, interpret and problem solve quickly with well-articulated action planning Strong verbal/written communication and conflict resolution skills Strong empathy to deliver compassionate, patient centered care Communicates effectively in interprofessional teams including peers, nursing, ancillary professionals and supplier providers Has professional and respectful interactions with patients, caregivers, and members of the interprofessional team Clinical knowledge Supports the transitioning of patients effectively within and across health delivery systems Identifies forces that impact the cost of health care, and advocates for, and practices cost-effective care and leadership Ability to use technology in addition to Epic What You Will Do The Virtual Care RN is responsible for providing and coordinating high-quality patient care to various patient populations within the framework of the Advanced Hospital at Home mode. The nursing care is provided from a centralized location, supported by technology and service provider network. Assesses the patient Utilizing monitoring, assessment, planning, intervention and critical thinking skills to care for acute care patient populations in the home Navigating patients and families across the continuum of the Advanced Care at Home phases of care Monitoring and responding to biometric data Conducting home and audio/visual patient care visits as directed by the care team and/or guidelines Additional perks of being a Texas Health RN/ Registered Nurse Benefits include 401k, PTO, medical, dental, Paid Parental Leave, flex spending, tuition reimbursement, student loan repayment programs as well as several other benefits. Delivery of high quality of patient care through nursing education, nursing research and innovations in nursing practice. Strong Unit Based Council (UBC). A supportive, team environment with outstanding opportunities for growth. Texas Health Presbyterian Hospital Dallas is one of North Texas's most established hospitals. As an 875 bed, full service hospital, we've served the Dallas community and surrounding areas including Lakewood, White Rock, and Highland Park since 1966 with a commitment to high quality, compassionate care. We specialize in cancer care, cardiology, neurosciences, women's services, and emergency medicine. Our hospital is home to a renowned Level III Neonatal Intensive Care Unit (NICU), a Comprehensive Stroke Center, and a Bariatric Surgery Center of Excellence. We also offer a wide range of outpatient services, including surgery, wellness programs, and advanced women's imaging. Our Women's Robotic Surgery program holds accreditation as a Center of Excellence in Robotic Surgery by the Surgical Review Corporation (SRC), reflecting our commitment to innovation in women's health and patient safety in surgery. Texas Health Dallas is a Joint Commission certified Comprehensive Stroke Center, Level I Trauma Center, and Comprehensive Heart Attack Center. We are proud to be a designated Magnet hospital and a top choice in North Texas for cancer treatment, emergency services, cardiac care, and bariatric surgery. If you’re ready to join us in our mission to improve the health of our community, then let’s show the world how we’re even better together! Learn More About Our Culture, Benefits, And Recent Awards. Do you still have questions or concerns? Feel free to email your questions to recruitment@texashealth.org
RN Telehealth
Molina Healthcare

Care Manager - (RN, BH Licensed LCSW, LMHC, LMFT, LMSW) Multiple Openings in FL

Molina Healthcare FL
$26 - $42 / hour
JOB DESCRIPTION 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 assessments of members per regulated timelines and determines who may qualify for care coordination/care management based on triggers identified in assessments. • Develops and implements care 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. • Collaborates with licensed care managers/leadership as needed or required. • 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. • Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. • Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. • 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. • Ability to demonstrate responsiveness in all forms of communication, and 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(s) proficiency. • In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). #PJCorp #LI-AC1 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: $26 - $42 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
RN Telehealth
Molina Healthcare

Care Manager - (RN, BH Licensed LCSW, LMHC, LMFT, LMSW) Multiple Openings in FL

Molina Healthcare Lakeland, FL
$26 - $42 / hour
JOB DESCRIPTION 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 assessments of members per regulated timelines and determines who may qualify for care coordination/care management based on triggers identified in assessments. • Develops and implements care 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. • Collaborates with licensed care managers/leadership as needed or required. • 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. • Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. • Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. • 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. • Ability to demonstrate responsiveness in all forms of communication, and 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(s) proficiency. • In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements). #PJCorp #LI-AC1 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: $26 - $42 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
RN Telehealth Part-time
UMass Memorial Health

Registered Nurse, Hospital at Home 24 Hours, 7P-7A

UMass Memorial Health Franklin Plantation, MA
$37.51 - $81.95 / hour
Are you a current UMass Memorial Health caregiver? Apply now through Workday. Exemption Status: Non-Exempt Hiring Range: $37.51 - $81.95 Please note that the final offer may vary within this range based on a candidate’s experience, skills, qualifications, and internal equity considerations . Schedule Details: Holidays - Every Third Holiday, Sunday through Saturday, Weekends - Every Third Weekend Scheduled Hours: 7P-7A Shift: 3 - Night Shift, 12 Hours (United States of America) Hours: 24 Cost Center: 10020 - 6614 Hospital At Home Union: MNA-Memorial/Hahnemann This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver – regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day. Responsible for the planning, coordinating, delivering and management of direct patient care utilizing the nursing process and adhering to the standards of nursing practice while delivering optimal family-centered patient care. Manages and directs day-to-day work responsibilities for the Hospital at Home program to assure optimal patient flow and satisfaction. I. Major Responsibilities: 1. Utilizes the Nursing Process for the delivery and management of patient’s care from Admission to Discharge, appropriate to the developmental age of the patient population. 2. Performs patient assessment/reassessment according to standard procedure. 3. Develops and coordinates individual plan of care including discharge planning. Develops, implements/coordinates and documents Education Plan for patient/family/ significant other. 4. Directs, supervises, coordinates and evaluate nursing care within assigned clinical setting. 5. Delegates appropriately to others in accordance with job description and competency level. Standard Staffing Level Responsibilities: 1. Complies with established departmental policies, procedures and objectives. 2. Attends variety of meetings, conferences, seminars as required or directed. 3. Participates in performance improvement initiatives and demonstrates use of Quality Improvement in daily operations. 4. Ensures compliance with regulatory agencies such as Joint Commission, DPH, etc. Develops and maintains procedures necessary to meet regulatory requirements. 5. Complies with all health and safety regulations and requirements. 6. Respects diverse views and approaches, demonstrates Standards of Respect, and contributes to creating and maintaining an environment of professionalism, tolerance, civility and acceptance toward all employees, patients and visitors. 7. Develops and maintains established departmental policies, procedures, and objectives. 8. Ensures that department complies with hospital established policies, quality assurance programs, safety, and infection control policies and procedures. 9. Maintains open lines of communication with Program leadership, other departments, staff, physicians, resident staff, and other support personnel. 10. Maintains, regular, reliable, and predictable attendance. 11. Performs other similar and related duties as required or directed. All responsibilities are essential job functions. II. Position Qualifications: License/Certification/Education: Required: 1. Current Massachusetts Nursing licensure and registration. 2. Current unrestricted Driver’s license. 3. BLS is a requirement for every RN unless an advance certification is current (ex ACLS, PALS, NRP). In addition, unit specific certification and competencies are defined in the Unit Profile. Preferred: 1. Bachelor of Science degree in Nursing. Experience/Skills: Required: 1. Minimum 5 year’s Nursing experience. 2. Thorough knowledge of the discipline of Nursing. Preferred: 1. Homecare or Telehealth experience. 2. Phlebotomy, IV insertion and telemetry experience. Unless certification, licensure or registration is required, an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements. Department-specific competencies and their measurements will be developed and maintained in the individual departments. The competencies will be maintained and attached to the departmental job description. Responsible managers will review competencies with position incumbents. III. Physical Demands and Environmental Conditions: Work is considered heavy. Position requires travel from operations center to local hospitals and patient residences with primary work being indoors in an alternative patient care environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We’re striving to make respect a part of everything we do at UMass Memorial Health – for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day. As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law. If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at talentacquisition@umassmemorial.org. We will make every effort to respond to your request for disability assistance as soon as possible.
RN Telehealth Full-time
Parkland Health (TX)

Senior Registered Nurse - Nurse Clinician - Virtual Nurse Call Center

Parkland Health (TX) Dallas, TX
Location: 8435 Stemmons Bldg. Work Schedule: 3 days a week (self scheduling) Shift: 12 hour shifts (7am to 7 pm) PRIMARY PURPOSE The RN is a licensed professional who uses the Parkland nursing professional practice model to coordinate patient care delivery, that focuses on a particular patient population(s)/specific health condition, by the health care team. Using the nursing process, the RN assesses the patient, identifies nursing diagnoses based on responses to health problems, develops and implements an individualized plan of care, and evaluates the patient's response. The RN utilizes knowledge of patient needs and the healthcare environment to assist patients to transition through the healthcare encounter without any preventable complications or delays. The RN delegates interventions to health care personnel based on the Texas Nursing Practice Act, each patient's condition and the competencies of the employee. MINIMUM SPECIFICATIONS Education Must be a graduate of an accredited school of nursing. Experience Must have a minimum of two (2) years of nursing experience. Prefer experience in an acute care setting. L&D (61920) Must have 5 years of experience in Labor and Delivery. Certification/Registration/Licensure Must have current, valid RN license or temporary RN license from the Texas Board of Nursing; or, valid Compact RN license. Must have current healthcare provider BLS for Healthcare Providers certification from one of the following: American Heart Association American Red Cross Military Training Network Burn Only: Must have certification as Advanced Burn Life Support (ABLS) Provider or must obtain within 6 months of hire/placement in classification. Must have or obtain certification as Advanced Burn Life Support (ABLS) Instructor within 18 months of hire/placement in classification (Instructor card replaces Provider card). Must have current Advanced Life Support (ALS) or Advanced Cardiac Life Support (ACLS) certification upon hire or placement in the role. Certification must be from one of the following: American Heart Association American Red Cross Military Training Network Must have current Pediatric Advanced Life Support (PALS) or Emergency Nursing Pediatric Course (ENPC) certification upon hire or placement in the role. Certification must be from one of the following: American Heart Association American Red Cross Military Training Network WISH: WISH -Neonatal Nursery-ICU (NICU) (61230) Must have certification in Neonatal Resuscitation Program (NRP) upon hire or placement in role. WISH - Labor & Delivery (61920): Must have upon hire or transition into the role: AWHONN (Association of Women's Health, Obstetrics and Neonatal Nurses) Intermediate Electronic Fetal Monitoring Certificate (Must be renewed every 2 years from completion date on previous certificate) OR, AWHONN (Association of Women's Health, Obstetrics and Neonatal Nurses) Advanced Electronic Fetal Monitoring Certificate (Must be renewed every 2 years from completion date on previous certificate) OR, NCC (National Corporation Certification) Electronic Fetal Monitoring Certification (Must be renewed every 3 years from completion date on previous certification). Must have current healthcare provider BLS for Healthcare Providers certification from one of the following: American Heart Association American Red Cross Military Training Network Must have certification in Neonatal Resuscitation Program (NRP) upon hire or placement in role. Skills or Special Abilities Provides care to assigned patient population in accordance with the current State of Texas Nursing Practice Act, established protocols, multidisciplinary plan of care, and clinical area specific standards. Burn Care Areas Only: Must be able to demonstrate an expert knowledge of all phases of burn care to include pre-hospital care, resuscitation, stabilization, supportive care, rehabilitation, and organ/tissue routine inquiry. Must have effective written and verbal communication skills. Must demonstrate patient centered/patient valued behaviors. Must be able to demonstrate knowledge regarding ICD-9 coding and EMTALA transfer guidelines and performance improvement. Must be able to work variable hours to include holidays and weekends. Must be able to demonstrate knowledge of performance improvement Responsibilities Serves as a patient advocate, by focusing on patient needs, patient rights, confidentiality, and religious and cultural preferences. Maintains positive working relationships with all Parkland internal and external customers, employees, etc. Serves as a resource for patients and other healthcare team members. Serves as a resource for specific clinical patient care issues. Provides patient care educational information and training to patients and family members for those requiring hemodialysis. Maintains and implements knowledge of applicable rules, regulations, policies, laws, and guidelines that impact or govern nursing practice, and ensures the hospital and Parkland are in compliance. Develops effective internal controls that promote adherence to applicable state/federal laws and the program requirements of accreditation agencies and federal, state, and private health plans. Maintains and updates knowledge of sanitation, infection control, safety, supplies, equipment, appropriate utilization of supplies and materials. Performs appropriate patient assessments including surveillance. Recognizes changes in a patient's condition and provides appropriate interventions as necessary. Consults with other team members as required, notifies providers to report changes in patient condition and implements orders in a timely manner. Exercises independent judgment in providing safe nursing care to patient. Completes appropriate documentation. Maintains accurate and timely entries and notations in patient care records and hospital documents. Ensures all records and documents meet the standards, goals, and objectives of the department and Parkland. Works with other staff in providing direction to non-nursing staff. Participates in information exchanges with nursing and other Parkland staff that support the standards, missions, goals and objectives of the department and Parkland. Provides appropriate hand off. Seeks and utilizes direction from more experience staff and team members as needed. Serves as a preceptor or trainer. Identifies ways to improve work process and improve patient and customer satisfaction. Makes recommendations to supervisor, implements and monitors results as appropriate in support of the overall goals of the department and Parkland. Virtual Care Only: Actively participates in proactive patient outreach utilizing motivational interviewing approach to coach patients, support health behavior change, and collaboratively set goals toward self-management, self-efficacy, and activation. Instructs the patient on condition management, behavioral support, and addresses emotional demands while reinforcing care plan and follows ups. Assists patients and families with health system navigation, making appointments, patient advocacy, clinical team communication, determination of community resources to reduce barriers to care, and support set-up and initiation of electronic communication modes (email, MyChart, etc.). Monitor, troubleshoot, and triage patient alerts and alarms remotely. Requisition ID: 989420
RN Utilization Review Telehealth
L.A. Care Health Plan

Utilization Management Admissions Liaison RN II (Nights)

L.A. Care Health Plan Los Angeles, 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 (UM) Admissions Liaison RN II is primarily responsible for receiving/reviewing admission requests and higher level of care (HLOC) transfer requests from inpatient facilities within regular timelines. Reviews clinical data in real-time and post admission to issue a determination based on clinical criteria for medical necessity. Assures timely, accurate determination and notification of admission and inter-facility transfer requests. Generates approval, modification, and denial communications for inpatient admission requests. Actively monitors for appropriate level of care (inpatient vs. observation) admission in the acute setting. Works with UM leadership, including the Utilization Management Medical Director, on requests where determination requires extended review. Collaborates with the inpatient care team for facilitation/coordination of patient transfers between acute care facilities. Acts as a department resource for medical service requests/referral management and processes. Actively participates in the discharge planning process, including providing clinical review and authorization for alternate levels of care, home health, durable medical equipment, and other discharge needs. Provides support to the inpatient review team as necessary to ensure timely processing of concurrent reviews. Duties Provides the primary clinical point of contact for inpatient acute care hospitals requesting Inpatient care/post-stabilization admission requests, Higher level of care transfers and other emergent transfers or needs. Ensures appropriate determination for admission requests/HLOC transfers based on clinical data presented and established criteria/guidelines, escalating to the medical director if needed. Triages and assesses members for admission needs, including, but not limited to, bed and accepting physician availability. (40%) Establishes and maintains ongoing communication with internal stakeholders and external customers while securing the L.A. Care member's admission or inter-facility transfer. Interfaces with physicians, house supervisors, and other hospital delegates to ensure that telephone triage results in appropriate patient placement. (10%) Applies clinical expertise and the nursing process to triage and prioritize admission acuity, servicing as an expert clinical resource for patient placement while utilizing medical knowledge and experience to facilitate consensus-building and development of satisfactory outcomes (10%) Continually seeks new ways to improve processes and increase efficiencies. Takes the initiative to communicate recommendations to UM Leadership. (5%) Completes all inpatient and discharge planning requests appropriately and timely including, but not limited to: Skilled nursing facility, outpatient needs (home health, physical therapy, infusion), and case management referrals (5%) Performs prospective, concurrent, post-service, and retrospective claim medical review processes. Utilizes clinical judgement, independent analysis, critical-thinking skills, detailed knowledge of medical policies, clinical guidelines and benefit plans to complete reviews and determinations within required turnaround times specific to the case type. Identifies requests needing medical director review or input and presents for second level review (20%) Performs other duties as assigned. (10%) Duties Continued Education Required Associate's Degree in NursingEducation Preferred Bachelor's Degree in NursingExperience Required: Minimum of 7 years of clinical experience in an acute hospital setting. Previous experience to have a strong understanding of Utilization Management/Case Management practices including, but not limited to, placement (with level of care) criteria (MCG, InterQual), concurrent review, and discharge planning. Preferred: Consistent Critical Care experience (Emergency Department, Intensive Care, Labor & Delivery) background highly desirable. Experience in bed placement decision-making highly desirable. Skills Required: Must be computer literate, with expertise in Outlook, Word, Excel, PowerPoint. Provision of excellent customer service required due to frequent communication with providers and other members of the interdisciplinary team 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. 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 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)American Case Management Association (ACM)Required Training Physical Requirements LightAdditional Information Required: Attend mandatory department trainings as scheduled Financial Impact: Management of all medical services has a tremendous potential impact on the cost of health care and budget. This position manages determinations to ensure services requested are medically appropriate and provided in the most cost effective manner without compromising quality healthcare delivery. Types of Shift: Day (7:00am - 3:30pm), Evening (3:00pm -11:30 pm), Night (11:00pm -7:30am). Float (Varies)* *All possible shifts. 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)
RN Telehealth Full-time
DaVita Kidney Care

Registered Nurse, Clinical Documentation Integrity Specialist

DaVita Kidney Care Denver, CO
$78,000 - $119,000 / year
Posting Date 08/19/2026 2000 16th St, Denver, Colorado, 80202-5117, United States of America A detail-oriented, clinically trained Registered Nurse that can provide expertise, education, coaching, and guidance on clinical practice and documentation to improve our clinical outcomes and increase the quality of provider documentation for diagnosis evaluation and quality metrics. This individual will serve as a role model and facilitator within the clinical documentation integrity team and support the leadership team with the execution of the department's strategic goals. They are self-directed and possess advanced analytical skills, critical thinking, creativity, and the ability to anticipate and identify opportunities and potential problems. Key Responsibilities: Performs clinical chart reviews to ensure documentation accuracy by applying established clinical criteria for diagnosing medical conditions. Applies their clinical knowledge to evaluate how provider documentation, lab results, diagnostic information, and treatment plans translate into coded data. Analyzes and interprets clinical data to identify gaps, inconsistencies, and/or opportunities for improvement in the clinical documentation and queries the provider using a concurrent query process following ACDIS/AHIMA Guidelines for Compliant Query Writing. Communicate with providers and other healthcare team members to clarify information or provide additional documentation when needed. Work directly with clinicians to improve the overall quality and completeness of documentation through the query process and/or provider education (correct disease processes and disease severity, complexity, and acuity with an eye towards accurate medical coding). Collaborates with team members as part of the clinical review process to promote high accuracy and consistency of results. Meets accuracy and productivity metrics to ensure the team achieves established departmental goals. Communicates with DaVita leaders to address documentation issues and trends. Actively participates in all department meetings as scheduled. Conduct individual and large group educational sessions for clinicians and medical coders (or other staff as applicable). Partner with data analytics, coding, compliance and education departments for onboarding, ongoing and targeted education for all IKC APPs and IKC partner providers on documentation requirements for Medicare risk adjustment. Flexible and able to adapt to change based on departmental needs. Excellent analytical and critical thinking skills. Excellent verbal/written communication and interpersonal skills. Ability to work independently and as part of a team in a fast-paced environment. Fully remote with the ability to travel as needed to present in-person training (travel is 2-4 times per year). Preferred Qualifications: Associate's degree with a current active clinical license (RN) (required) CCDS-O or CDIP (required or must be obtained within six months of hire) CRC (required or must be obtained within one year of hire) 5+ years of clinical experience as a Registered Nurse (adult-geriatric or family) (preferred) 3+ years of clinical documentation improvement experience, coding experience, or equivalent ( required ) 1+ year of experience working with advanced practice providers as well as other clinical and non-clinical staff (required) Solid clinical background in evidence-based medicine, including chronic disease management and prevention. Experience in ICD-10 coding and documentation requirements and risk adjustment. Knowledge of compliant query writing/process. Ability to perform a comprehensive chart review of 20-30 medical records daily, with workload variations based on daily tasks. Technical experience using EMR systems. Proficiency in MS applications (Excel, Outlook, Teams, PowerPoint, Word) Ability to travel for on-site meetings 2-4 times per year. Motivated self-starter and creative problem-solver who is comfortable working in a fast-paced, dynamic environment. A Shining Star for our Clinical Documentation Integrity (CDI) RN will have: Expert-level knowledge of Medicare risk adjustment, documentation, and coding requirements. 2+ years experience of experience providing risk adjustment education or management. 4+ years experience developing educational content for clinical professionals, including NPs, PAs, RNs, and/or physicians, pharmacists, etc. Associate's degree in nursing required. Comfortable presenting via Teams or in-person Possess strong technical skills, including Excel, Word, PowerPoint and Outlook. Coding certification from AAPC or AHIMA professional coding association or additional coursework/experience in coding and Risk Adjustment. These include but are not limited to: CPC, CRC, CCDS-O or CDIP. Expert experience working with Medicare Advantage programs and CMS Risk Adjustment model. Previous work experience in clinical documentation review or a clinical quality program. Experience developing and delivering clinical education and training. What We’ll Provide: More than just pay, our DaVita Rewards package connects teammates to what matters most. Teammates are eligible to begin receiving benefits on the first day of the month following or coinciding with one month of continuous employment. Below are some of our benefit offerings. Comprehensive benefits: Medical, dental, vision, 401(k) match, paid time off, PTO cash out Support for you and your family: Family resources, EAP counseling sessions, access Headspace®, backup child and elder care, maternity/paternity leave and more Professional development programs: DaVita offers a variety of programs to help strong performers grow within their career and also offers on-demand virtual leadership and development courses through DaVita’s online training platform StarLearning. #LI-CM5 At DaVita, we strive to be a community first and a company second. We want all teammates to experience DaVita as "a place where I belong." Our goal is to embed belonging into everything we do in our Village, so that it becomes part of who we are. We are proud to be an equal opportunity workplace and comply with state and federal affirmative action requirements. Individuals are recruited, hired, assigned and promoted without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, protected veteran status, or any other protected characteristic. This position will be open for a minimum of three days. The Salary Range for the role is $78,000.00 - $119,000.00 per year. If a candidate is hired, they will be paid at least the minimum wage according to their geographical jurisdiction and the exemption status for the position. New York Exempt: New York City and Long Island: $66,300.00/year, Nassau, Suffolk, and Westchester counties: $66,300.00/year, Remainder of New York state: $62,353.20/year New York Non-exempt: New York City and Long Island: $17.00/hour, Nassau, Suffolk, and Westchester counties: $17.00/hour, Remainder of New York state: $16.00/hour Washington Exempt: $80,168.40/year Washington Non-exempt: Bellingham: $19.13/hour, Burien: $21.71/hour, Everette: $20.77/hour, Unincorporated King County: $20.82/hour, Renton: $21.57/hour, Seattle: $21.30/hour, Tukwila: $21.65/hour, Remainder of Washington state: $17.13/hour For location-specific minimum wage details, see the following link: DaVita.jobs/WageRates Compensation for the role will depend on a number of factors, including a candidate’s qualifications, skills, competencies and experience. DaVita offers a competitive total rewards package, which includes a 401k match, healthcare coverage and a broad range of other benefits. Learn more at https://careers.davita.com/benefits Colorado Residents: Please do not respond to any questions in this initial application that may seek age-identifying information such as age, date of birth, or dates of school attendance or graduation. You may also redact this information from any materials you submit during the application process. You will not be penalized for redacting or removing this information.
RN Telehealth
Kaiser Permanente

Staff Nurse - Med /Tele

Kaiser Permanente Honolulu, HI
This position is a Hawaii Nurses and Healthcare Professionals Bargaining Unit represented position. Job Summary: Provides nursing care and services to patients/families. Provides direction to licensed practical nurses (LPNs) and nursing assistive personnel. Delegates nursing care according to legal and regulatory guidelines/statutes and organizational policies. Utilizes reasonable judgment in carrying out prescribed medical orders of a practitioner. Functions as primary nurse/total patient caregiver. Serves as resource nurse. Acts as preceptor and takes charge duties as assigned. Essential Responsibilities: Practices professional nursing and delegates nursing tasks to nursing assistive personnel and provides direction to the LPN as appropriate. Utilizes nursing process to deliver care. Performs any nursing task requiring nursing knowledge, judgment, and skill. Administers medications. Teaches LPNs and nursing assistive personnel special tasks of nursing care. Verifies staff competency to perform special tasks of nursing care as appropriate. Is responsible and accountable for quality of nursing rendered and adequacy of nursing care provided when special tasks are delegated to nursing assistive personnel. Functions as primary nurse/total patient caregiver. Serves as resource nurse and acts as preceptor. Takes charge duties as assigned. Incorporates the KP Vision, Model and Values through out their Nursing Practice. Performs administrative and other duties and accepts responsibility as assigned. May perform patient care to the extent necessary to maintain clinical expertise, competency and licensing necessary to fulfill job responsibilities and to direct the provision of care on the unit.
RN Telehealth
Fairview Health Services

Triage Nurse Advisor - RN

Fairview Health Services Saint Paul, MN
Job Overview Apply today to join our 34,000+ employees and 5,000+ system providers working to build lasting relationships with the people we serve: our patients, our communities, and each other! Are you ready to use your nursing skills and continue making a difference while not having to be full time or needing to face the physical demands of a hospital or clinic nurse role? On the Telephone Triage Nurse Line Advisor with Fairview, that's what we do! Join other nursing professionals in an encouraging environment where we support each other. We are adding new positions due to growth. Training: Training for this position requires flexibility to work full time (1.0 FTE) on-site for 4-6 weeks. Our training shifts are variable including days, mid-shift, evenings, and weekends. Following training, we work remotely. The work from home location is required to be within driving distance from Midway Corporate Campus in Saint Paul, Minnesota. Schedule: This opening is 0.6 FTE (48 hours per two weeks) on our EVENING shift with an every other weekend rotation. ( Weekday shifts: 6:00 pm - 10:00 pm, Every Weekend: 12:30 pm - 9:00 pm) As RN Advisors, we independently triage calls from patients inquiring about their symptoms, medication refills, test results, and information regarding our facilities. We handle approximately 6 calls per hour with calls lasting 6-9 minutes in duration. We are advocates, assisting callers through the health care system. Responsibilities include: Accountable for quality assessment; efficient management of care and client happiness. Demonstrate knowledge and expertise in triaging callers properly such that all callers receive a timely and appropriate response. Focus on callers, maintain a professional demeanor, and continuously implement strategies to improve customer satisfaction. Collect information regarding concerns, medical history and description of symptoms via the telephone using the nursing process. Use symptom-based protocols to systematically assess, address needs and provide education. Prioritize calls based on patients needs. Qualifications: Current Minnesota RN License 3 + years RN work experience Wisconsin RN License; application submitted within 30 days of hire and obtained within 120 days of hire Computer skills: able to document reliably in electronic health record softwar RN Triage experience Preferred Qualifications Bachelors Degree in Nursing Basic Life Support (American Heart Assoc or Red Cross) Benefit Overview Fairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link foradditional information: https://www.fairview.org/careers/benefits/noncontract Compensation Disclaimer An individual's pay rate within the posted range may be determined by various factors, including skills, knowledge, relevant education, experience, and market conditions. Additionally, our organization prioritizes pay equity and considers internal team equity when making any offer. Hiring at the maximum of the range is not typical. If your role is eligible for a sign-on bonus, the bonus program that is approved and in place at the time of offer, is what will be honored. EEO Statement EEO/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status
RN Telehealth Part-time
Providence

Advice RN - Nurse Advice Call Center

Providence Brea, CA
$48.03 - $74.56 / hour
Description This posting is for multiple openings of a Call Center Advice RN at The Nurse Advice Call Center in Brea, CA! We offer Part Time and Full Time positions, based on availability. Please ask at the time of interview! Under the direction of the Supervisor/Manager, this position is responsible for triaging incoming calls, assessing needs and providing appropriate healthcare options including facilitating referral to primary providers, health care facilities and community resources. In addition, this position will be responsible for educating the caller regarding immediate health care advice, possible health related risks, as well as wellness/prevention behaviors and opportunities. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Medical Foundation and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Required Qualifications: Graduate of an accredited school of nursing. California Registered Nurse License upon hire. Case management or acute care experience in a healthcare setting; 2 years preferred. 2 years - Acute or ambulatory nursing experience; 7 years preferred. Preferred Qualifications: Bachelor's Degree - Nursing or related field. Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. About Providence At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits . Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act . About the Team Providence Clinical Network (PCN) is a service line within Providence serving patients across seven states with quality, compassionate, coordinated care. Collectively, our medical groups and affiliate practices are the third largest group in the country with over 11,000 providers, 900 clinics and 30,000 caregivers. PCN is comprised of Providence Medical Group in Alaska, Washington, Montana and Oregon; Swedish Medical Group in Washington’s greater Puget Sound area, Pacific Medical Centers in western Washington; Kadlec in southeast Washington; Providence’s St. John’s Medical Foundation in Southern California; Providence Medical Institute in Southern California; Providence Facey Medical Foundation in Southern California; Providence Medical Foundation in Northern and Southern California; and Covenant Medical Group and Covenant Health Partners in west Texas and eastern New Mexico. Providence is proud to be an Equal Opportunity Employer . We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. Requsition ID: 453427 Company: Providence Jobs Job Category: Clinical Administration Job Function: Clinical Support Job Schedule: Part time Job Shift: Multiple shifts available Career Track: Nursing Department: 7520 NURSE ADVICE CALL CENTER CA HERITAGE SERVICES Address: CA Brea 955 W Imperial Hwy Work Location: St Jude Heritage Medical Grp-W Imperial Hwy Brea Workplace Type: On-site Pay Range: $48.03 - $74.56 The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
RN Telehealth Full-time
Pharmko

Remote Care Manager- RN/ Colorado

Pharmko Lawrence, NY
CCM/RPM The ideal candidate works in collaboration and continuous partnership with chronically ill patients and their family/caregiver(s), clinic/hospital/specialty provider and staff, and community resources in a team We are seeking a bilingual and remote care manager to join our rapidly growing team at Preventel Health performing Chronic Care Management (CCM), Remote Patient Monitoring (RPM) and Behavioral Health Integration (BHI) by telephonically delivering health and wellness calls to assigned patients. Responsibilities: Remotely providing basic patient coaching and care to improve patient outcomes Develop a care plan with the patient, family/caregiver(s) and provider Monitor patient outcomes, adherence to care plans, evaluate effectiveness, monitor patient progress in a timely manner and facilitate changes as needed Coaching and educating patients on improving their Chronic Conditions, preventive care and physician directives Telephone outreach to English and Spanish-speaking patients Facilitate CCM, RPM and BHI program enrollment Concise and accurate documentation Cultivate and support the primary care providers with timely communication, inquiry follow-up, and integration of information into the care plan regarding transitions-in-care and referral Requirements: Must be mininally licensed RN COLORADO Must have good customer service skills Prefer Bilingual (Spanish) Knowledgeable with Microsoft Office Reliable Computer with internet COMPENSATION: Based on a base plus incentive model.
RN Telehealth Part-time
LCMC Health

PRN RN Care Manager

LCMC Health New Orleans, LA
Your job is more than a job You overthink every care option and scenario because, as a Care Manager, you’re the hub of your patient's case management and care plan. You assure quality through the continuum of care, collaborate with members of the care team, and implement the plan of care and transition strategies. Achieving the best possible patient outcomes, appropriate length of stay, efficient utilization of resources, coordination of patient, family, and staff communication and education is the center of your nursing universe. You give new meaning to a 9 to 5 schedule because caring doesn’t stop just because you’ve punched a clock and neither does your innovative brain. If it were your loved one, you’d expect nothing less, so you give so much more. Gatekeeper, facilitator and decision-maker, and hand-holder, you apply nursing knowledge, logic, and a little “extra” heart into everything you do. We love that about you. Your experiences, knowledge, skills, empathy, compassion, and your “little something extra” all add up to you. And we’re excited to get to know you and find out what you’ll bring to this case management nursing role. Your Everyday Develop individualized care plans, including prioritized goals, that consider the patient’s and caregivers’ goals, preferences and desired level of involvement in the care management plan. Make outbound calls to assess patient’s current health status. Identify gaps or barriers in treatment plans. Coordinate care for members and makes referrals to outside sources. Ensure members discharging from hospital or emergency department receive the necessary services and resources, including medication reconciliation. Triage symptom-based calls per approved protocols for a wide range of patients. Enroll patients and manage alerts for various home monitoring programs. Provide approved general health information and guidance to public caller from approved sources by assessing needs of the caller. Document all workflows in EPIC system for purposes of tracking and quality assessment. Provide patient education to assist with self-management of wellness and disease. Educate enrolled members on chronic and acute disease processes. Interact with LCMC Health care partners, leadership and/or physicians to discuss clinical questions, concerns, strategies, and care plans to achieve quality and cost management objectives. Demonstrate energy, excitement, and a passion for quality work. Schedule: PRN for weekday coverage. The Must-Haves Minimum: Current nursing license to practice in Louisiana and as defined by the Louisiana State Board of Nursing. 2 years of professional nursing or care management experience. WORK SHIFT: Weekends (United States of America) LCMC Health is a community. Our people make health happen. While our NOLA roots run deep, our branches are the vessels that carry our mission of bringing the best possible care to every person and parish in Louisiana and beyond and put a little more heart and soul into healthcare along the way. Celebrating authenticity, originality, equity, inclusion and a little “come on in” attitude is the foundation of LCMC Health’s culture of everyday extraordinary Your extras Deliver healthcare with heart. Give people a reason to smile. Put a little love in your work. Be honest and real, but with compassion. Bring some lagniappe into everything you do. Forget one-size-fits-all, think one-of-a-kind care. See opportunities, not problems – it’s all about perspective. Cheerlead ideas, differences, and each other. Love what makes you, you - because we do You are welcome here. LCMC Health is an equal opportunity employer. All qualified applicants receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law. The above job summary is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary. Simple things make the difference. 1. To get started, take your time to fully and accurately complete the application for employment. Incomplete applications get bogged down and are often eliminated due to missing information. 2. To ensure quality care and service, we may use information on your application to verify your previous employment and background. 3. To keep our career applications up-to-date, applications are inactive after 6 months and, therefore, require a new application for employment to be completed. 4. To expedite the hiring process, proof of citizenship or immigration status will be required to verify your lawful right to work in the United States.
RN Director of Nursing Telehealth Full-time
MedStar Health

Senior Director of Nursing Connected & Remote Care (RN)

MedStar Health Town Center, MD
$142,064 - $287,996 / year
About this Job: Senior Director, Nursing – Connected & Remote Care Transform How Nursing Care Is Delivered MedStar Health is seeking a visionary nursing leader to serve as Senior Director, Nursing – Connected & Remote Care , providing system-level leadership for the strategy, design, implementation, and advancement of virtual, connected, hybrid, and remote nursing care across MedStar Health. As a member of the MedStar Health System Nursing leadership team , the Senior Director will help shape the future of nursing by bringing together clinical practice, technology, data, innovation, and workforce strategy to create new models of care that improve access, safety, patient and nurse experience, clinical outcomes, and operational performance. This leader will partner across Nursing, Digital Health, Information Technology, Clinical Informatics, Innovation, Operations, and physician leadership to move emerging care models from concept to implementation and system-wide scale . The successful candidate will be an accomplished nursing leader who combines clinical and operational credibility with an ability to lead transformation, navigate emerging technologies, build strong interdisciplinary partnerships, and translate innovation into sustainable clinical practice. What You'll Lead Develop and execute the enterprise nursing strategy for connected, virtual, hybrid, and remote care in alignment with MedStar Health's nursing and digital health priorities. Lead the design, implementation, evaluation, optimization, and scaling of virtual nursing, remote patient monitoring, connected care, and other technology-enabled nursing models. Provide operational and nursing practice leadership for connected and remote care programs, including responsibility for workforce, technology, quality, safety, productivity, and financial performance. Represent Nursing on enterprise digital health, telehealth, connected care, remote monitoring, technology, and innovation initiatives and governance structures. Partner with Nursing, Information Technology, Clinical Informatics, MedStar Institute for Innovation, physicians, advanced practice providers, and operational leaders to integrate technology into clinical workflows and care delivery. Evaluate emerging technologies—including artificial intelligence, clinical decision-support tools, remote monitoring technologies, virtual care platforms, and digital communication solutions —for their potential to improve nursing practice and patient care. Lead technology and care-model implementation from initial evaluation through workflow design, adoption, change management, measurement, optimization, and scale. Establish and monitor performance measures for connected and remote nursing, including clinical outcomes, patient access, patient and nurse experience, quality and safety, productivity, workload, utilization, and cost effectiveness . Use data and analytics to evaluate program effectiveness, identify opportunities, demonstrate value, and guide future investment and expansion. Partner with clinical and operational leaders to leverage connected care in support of capacity management, patient throughput, care transitions, and reduced length of stay. Develop innovative workforce and staffing models that appropriately integrate virtual and in-person nursing care. Partner with Nursing Professional Development to establish education, competency, and professional development programs supporting new technology-enabled nursing roles and care models. Recruit, develop, mentor, and retain high-performing leaders and associates while building future nursing leadership capability in connected and digital care. Ensure regulatory, accreditation, licensure, privacy, clinical practice, and patient safety requirements are integrated into connected and remote nursing operations. What We're Looking For Required Bachelor of Science in Nursing (BSN) from a nationally accredited program. Master's degree in Nursing, Healthcare Administration, Health Services Administration, Informatics, or a related field from a nationally accredited program, with either the bachelor's or master's degree in Nursing. Current Registered Nurse licensure in Maryland, the District of Columbia, and/or appropriate Compact State Licensure as applicable. Minimum of five years of progressively responsible nursing leadership experience , including significant experience at the Director of Nursing or comparable leadership level. Demonstrated success leading complex clinical operations, care-model transformation, digital transformation, technology-enabled clinical programs, or significant system/process redesign . Demonstrated experience leading multidisciplinary and cross-functional initiatives involving clinical, operational, and technology stakeholders. Strongly Preferred Leadership experience involving one or more of the following: Virtual nursing or virtual care Telehealth/telemedicine Remote patient monitoring Connected care Clinical informatics Digital health Technology-enabled care delivery Nursing workforce or care-model redesign Experience implementing and scaling new clinical programs or technologies across multiple hospitals, entities, or care settings. Experience developing business cases, measuring return on investment, or demonstrating the clinical, operational, workforce, or financial value of new care models. Experience with project/program management, change management, or large-scale transformation. Experience evaluating or implementing emerging technologies, including artificial intelligence or clinical decision-support solutions. Certification NEA-BC (Nurse Executive Advanced) or CENP (Certified in Executive Nursing Practice) required within one year of hire. Additional certification in nursing informatics, project management, digital health, or related disciplines preferred. Leadership Capabilities The successful candidate will demonstrate: Visionary and strategic nursing leadership. Strong understanding of clinical operations and professional nursing practice. Digital fluency and curiosity about emerging healthcare technologies. Ability to translate technology into practical clinical workflows and sustainable care models. Strong business, financial, and operational acumen. Data-driven decision-making and performance measurement capabilities. Exceptional program implementation and change leadership skills. Ability to influence across organizational boundaries without relying solely on direct authority. Strong executive communication and presentation skills. Ability to build credibility with nurses, physicians, technology leaders, executives, and external partners. Commitment to responsible, evidence-based adoption of emerging technologies. The Opportunity Healthcare is rapidly redefining where, when, and how nursing care is delivered . The Senior Director, Nursing – Connected & Remote Care will help MedStar Health lead that transformation. This leader will have the opportunity to shape new nursing care models, expand the reach of the nursing workforce, evaluate emerging technologies, advance virtual and connected care, and build the clinical and operational infrastructure necessary to bring innovation safely and effectively to patients across the MedStar Health system. This position has a hiring range of : USD $142,064.00 - USD $287,996.00 /Yr.
RN Telehealth Full-time
Central Ohio Primary Care

Triage Specialist-RN (Day Shift)- Care Navigation

Central Ohio Primary Care Westerville, OH
The Triage Specialist conducts a thorough telephonic nursing triage for acute and chronic medical complaints and uses electronic health record (EHR) EPIC for documentation of patient interactions regarding triage protocols, appointment scheduling, homecare nursing instruction, and collaboration with other healthcare team members. Full Time/Benefits Eligible Monday-Friday - 8:00am - 6:00pm, 4-10 hour shifts variable days during the week and every other weekend Westerville, OH Essential Functions and Responsibilities: Conduct telephone triage for patient health complaints using an electronic triage assessment tool. Navigate multiple electronic platforms to assess current health complaint, patients’ electronic chart, PCP appointment scheduling, and ancillary center scheduling. Document nursing triage notes into the EHR system for clear and concise documentation. Document phone call details in tracking system for department data tracking and collection. Assess, identify, and close patient care gaps. Develop positive and effective working relationship with COPC staff, offices, and physicians in order to deliver high quality patient care. Qualifications: Education, Licensures & Certifications Required: Bachelor’s degree in Nursing Required: Active and unrestricted registered nurse license in the state of Ohio Required: 2 years minimum of Register Nurse experience in a hospital and/ or medical practice setting Preferred: Experience in telephonic nursing triage Knowledge, Skills & Abilities Exceptional active listening, communication, and documentation skills Excellent customer service skills, and mind-set Ability to work on a team and display a positive attitude Ability to adapt to department growth, expansion, and policies/ procedures Ability to offer flexible work hours, including the ability to work weekend hours Basic knowledge of Microsoft Office Programs, such as Excel Proficient knowledge of electronic health records Excellent listening, communication and documentation skills Proficient in clinical practice protocols and telemedicine patient care Strong knowledge of medical terminology Excellent relationship building skills Possesses customer service-oriented mindset
RN Telehealth Part-time
UMass Memorial Health

Registered Nurse, Hospital at Home 24 Hours, 7P-7A

UMass Memorial Health Franklin Plantation, MA
$37.51 - $81.95 / hour
Are you a current UMass Memorial Health caregiver? Apply now through Workday. Exemption Status: Non-Exempt Hiring Range: $37.51 - $81.95 Please note that the final offer may vary within this range based on a candidate’s experience, skills, qualifications, and internal equity considerations . Schedule Details: Holidays - Every Third Holiday, Sunday through Saturday, Weekends - Every Third Weekend Scheduled Hours: 7P-7A Shift: 3 - Night Shift, 12 Hours (United States of America) Hours: 24 Cost Center: 10020 - 6614 Hospital At Home Union: MNA-Memorial/Hahnemann This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver – regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day. Responsible for the planning, coordinating, delivering and management of direct patient care utilizing the nursing process and adhering to the standards of nursing practice while delivering optimal family-centered patient care. Manages and directs day-to-day work responsibilities for the Hospital at Home program to assure optimal patient flow and satisfaction. I. Major Responsibilities: 1. Utilizes the Nursing Process for the delivery and management of patient’s care from Admission to Discharge, appropriate to the developmental age of the patient population. 2. Performs patient assessment/reassessment according to standard procedure. 3. Develops and coordinates individual plan of care including discharge planning. Develops, implements/coordinates and documents Education Plan for patient/family/ significant other. 4. Directs, supervises, coordinates and evaluate nursing care within assigned clinical setting. 5. Delegates appropriately to others in accordance with job description and competency level. Standard Staffing Level Responsibilities: 1. Complies with established departmental policies, procedures and objectives. 2. Attends variety of meetings, conferences, seminars as required or directed. 3. Participates in performance improvement initiatives and demonstrates use of Quality Improvement in daily operations. 4. Ensures compliance with regulatory agencies such as Joint Commission, DPH, etc. Develops and maintains procedures necessary to meet regulatory requirements. 5. Complies with all health and safety regulations and requirements. 6. Respects diverse views and approaches, demonstrates Standards of Respect, and contributes to creating and maintaining an environment of professionalism, tolerance, civility and acceptance toward all employees, patients and visitors. 7. Develops and maintains established departmental policies, procedures, and objectives. 8. Ensures that department complies with hospital established policies, quality assurance programs, safety, and infection control policies and procedures. 9. Maintains open lines of communication with Program leadership, other departments, staff, physicians, resident staff, and other support personnel. 10. Maintains, regular, reliable, and predictable attendance. 11. Performs other similar and related duties as required or directed. All responsibilities are essential job functions. II. Position Qualifications: License/Certification/Education: Required: 1. Current Massachusetts Nursing licensure and registration. 2. Current unrestricted Driver’s license. 3. BLS is a requirement for every RN unless an advance certification is current (ex ACLS, PALS, NRP). In addition, unit specific certification and competencies are defined in the Unit Profile. Preferred: 1. Bachelor of Science degree in Nursing. Experience/Skills: Required: 1. Minimum 5 year’s Nursing experience. 2. Thorough knowledge of the discipline of Nursing. Preferred: 1. Homecare or Telehealth experience. 2. Phlebotomy, IV insertion and telemetry experience. Unless certification, licensure or registration is required, an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements. Department-specific competencies and their measurements will be developed and maintained in the individual departments. The competencies will be maintained and attached to the departmental job description. Responsible managers will review competencies with position incumbents. III. Physical Demands and Environmental Conditions: Work is considered heavy. Position requires travel from operations center to local hospitals and patient residences with primary work being indoors in an alternative patient care environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We’re striving to make respect a part of everything we do at UMass Memorial Health – for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day. As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law. If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at talentacquisition@umassmemorial.org. We will make every effort to respond to your request for disability assistance as soon as possible.
RN Pediatric Telehealth
Imagine Pediatrics

Bilingual Pediatric Registered Nurse

Imagine Pediatrics TN
$40 - $47 / hour
Who We Are Imagine Pediatrics is a tech enabled, pediatrician led medical group reimagining care for children with special health care needs. We deliver 24/7 virtual first and in home medical, behavioral, and social care, working alongside families, providers, and health plans to break down barriers to quality care. We do not replace existing care teams; we enhance them, providing an extra layer of support with compassion, creativity, and an unwavering commitment to children with medical complexity. The primary location for this position is remote (CST required), with a strong preference of those residing in Tennessee, Louisiana, Missouri, or Illinois. Expected schedule will be 3x12s (Monday-Wednesday or Wednesday-Friday) 7:00am-7:00pm CST. Nurses must physically be working in the United States. What You’ll Do As a Pediatric Registered Nurse at Imagine Pediatrics, you are the primary point of contact for our families as you work to deeply know our patients through frequent virtual touchpoints and are the first line of defense when our patients are having a clinical problem. You leverage an integrated technology platform and are complimented by an entire interdisciplinary team including MDs, APPs, social workers, navigators, pharmacists, and dietitians. In this role, you will: Provide professional and friendly proactive care and triage for clinical issues. Embed a family centered care philosophy in care delivery. Demonstrate cultural competence and sensitivity as ability to work with culturally diverse populations and seek out additional resources when needed. Transition of care for ED/IP/UC care coordination with clinical providers following discharge. Perform a comprehensive assessment of a patient’s clinical, psychosocial, discharge planning and financial needs. Establishes clinical milestones and goals related to these issues. Establish rapport and a relationship with the patient and family in order to understand their needs and expectations and to assist them in setting realistic and mutual goals. Integrate an awareness of cultural factors in the patient/family interview process and elicit clinically relevant cultural information. Establish, in conjunction with the physician, the patient and interdisciplinary team, a comprehensive plan of care to appropriately address clinical milestones. Communicate plan of care, including changes and issues related to plan of care to patient/family, physicians and other members of the healthcare team. Gather sufficient information from all relevant sources to determine the effectiveness of the plan of care to assure it is done in an accurate, safe, timely and cost-effective manner. Document all care management assessments and interventions. Refer to Social Worker or Behavioral Health for complex psychosocial and discharge planning issues (per criteria) and ensures appropriate follow-up. Consults with other members of the interdisciplinary team (dietary, pharmacy, etc.) to provide safe discharge as appropriate. Perform other duties as assigned What You Bring & How You Qualify First and foremost, you’re passionate and committed to reimagining pediatric health care and creating a world where every child with special health care needs gets the care and support they deserve. You will need: Licensed RN in at least one state with eligibility to register for other state licensures. Bachelors in nursing from an accredited university required. 5+ years of pediatrics experience required Outpatient (primary care and/or subspecialty), home health, complex care, pediatric ICU, emergency medicine, etc. strongly preferred 1+ years' experience in care coordination or case management experience preferred B ilingual Spanish required Familiarity with Medicaid regulations and services a plus Value Based Care (VBC) experience a plus Virtual care experience a plus What We Offer (Benefits + Perks) The hourly rate for this position ranges from $40 - 47 per hour in addition to competitive company benefits package and eligibility to participate in an employee equity purchase program (as applicable). When determining compensation, we analyze and carefully consider several factors including job-related knowledge, skills and experience. These considerations may cause your compensation to vary. We provide these additional benefits and perks: Competitive medical, dental, and vision insurance Healthcare and Dependent Care FSA; Company-funded HSA 401(k) with 4% match, vested 100% from day one Employer-paid short and long-term disability Life insurance at 1x annual salary 20 days PTO + 10 Company Holidays & 2 Floating Holidays Paid new parent leave Additional benefits to be detailed in offer What We Live By We’re guided by our five core values: Our Values: Children First. We put the best interests of children above all. We know that the right decision is always the one that creates more safe days at home for the children we serve today and in the future. Earn Trust. We listen first, speak second. We build lasting relationships by creating shared understanding and consistently following through on our commitments. Innovate Today. We believe that small improvements lead to big impact. We stay curious by asking questions and leveraging new ideas to learn and scale. Embrace Humanity. We lead with empathy and authenticity, presuming competence and good intentions. When we stumble, we use the opportunity to grow and understand how we can improve. One Team, Diverse Perspectives. We actively seek a range of viewpoints to achieve better outcomes. Even when we see things differently, we stay aligned on our shared mission and support one another to move forward — together. We Value Diversity, Equity, Inclusion and Belonging We believe that creating a world where every child with complex medical conditions gets the care and support, they deserve requires a diverse team with diverse perspectives. We're proud to be an equal opportunity employer. People seeking employment at Imagine Pediatrics are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information, or characteristics (or those of a family member), pregnancy or other status protected by applicable law.
RN Telehealth
University Hospitals

RN-System Operations Center

University Hospitals Highland Hills, OH
$1 - $1,000,000 / year
This position is part-time, 24 hours per week, and will be located at the UH Management Services Center in Shaker Heights, OH. Position Summary/Essential Duties: Provides virtual clinical care to patients within the recognized scope of practice for the profession and professional licensure requirements Provides clinical triage and clinical support using established protocols during in-bound and out-bound telephone communication with patients, family, caregivers and other members of the healthcare team Assists in coordination of incoming patient transfer requests with receiving facility and physicians Demonstrates technical skills in care delivery that result in safe practice and positive care outcomes Possess and obtain working knowledge of external and inter-facility protocols and standards of practice Demonstrates clear communication and effective collaboration to optimize patient care and clinical operations Delivering exceptional customer service while facilitating communication across multiple disciplines Work with all System Operations Center (SOC) staff in a team orientated, collaborative approach Responsible for promoting a Best Place to Work Culture and positive and professional work environment Actively participates in the development and implementation of performance/quality improvement Other duties as assigned
RN Utilization Review Telehealth Full-time
Astrana Health

UM Review Nurse

Astrana Health Monterey Park, CA
$34 - $42 / hour
UM Review Nurse Department: HS - UM Employment Type: Full Time Location: 1600 Corporate Center Dr., Monterey Park, CA 91754 Reporting To: Phillip Vasquez Compensation: $34.00 - $42.00 / hour Description Astrana Health is looking for a CA-licensed Utilization Review Nurse to assist our Health Services Department. In this position, you will utilize your clinical judgement to approve or deny outpatient medical services for patients based on Medical Necessity Criteria, respective to various Health Plans. This is a remote position for CA-licensed nurses. Candidates must live in California. We are seeking nurses with at least one year of outpatient Utilization Management experience in a fast-paced setting. Our Values: Put Patients First Empower Entrepreneurial Provider and Care Teams Operate with Integrity & Excellence Be Innovative Work As One Team What You'll Do Complete prior authorization/retrospective review of elective inpatient admissions, outpatient procedures, post-homecare services, and durable medical equipment Refer cases to Medical Directors as needed/appropriate Maintain knowledge of state and federal regulations and accreditation standards Comply with internal policies and procedures Perform any other job duties as requested Qualifications Active and unrestricted LVN license in CA. At least 1 years of outpatient UM experience Experience with Microsoft applications such as Word, Excel, and Outlook You’ll be Great for this Role If: At least two (2) years of health plan, IPA or MSO experience Strong interpersonal skills Ability to collaborate with co-workers, senior leadership, and other management Experience educating and training staff Enviornmental Job Requirements and Working Conditions This is a remote position. Our office is located at 1600 Corporate Center Drive in Monterey Park, CA. Candidates who live within a 30 mile radius of the office may be expected to work hybrid. Typical business hours are Monday - Friday from 8:30 AM to 5 PM, however, this position requires open availability between 8 AM - 8 PM PST, M-Su. Your schedule will be compromised of 5 shifts per week. Nurses rotate weekend and holiday coverage. Overtime is required in this position. The national target pay range for this role is $34.00 - $47.00 per hour. Actual compensation will be based on job level, geographic location (current or future), experience, and other job-related factors. Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided based on qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation. Additional Information: The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
RN Telehealth
BestMed

Triage RN (Remote)

BestMed Dallas, 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 an uninhibited driver’s license to accommodate travel to off -site meetings and workgroup sessions. Community Care Partners is an Equal Opportunity Employer (EEO). #LPN