RN Telehealth Full-time
Sanford Health

Remote RN - Internal Medicine (must reside within 60 miles)

Sanford Health Bismarck, ND
$29.50 - $44.50 / hour
Careers With Purpose Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America’s heartland. Facility: 5th Broadway Clinic Location: Bismarck, ND Address: 515 E Broadway Ave, Bismarck, ND 58501, USA Shift: 8 Hours - Day Shifts Job Schedule: Full time Weekly Hours: 40.00 Salary Range: $29.50 - $44.50 Pay Info: $20,000 Sign on Bonus Department Details Our Internal Medicine team provides comprehensive, patient-centered care for adults, focusing on the prevention, diagnosis, and management of acute and chronic conditions. As a Nurse in our clinic, you will play a key role in supporting providers and ensuring a positive patient experience. Daily tasks include coordinating care across specialty and primary care teams and maintaining accurate documentation and follow clinical protocols and quality standards. This role is the best of both worlds having face to face collaboration and local flexibility to be fully remote after a 6 month in-clinic orientation. ✅Must reside within 60 miles of Bismarck, ND ✅ Monday - Friday 8:00a-5:00pm ✅$20,000 Sign on bonus ✅Experience is credit to wage range Great opportunity for those looking to advance and create efficient workflow for staff and patients. Come join a great team in a fast paced environment! Job Summary The Registered Nurse (RN) is responsible for utilizing the nursing process (assessment, diagnosis, outcomes/planning, implementation and evaluation) to provide individualized nursing care to patients. Responsible for the coordination of care, patient assessment, patient education, triage, and various other nursing interventions. Collaborates with other inter-professional colleagues, including physicians, to plan, implement and evaluate care. Demonstrates competency and practices within the full scope of nursing expertise/knowledge and utilizes appropriate age and population specific standards as designated in their assigned clinical setting. Functions within the scopes and standards of nursing practice as outlined in the Nurse Practice Act and Administrative Rules in state of practice and licensure. The Sanford Professional Nursing Practice recognizes the Scope and Standards of Practice and the Code of Ethics for Nurses with Interpretive Statements as published by the American Nurses Association as the foundation of nursing care delivery and professional conduct. Qualifications Graduate from an accredited nursing program preferred, including, but not limited to, American Association of Colleges of Nursing (AACN), Accreditation Commission for Education in Nursing (ACEN), and National League for Nursing Commission for Nursing Education Accreditation (NLN CNEA). Bachelor’s Degree in nursing preferred. Currently holds an unencumbered RN license with the State Board of Nursing where the practice of nursing is occurring and/or possess multistate licensure if in a Nurse Licensure Compact (NLC) state. Obtains and subsequently maintains required department specific licensure, competencies and certifications. Benefits Sanford offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance. For more information about Total Rewards, visit https://sanfordcareers.com/benefits . Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to talent@sanfordhealth.org . Sanford has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment. Req Number: R-0266008 Job Function: Nursing Featured: No
RN Telehealth Full-time
Southeast Georgia Health System

On-Site Virtual Registered Nurse, Full Time, Brunswick

Southeast Georgia Health System Brunswick, GA
Interested in working for the Golden Isles’ healthcare provider and employer of choice? Throughout the many locations that make up the Southeast Georgia Health System network, there is a common thread that pulls everything together: A team of committed professionals like you. These individuals appreciate the value of every person who walks through our doors and are the key to our culture of Service Excellence. As a Registered Nurse, you will provide compassionate care at the bedside of our patients every day. You will develop and maintain positive relationships with our patients, guests, other team members, and medical staff by striving for excellence in service and quality. For our team members, this is more than a career — it’s a calling. You will be responsible for: * Conducting virtual assessments, triage, and follow-up visits via video, phone, or secure messaging. * Monitoring patient status using hospital telehealth systems and escalate concerns to bedside staff & providers. * Conducting virtual patient assessments, focusing on pain management, mobility, and discharge readiness. * Providing evidence-based nursing interventions virtually / remotely. *Assisting with medication reconciliation, admission & discharge planning, and chronic disease management. * Documenting all patient interactions in the electronic health record (EHR) in compliance with hospital standards. * Providing real-time consultation to staff for clinical decision-making. * Supporting rapid response teams virtually by reviewing patient data and escalating concerns. * Partnering with physicians, bedside nurses, and allied health professionals to coordinate patient care. * Supports transitions of care between inpatient, outpatient, and community settings. * Educating patients and families on treatment plans, medication adherence, and lifestyle modifications. * Advocating for patients need to ensure equitable access to virtual care services. What you will need: * ASN Required, Bachelor of Science in Nursing (preferred) * Current RN License to Practice in the State of Georgia * Minimum 3 years of RN experience in an acute care hospital. Critical care cardiac experience (preferred) CAVRN within one year of hire or 1000 hours VC Why choose Southeast Georgia Health System? • We are mission-focused to provide safe, quality, accessible, and cost-effective care to meet the health needs of the people and communities it serves • Our workplace is as pleasant and rewarding as the setting we enjoy outside of work -- imagine stepping out of your workspace and into a world of scenic beauty, outdoor recreational activities, mild winters, natural beaches, fine dining, and a full array of cultural and colonial historic attractions • The chance to work within a culture that is collegial yet professional, has exceptional career-advancement potential, and work/life balance that is practically unparalleled • Our facility will allow you to use, sharpen, and add to your skills without having to commute to a large city environment • We offer competitive salaries and a comprehensive benefits package which includes generous Paid Time Off, tuition reimbursement, and wellness programs. • The ability to be a part of the prestigious Coastal Community Health, a regional affiliation between Baptist Health and Southeast Georgia Health System. This collaboration forms a highly-integrated hospital network focused on significant initiatives designed to enhance the quality and value of care provided to our contiguous communities. adherence, and lifestyle modifications.
RN Telehealth
Virginia Garcia Memorial Health Center

Registered Nurse - Call Center Advice RN

Virginia Garcia Memorial Health Center Hillsboro, OR
At Virginia Garcia Memorial Health Center, we honor all members of our community and acknowledge the dignity of each person we serve. Our purpose is to provide high-quality, comprehensive primary health care to the communities of Washington and Yamhill counties with a special emphasis on migrant and seasonal farm workers and a view to removing barriers to health care. We strive to provide an environment that welcomes and values the people we employ and serve. If you are unsure whether you meet all the required qualifications for this role but are interested and passionate about this potential position, we encourage you to apply. Job Summary: The Call Center Advice Nurse (CCAN) provides clinical advice and support over the phone to patients calling our call center. The CCAN utilizes their clinical background and critical thinking skills to assess symptoms, offer guidance on self-care, and determine the appropriate level of care needed, potentially referring them to other healthcare professionals or facilities like the Emergency Department (ED). This role works collaboratively with the Call Center, but practices independently to assist patients and uses evidence-based telephone triage nursing protocols and their nursing experience and judgment to provide guidance on a wide range of care concerns. Position allows for a hybrid schedule of four (4) ten-hour days per week with remote work up to three (3) days per week, negotiated based on performance and successful completion of the 150-day probationary period and orientation. Remote work is expected during interruptions to clinic services due to inclement weather or other emergencies. Hybrid or remote work requires adequate Wi-Fi and private space to care for patients and properly store any confidential materials. Laptop and peripheral equipment will be provided. Essential Duties and Responsibilities: • Provide triage assessment over the phone utilizing the nursing process, making both independent and collaborative decisions to advise patients. • Utilize telephone interpretation services to meet the needs of patients where appropriate. • Provide high-quality customer service and a clinically appropriate and timely experience for patients calling the VGMHC Call Center. • Coordinate care services for follow-up with the Emergency Department (ED) and internal and external departments/clinics based on patient needs. • Perform patient education, including explaining to the patient the triage disposition, treatment plan (including use of medications and their effects and side effects if appropriate), infection control (if indicated), and preventative techniques to lower the risk of future disease or accident. • Offer patients guidance on self-care, medication management, and preventative measures based on clinical protocols. • Identify care gaps and problem-solve with patients to schedule appropriate appointments with their care team. • Update on-call providers as needed on the changing needs of complex, high-risk patients. • Document all interactions with patients and others involved in the care of the patient, accurately, timely, and efficiently in the Electronic Health Record (EHR). • Communicate problems or concerns immediately to the supervisor to prevent delayed or inappropriate care decisions. • Maintain up-to-date knowledge and skills in professional, clinical, and system VGMHC areas. • Perform other duties as assigned. • Handle protected health information (PHI) in a manner consistent with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) HIPAA Requirements: The CCAN will use PHI to answer patient questions about their medical problems or plan of care, to triage and schedule appointments for urgent medical problems, to relay information from the health care providers to the patient. Applying the minimum necessary rules of HIPAA, the designated record sets to which this employee will have access include scheduling, demographics, and view only patient account information in the practice management system, and the complete medical record, including confidential sections. Knowledge, Skills and Abilities Required: • Relevant nursing experience that utilizes the nursing process and assessment skills, in person or over the phone. • Strong ability to accurately elicit information, determine existing health problems and evaluate current symptoms without the advantage of a physical patient assessment required. • Strong critical thinking skills and clinical judgment. Flexible and adaptable to daily needs. • Proficiency in English, written and spoken language required. Proficiency in Spanish (or another 2nd language on the VG language list) preferred. The person hired for this role will need to pass a language proficiency test to qualify for a bilingual pay differential. • Commitment to providing quality health care to all. • Demonstrated commitment to working with patients and staff from a wide range of ethnic, economic, cultural, and social backgrounds. Education and Experience Required: • Current Oregon RN License • Two (2) years’ minimum experience with telephone or in-person nurse triage required, 3-5 years of experience preferred. Physical Requirements: Percentage of time spent • Standing: 5% • Walking: 5% • Sitting: 90% • Lifting/Carrying: 0% Equipment Used: • Office Equipment o Computer o Telephone, fax, copier, scanner • Medical equipment - The medical equipment listed provides examples of the clinical data you will be reviewing and analyzing in your role. You may not be expected to physically operate this equipment on a regular basis. o Pulse oximeter o O2 tank o Blood pressure equipment o Glucometer o EKG o Fetal monitor o Other emergency equipment as ordered • Electronic Software o Electronic Health Record EHR (Epic OCHIN) o ClearTriage Other Equipment and Requirements (for remote work): • Computer or laptop (provided by VGMHC IT) • Telephone (May be provided by VGMHC IT or calls can be routed through the laptop) • High-speed wired Internet service • Private home office Immunization: Staff members must meet immunization requirements as stated in VGMHC’s immunization policy and state and federal guidelines. Job descriptions represent a general outline of the essential and major job duties, functions and qualifications required. They cannot be all-inclusive and comprehensive due to the dynamic nature of work performed to accomplish VGMHC’s Mission. VGMHC is an Equal Opportunity Employer. No person is unlawfully excluded from consideration for employment because of race, color, religious creed, national origin, ancestry, sex, age, veteran status, marital status, or physical challenges. The policy applies not only to recruitment and hiring practices, but also includes fairness in placement, promotion, transfer, rate of pay, and termination.
RN Telehealth Full-time
Acentra Health

Clinical Care Coordinator - RN (Remote within Florida) Template FL UM/CM

Acentra Health
$36.72 / hour
Company Overview: Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the company’s mission, actively engage in problem-solving, and take ownership of your work daily. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. Job Summary and Responsibilities: Acentra is looking for a Clinical Care Coordinator RN (Remote within Florida) to join our growing team. Job Summary As a Clinical Care Coordinator RN, you will play a pivotal role in ensuring seamless care coordination and advocacy for patients enrolled in the care management program. In this role, you will act as a trusted patient advocate, facilitating immediate communication between patients and providers to ensure timely access to necessary care and resources. Leveraging your clinical expertise, you will conduct comprehensive medical record reviews, applying appropriate criteria in alignment with contract requirements. Utilizing critical thinking and sound decision-making, you will assess medical necessity while maintaining productivity goals and quality assurance standards. Additionally, you will ensure compliance with NCQA, URAC, and other regulatory guidelines, contributing to the highest standards of patient care. ** To qualify for this role, you must reside and work remotely from the state of Florida ** ** Work Schedule: Monday through Friday, 8:00 AM – 5:00 PM Eastern ** ** Occasional travel (up to 5% annually) within the State of Florida may be required ** ** Access to a dedicated, private, and secure workspace at home, free from distractions, to ensure productivity and confidentiality. ** ** Access to reliable, high-speed internet service. ** Responsibilities Ensure the responsible and comprehensive delivery of services to enrollees, supporting high-quality patient care. Conduct initial assessments for supervisor/lead evaluation to determine appropriate case manager or health coach assignments. Actively participate in interdisciplinary team meetings, collaborating on assessments and care coordination to ensure optimal patient outcomes. Proactively contribute to quality management program activities, supporting the Health Services team in delivering high-performance outcomes. Assist in achieving and maintaining accreditations for designated programs by ensuring compliance with regulatory standards. Provide education, guidance, and resources to beneficiaries, families, and providers to promote informed healthcare decisions. Review and interpret patient records, applying established criteria to assess medical necessity and appropriateness of care. Determine approval or escalate cases to a physician consultant when necessary, ensuring all decisions—including denials—are clearly documented with sufficient rationale. Accurately abstract and document case data and medical information using appropriate review tools in a timely manner. Ensure the accurate and timely submission of all administrative and review-related documentation to the appropriate parties. Conduct ongoing reassessments of the review process, identifying opportunities for improvement and implementing necessary changes. Build and maintain positive, professional relationships with internal and external stakeholders to facilitate effective care coordination. Stay up to date by attending training sessions and scheduled meetings, applying the latest policies and procedures in clinical reviews. Maintain strict confidentiality of medical records by adhering to HIPAA regulations, using secure systems, and safeguarding sensitive information. Utilize professional communication—both verbal and written—following Acentra Health's policies, procedures, and guidelines. Actively cross-train to support other contracts within the Acentra Health network, ensuring a flexible workforce that adapts to client and consumer needs. The list of responsibilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary. Qualifications: Required Qualifications/Experience: Must have an active, unrestricted Registered Nurse (RN) Florida state license and/or Compact State Clinical license. 2+ years of pediatric experience, demonstrating expertise in pediatric care. Graduate of an accredited Associate, Bachelor’s, Master’s degree program or a Diploma in Nursing. Valid driver’s license with a clean Motor Vehicle Record (MVR) and reliable transportation for up to 5% annual travel within the state of Florida. Strong clinical assessment and critical thinking skills, enabling effective patient evaluation and care coordination. This role requires fingerprinting for the state of Florida. Preferred Qualifications/Experience: Proficiency in computer systems, including care management applications, internet-based tools, and Microsoft Office (Word, Excel). Experience in medical record abstracting, ensuring accurate and efficient data retrieval. Knowledge and familiarity with public sector health coverage systems (e.g., Medicare/Medicaid). Knowledge of current Utilization Review Accreditation Commission (URAC) standards and compliance requirements. Knowledge of National Committee for Quality Assurance (NCQA) standards and best practices. Excellent verbal and written communication skills, ensuring clear, professional interactions with patients, providers, and stakeholders. Comprehensive understanding of care management principles, ethics, and service delivery standards. Solid prioritization and organizational abilities, managing workload efficiently while maintaining high-quality standards. Knowledge of customer service principles, ensuring a patient-centered approach to care. Proficient telephonic interviewing skills, enabling effective assessments and engagement. Ability to accept and apply feedback professionally, continuously improving performance and productivity. Familiarity with medical record organization, medical terminology, and disease processes, ensuring accuracy in case review and documentation. #LI-SD1 Why us? We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes. We do this through our people. You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career. Thank You! We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search! ~ The Acentra Health Talent Acquisition Team Benefits Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more. Visit us at Acentra Health EEO AA M/F/Vet/Disability Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law. Experience in Lieu of Degree For non-clinical roles, or when not required by the contract specifically, the Company acknowledges that practical, hands-on experience can provide skills and competencies equivalent to formal education. As such, in cases where a Bachelor's degree may be required, the Company will accept a minimum of six (6) years of directly relevant professional experience in lieu of a degree. In instances where the candidate has an Associate's degree, the Company will accept a minimum of three (3) years of directly relevant professional experience in lieu of the Bachelor's degree. Compensation The pay range for this position is listed below. “Based on our compensation philosophy, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.” Pay Range: Up to USD $36.72/Hr.
RN Telehealth Full-time
Oak Street Health

Registered Nurse-Bilingual Spanish Preferred

Oak Street Health Rockford, IL
$60,522 - $129,615 / year
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Registered Nurse Company: Oak Street Health Role Description: The purpose of a Registered Nurse at Oak Street Health is to build strong relationships with Oak Street Health patients by coordinating their care and providing a seamless experience to patients and their support team. At Oak Street Health you will use an integrated approach toward achieving desired patient outcomes by utilizing standards, guidelines and pathways for care delivery. Through clinical assessment, intervention and education you will ensure our patients are provided competent nursing care in a timely manner. Our Registered Nurses drive quality care, it is of vital importance that our nurses incorporate data and information to improve care and enhance our patient outcomes. You will work to create an engaging and welcoming environment through team communication and delegation to empower other members of the care team to deliver the best care to our patients. Our Registered Nurses report to the Practice Manager or Nurse Supervisor (where applicable). Core Responsibilities: Provide competent nursing care by displaying proficiency in this role and executing job responsibilities in a safe and consistent manner Respond to incoming telephonic requests in a dependable manner, ensuring we are responsive to their needs and exceeding expectations Provide clinically competent triage and symptom management to patients who may or may not be physically present Utilize standardized protocols for medication management, prescription refills and prior authorizations. Conduct thorough and accurate reviews of patient medications and update as needed Provide comprehensive education and direct patient care, particularly around chronic conditions; may occur in person, over the phone or in group settings Actively collaborate and monitor the implementation and progress of the care plan for patients on multiple provider panels Form relationships with patients and their caregivers to support preventative care and ED/hospital diversion where appropriate Create a welcoming and engaging environment to meet the needs of our patients, communities, families and teams where they are Delegation of activities to other clinical care team members to support the needs of our patients Participate in care team meetings to discuss patient care and clinic operations Deliver an exceptional patient experience through service, responsiveness and respectful care Perform point of care testing, procedures and specimen collection (including phlebotomy) as needed Performs other related duties as assigned What we're looking for Required Qualifications: Active Registered Nurse (RN) Licensure in good standing with the applicable state BLS Certification Electronic Medical Record (EMR) experience Ability to maintain patient confidentiality and process information in a confidential manner US work authorization Ability to assess patients without face-to face interaction, strong communication and assessment skill Strongly Preferred Qualifications: Ability to collaborate and communicate with members of an interdisciplinary care team Excellent computer skills with ability to read, interpret and analyze data from various computer systems Effective problem solving and prioritization skills 2+ years of healthcare experience, working as an RN Preferred Qualifications: Previous experience in clinic setting Ability to work independently Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $60,522.00 - $129,615.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 10/23/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.
RN Telehealth Full-time
Oak Street Health

Registered Nurse

Oak Street Health Chamberlayne, VA
$60,522 - $129,615 / year
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Registered Nurse Company: Oak Street Health Role Description: The purpose of a Registered Nurse at Oak Street Health is to build strong relationships with Oak Street Health patients by coordinating their care and providing a seamless experience to patients and their support team. At Oak Street Health you will use an integrated approach toward achieving desired patient outcomes by utilizing standards, guidelines and pathways for care delivery. Through clinical assessment, intervention and education you will ensure our patients are provided competent nursing care in a timely manner. Our Registered Nurses drive quality care, it is of vital importance that our nurses incorporate data and information to improve care and enhance our patient outcomes. You will work to create an engaging and welcoming environment through team communication and delegation to empower other members of the care team to deliver the best care to our patients. Our Registered Nurses report to the Practice Manager or Nurse Supervisor (where applicable). Core Responsibilities: Provide competent nursing care by displaying proficiency in this role and executing job responsibilities in a safe and consistent manner Respond to incoming telephonic requests in a dependable manner, ensuring we are responsive to their needs and exceeding expectations Provide clinically competent triage and symptom management to patients who may or may not be physically present Utilize standardized protocols for medication management, prescription refills and prior authorizations. Conduct thorough and accurate reviews of patient medications and update as needed Provide comprehensive education and direct patient care, particularly around chronic conditions; may occur in person, over the phone or in group settings Actively collaborate and monitor the implementation and progress of the care plan for patients on multiple provider panels Form relationships with patients and their caregivers to support preventative care and ED/hospital diversion where appropriate Create a welcoming and engaging environment to meet the needs of our patients, communities, families and teams where they are Delegation of activities to other clinical care team members to support the needs of our patients Participate in care team meetings to discuss patient care and clinic operations Deliver an exceptional patient experience through service, responsiveness and respectful care Perform point of care testing, procedures and specimen collection (including phlebotomy) as needed Performs other related duties as assigned What we're looking for Required Qualifications: Active Registered Nurse (RN) Licensure in good standing with the applicable state BLS Certification Electronic Medical Record (EMR) experience Ability to maintain patient confidentiality and process information in a confidential manner US work authorization Ability to assess patients without face-to face interaction, strong communication and assessment skill Strongly Preferred Qualifications: Ability to collaborate and communicate with members of an interdisciplinary care team Excellent computer skills with ability to read, interpret and analyze data from various computer systems Effective problem solving and prioritization skills 2+ years of healthcare experience, working as an RN Preferred Qualifications: Previous experience in clinic setting Ability to work independently Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $60,522.00 - $129,615.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 12/17/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.
RN Telehealth Full-time
Oak Street Health

Registered Nurse

Oak Street Health Independence, MO
$60,522 - $129,615 / year
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Registered Nurse Company: Oak Street Health Role Description: The purpose of a Registered Nurse at Oak Street Health is to build strong relationships with Oak Street Health patients by coordinating their care and providing a seamless experience to patients and their support team. At Oak Street Health you will use an integrated approach toward achieving desired patient outcomes by utilizing standards, guidelines and pathways for care delivery. Through clinical assessment, intervention and education you will ensure our patients are provided competent nursing care in a timely manner. Our Registered Nurses drive quality care, it is of vital importance that our nurses incorporate data and information to improve care and enhance our patient outcomes. You will work to create an engaging and welcoming environment through team communication and delegation to empower other members of the care team to deliver the best care to our patients. Our Registered Nurses report to the Practice Manager or Nurse Supervisor (where applicable). Core Responsibilities: Provide competent nursing care by displaying proficiency in this role and executing job responsibilities in a safe and consistent manner Respond to incoming telephonic requests in a dependable manner, ensuring we are responsive to their needs and exceeding expectations Provide clinically competent triage and symptom management to patients who may or may not be physically present Utilize standardized protocols for medication management, prescription refills and prior authorizations. Conduct thorough and accurate reviews of patient medications and update as needed Provide comprehensive education and direct patient care, particularly around chronic conditions; may occur in person, over the phone or in group settings Actively collaborate and monitor the implementation and progress of the care plan for patients on multiple provider panels Form relationships with patients and their caregivers to support preventative care and ED/hospital diversion where appropriate Create a welcoming and engaging environment to meet the needs of our patients, communities, families and teams where they are Delegation of activities to other clinical care team members to support the needs of our patients Participate in care team meetings to discuss patient care and clinic operations Deliver an exceptional patient experience through service, responsiveness and respectful care Perform point of care testing, procedures and specimen collection (including phlebotomy) as needed Performs other related duties as assigned What we're looking for Required Qualifications: Active Registered Nurse (RN) Licensure in good standing with the applicable state BLS Certification Electronic Medical Record (EMR) experience Ability to maintain patient confidentiality and process information in a confidential manner US work authorization Ability to assess patients without face-to face interaction, strong communication and assessment skill Strongly Preferred Qualifications: Ability to collaborate and communicate with members of an interdisciplinary care team Excellent computer skills with ability to read, interpret and analyze data from various computer systems Effective problem solving and prioritization skills 2+ years of healthcare experience, working as an RN Preferred Qualifications: Previous experience in clinic setting Ability to work independently Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $60,522.00 - $129,615.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments . We anticipate the application window for this opening will close on: 12/15/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
RN Telehealth Full-time
Oak Street Health

Registered Nurse

Oak Street Health Truman, MN
$60,522 - $129,615 / year
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Registered Nurse Company: Oak Street Health Role Description: The purpose of a Registered Nurse at Oak Street Health is to build strong relationships with Oak Street Health patients by coordinating their care and providing a seamless experience to patients and their support team. At Oak Street Health you will use an integrated approach toward achieving desired patient outcomes by utilizing standards, guidelines and pathways for care delivery. Through clinical assessment, intervention and education you will ensure our patients are provided competent nursing care in a timely manner. Our Registered Nurses drive quality care, it is of vital importance that our nurses incorporate data and information to improve care and enhance our patient outcomes. You will work to create an engaging and welcoming environment through team communication and delegation to empower other members of the care team to deliver the best care to our patients. Our Registered Nurses report to the Practice Manager or Nurse Supervisor (where applicable). Core Responsibilities: Provide competent nursing care by displaying proficiency in this role and executing job responsibilities in a safe and consistent manner Respond to incoming telephonic requests in a dependable manner, ensuring we are responsive to their needs and exceeding expectations Provide clinically competent triage and symptom management to patients who may or may not be physically present Utilize standardized protocols for medication management, prescription refills and prior authorizations. Conduct thorough and accurate reviews of patient medications and update as needed Provide comprehensive education and direct patient care, particularly around chronic conditions; may occur in person, over the phone or in group settings Actively collaborate and monitor the implementation and progress of the care plan for patients on multiple provider panels Form relationships with patients and their caregivers to support preventative care and ED/hospital diversion where appropriate Create a welcoming and engaging environment to meet the needs of our patients, communities, families and teams where they are Delegation of activities to other clinical care team members to support the needs of our patients Participate in care team meetings to discuss patient care and clinic operations Deliver an exceptional patient experience through service, responsiveness and respectful care Perform point of care testing, procedures and specimen collection (including phlebotomy) as needed Performs other related duties as assigned What we're looking for Required Qualifications: Active Registered Nurse (RN) Licensure in good standing with the applicable state BLS Certification Electronic Medical Record (EMR) experience Ability to maintain patient confidentiality and process information in a confidential manner US work authorization Ability to assess patients without face-to face interaction, strong communication and assessment skill Strongly Preferred Qualifications: Ability to collaborate and communicate with members of an interdisciplinary care team Excellent computer skills with ability to read, interpret and analyze data from various computer systems Effective problem solving and prioritization skills 2+ years of healthcare experience, working as an RN Preferred Qualifications: Previous experience in clinic setting Ability to work independently Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $60,522.00 - $129,615.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 12/15/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.
RN Telehealth Full-time
Acentra Health

Case Manager RN

Acentra Health OR
$67,300 - $93,050 / year
Company Overview: Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. Job Summary and Responsibilities: Acentra seeks a Case Manager RN to join our growing team. Job Summary: The Case Manager RN will contribute to enhancing the company’s success through personalized care planning, ensuring optimal outcomes and compliance with payer standards. Their collaboration with healthcare team members strengthens the overall effectiveness of care delivery, while their expertise in coordinating diverse beneficiary needs reflects the company's commitment to overall well-being. **This is a remote position within the State of Oregon. Key Responsibilities: Provide care coordination/care management for beneficiaries, ensuring a high level of clinical knowledge and performance by the clinical team Foster a caring philosophy in leadership and all aspects of the care management process Manage the care of beneficiaries through the healthcare system based on their individual needs for social, physical, vision, dental, behavioral, pharmacy, and preventative health services Use independent judgment and discretion to address and proactively resolve barriers impeding diagnostic, social or treatment progress Interact and collaborate with a multidisciplinary care team, including physicians, nurses, case managers, OHA staff, and social workers/educators to ensure as well as participate in IDT meetings beneficiary needs and preferences for health services/information are shared Educate beneficiaries about community resources/options and advocate on behalf of the beneficiary Complete health and social assessments for the purposes of care planning using motivational interviewing, trauma informed care and equity principles for all engagements Establish a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality outcomes Maintain operational requirements for caseload management, securing PHI, working from a plan of care, documentation standards, and other program standards Maintain strict standards for client confidentiality and client-related information Comply with all organizational, state, and federal regulations and policies on confidentiality Prepare documentation, status updates, event notifications, and other documentation regarding beneficiaries in accordance with regulatory requirements and company policies and procedures Monitor case load to ensure all required documentation, plan of care, and entry of assessment results into a web-based database are completed accurately and promptly Pursue ongoing education, certification, and self-development to remain current with case management standards Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules Other duties as assigned Qualifications: Required Qualifications/Experience: Current, active and unrestricted Oregon Registered Nursing license Associate's degree in nursing or bachelor's degree from an accredited college or university 2+ years clinical experience 1+ years case management or home care experience Must reside in Oregon Preferred Qualifications/Experience: Certified Case Manager (CCM) Ability to multi-task and prioritize with variable and sometimes conflicting deadlines Superior attention to detail Demonstrated ability in decision-making Demonstrated initiative and judgment in performance of job responsibilities Maintain professionalism, flexibility and dependability under pressure Strong communication (written/verbal), interpersonal, organizational, time management and communication skills Exceptional customer service skills Ability to foster relationships with internal/external customers and facilitating meetings Ability to work independently and as part of a team Ability to research/identify and apply appropriate standards of care Interest in continuous learning and a commitment to staying informed on regulatory changes Why us? We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes. We do this through our people. You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career. Benefits Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more. Thank You! We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search! ~ The Acentra Health Talent Acquisition Team Visit us at https://careers.acentra.com/jobs EEO AA M/F/Vet/Disability Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law. Experience in Lieu of Degree For non-clinical roles, or when not required by the contract specifically, the Company acknowledges that practical, hands-on experience can provide skills and competencies equivalent to formal education. As such, in cases where a Bachelor's degree may be required, the Company will accept a minimum of six (6) years of directly relevant professional experience in lieu of a degree. In instances where the candidate has an Associate's degree, the Company will accept a minimum of three (3) years of directly relevant professional experience in lieu of the Bachelor's degree. Compensation The pay for this position is listed below. "Based on our compensation philosophy, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level." Pay Range: USD $67,300.00 - USD $93,050.00 /Yr.
RN Telehealth Full-time
VNS Health

Clinical Specialist, RN - Contact Center

VNS Health New York, NY
$85,000 - $106,300 / year
Overview Triages incoming calls from patients and/care givers, assesses needs, gives appropriate clinical recommendations, and guides patient to appropriate level of care or resources. Communicates and coordinates care of patient when regional centers are closed. Works under general direction. Split shift Tuesday - Friday 6AM-9AM, 4PM-9PM and every Saturday 9AM - 5PM. What We Provide Referral bonus opportunities Generous paid time off (PTO), starting at 3 0 days of paid time off and 9 company holidays Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability Employer-matched retirement saving funds Personal and financial wellness programs Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care Generous tuition reimbursement for qualifying degrees Opportunities for professional growth and career advancement Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities. What You Will Do Collects and compiles necessary medical and social information and utilizes clinical expertise, VNS Health policy and procedure and approved guidelines to assess the physical, social, and psychological needs of patients calling the Contact Center after-hours. Utilizes assessment data, clinical expertise, VNS Health policy and procedures and approved guidelines to provide appropriate care advice and direct caller to appropriate disposition during telephone encounter. Refers inquiries to an appropriate resource or level of care. Utilizes an automated set of clinical protocols, which guides the telephone interaction through a highly focused assessment and prompt disposition of the caller’s problem. Enters telephone encounter into the computer system at time of call, including details of the situation, and outcome. Documents all inquiries for medical and statistical purposes and follows up with appropriate region and/or program to ensure individual patient situations requiring supervisory attention are met. Coordinates after hours care of patients by contacting field staff, MD’s, patients, family members, contacts and/or vendors to ensure continuity of care after hours. Provides report on significant events, plan of care changes and other patient/caregiver issues requiring further action and/or follow-up to respective team. Supports field staff after-hours; consults and collaborates with clinical management to resolve complex issues with clinical information received. Assists with orientating new nurses to the Contact Center RN role and responsibilities Keeps abreast of new nursing trends and assumes responsibility for professional growth; maintains high levels of clinical knowledge and skills. Participates in on call coverage as needed to ensure department operational needs are met. Participates in special projects and performs other duties as assigned. Qualifications Licenses and Certifications: License and current registration to practice as a Registered Professional Nurse in New York State required For Hospice only: Hospice and Palliative Nurses Association (HPNA) certified preferred Education: Associate's Degree in nursing required Bachelor's Degree in nursing preferred Work Experience: Minimum of two years of experience in Home Care, Ambulatory Care, Emergency Room, Acute Care Telephone Triage and/or Management required Clinical competence in nursing required Ability to multitask in a fast-paced setting required Demonstrated ability to listen attentively, evaluate calls, and use judgment in a time sensitive environment required Effective oral/written communication, analytical, interpersonal and leadership skills required Proficient in the use of a personal computer preferably Microsoft Windows preferred Pay Range USD $85,000.00 - USD $106,300.00 /Yr. About Us VNS Health has been committed to meeting the needs of New Yorkers for over 130 years. We’re one of the largest nonprofit home- and community-based health care organizations in the country, and today, more than 11,500 team members work together to make a difference in the lives of more than 99,000 patients and members on any given day.
RN Telehealth Full-time
Pacific Health Group

Registered Nurse - Clinical Case Consultant - ECM

Pacific Health Group San Joaquin, CA
$85,000 - $95,000 / year
Department: Enhanced Care Management (ECM) Reports To: ECM Program Manager Classification: Exempt Work Arrangement: Hybrid – Hiring County Compensation: $85,000.00 - $95,000.00 annually Schedule: Monday – Friday | Full-Time About Pacific Health Group At Pacific Health Group, we are transforming healthcare by addressing social determinants of health and delivering innovative, community-based solutions that improve lives. Through programs such as Enhanced Care Management (ECM), Community Supports, Behavioral Health Services, Community Health Workers, Street Medicine, and other whole-person care initiatives, we help individuals navigate complex healthcare systems and access the resources they need to thrive. We meet individuals where they are—with compassion, dignity, respect, and a commitment to whole-person care. Our work focuses on improving outcomes for individuals experiencing homelessness, serious mental illness, substance use disorders, chronic health conditions, justice involvement, and other complex social and medical challenges. If you are passionate about improving healthcare outcomes and supporting vulnerable populations through innovative community-based care, we invite you to join our team. Our Core Values Speak with integrity—clear, respectful, and honest in every interaction. Embrace innovation by trying new ideas, learning quickly, and continuously improving. Own our roles by remaining accountable for outcomes and documentation. Build genuine connections through empathy, compassion, and cultural humility. Lead with trust through consistency, transparency, and follow-through. Celebrate wins together and recognize team achievements. Collaborate with purpose across departments, providers, and community partners. Ask for support and offer support because thriving together strengthens our ability to serve our members. Position Summary The Registered Nurse – Clinical Case Consultant serves as the clinical subject matter expert for Pacific Health Group's CalAIM Enhanced Care Management (ECM) program. This position provides clinical guidance, consultation, oversight, and support to interdisciplinary care teams serving high-risk Medi-Cal members with complex medical, behavioral health, and social needs. The Clinical Case Consultant works closely with Lead Care Managers, Community Health Workers, Licensed Vocational Nurses, Behavioral Health staff, healthcare providers, health plans, hospitals, and community-based organizations to ensure members receive coordinated, high-quality, person-centered care. This role combines clinical expertise, care coordination, quality improvement, staff development, field-based oversight, and community collaboration to improve health outcomes, reduce avoidable utilization, and support compliance with CalAIM ECM requirements and best practices. This position serves as the clinical leader for field-based care management activities, providing direct supervision and clinical oversight of Licensed Vocational Nurses (LVNs), conducting field visits and ride-alongs with Lead Care Managers (LCMs), Community Health Workers (CHWs), and other care team members, and ensuring the delivery of safe, high-quality, member-centered services throughout hiring county. Essential Duties and ResponsibilitiesClinical Leadership & Consultation Serve as the primary clinical resource for ECM care teams. Provide clinical consultation and guidance to Lead Care Managers, Community Health Workers, Licensed Vocational Nurses, and interdisciplinary team members. Review complex member cases and provide recommendations regarding care planning, interventions, risk mitigation, and treatment coordination. Participate in interdisciplinary case reviews, case conferences, and care team meetings. Assist care teams in identifying clinical risks and developing appropriate intervention strategies. Support development of individualized, member-centered care plans that align with CalAIM ECM requirements and member goals. Promote evidence-based practices and whole-person care approaches. Assist leadership with clinical decision-making and complex case management strategies. Enhanced Care Management (ECM) Support Support implementation and ongoing success of CalAIM Enhanced Care Management services. Ensure clinical interventions align with ECM program requirements, contractual obligations, and best practices. Collaborate with health plans, providers, hospitals, behavioral health agencies, and community-based organizations to coordinate care and improve outcomes. Assist care teams in navigating complex healthcare systems and addressing barriers to care. Support care transitions following hospitalizations, emergency department visits, skilled nursing facility discharges, and other significant healthcare events. Monitor high-risk members and provide recommendations to prevent avoidable utilization and adverse outcomes. Field-Based Clinical Support & Quality Oversight Conduct regular field visits with Lead Care Managers (LCMs), Community Health Workers (CHWs), Licensed Vocational Nurses (LVNs), and other care team members to observe service delivery and provide clinical guidance. Shadow care team members during member visits to assess care coordination effectiveness, member engagement, documentation practices, safety considerations, and adherence to program standards. Provide real-time coaching, mentorship, and clinical consultation during field-based activities. Evaluate field operations and identify opportunities to improve member outcomes, care coordination practices, workflow efficiency, and service quality. Support staff in managing complex member situations, high-risk cases, crisis intervention needs, and care transitions. Conduct quality assurance reviews of field-based activities and provide recommendations for improvement. Participate in joint member visits when clinical support, member education, care coordination, or provider collaboration is needed. Monitor field-based documentation and ensure compliance with Medi-Cal ECM requirements, organizational standards, and regulatory expectations. LVN Supervision & Clinical Oversight Provide direct clinical supervision and oversight for Licensed Vocational Nurses (LVNs) in accordance with California nursing regulations and Pacific Health Group policies. Review and monitor LVN clinical activities, documentation, assessments, care coordination efforts, and member interactions. Provide ongoing coaching, education, mentorship, and professional development to LVNs. Support competency development and clinical skill enhancement among LVN staff. Ensure delegated nursing functions are performed appropriately and within scope of practice. Collaborate with leadership regarding LVN performance, development needs, and clinical support requirements. Promote adherence to clinical standards, documentation requirements, quality measures, and regulatory expectations. Assist with performance evaluations, corrective action recommendations, and clinical competency assessments as needed. Care Coordination & Community Collaboration Collaborate with primary care providers, specialists, behavioral health providers, hospitals, managed care plans, and community organizations. Facilitate communication among interdisciplinary team members to ensure continuity of care. Assist in identifying and resolving gaps in care, treatment adherence challenges, and service coordination issues. Support linkage to healthcare services, behavioral health services, housing resources, community supports, and social service programs. Participate in field-based consultations and community meetings as needed. Documentation, Compliance & Quality Assurance Maintain accurate, timely, and compliant documentation of clinical reviews, recommendations, consultations, and member interactions. Review care team documentation for quality, completeness, and compliance with Medi-Cal and ECM standards. Ensure documentation supports audit readiness and contractual compliance. Monitor clinical quality indicators and identify opportunities for improvement. Assist leadership in preparing for audits, quality reviews, and compliance monitoring activities. Promote data integrity and accountability throughout the care management process. Training & Staff Development Develop and deliver clinical training to non-clinical staff, including Community Health Workers, Care Coordinators, and Lead Care Managers. Provide education on chronic disease management, medication safety, behavioral health conditions, symptom recognition, healthcare navigation, and clinical best practices. Mentor staff to enhance clinical understanding and confidence in supporting members with complex needs. Support onboarding and ongoing professional development initiatives. Quality Improvement & Program Development Analyze clinical and programmatic outcomes to identify trends, barriers, risks, and opportunities for improvement. Participate in quality improvement initiatives focused on member outcomes, care coordination, compliance, and operational effectiveness. Assist in developing clinical workflows, policies, procedures, and best practices. Collaborate with leadership to improve program performance and service delivery. Support organizational initiatives related to innovation, quality, and population health management. Reporting & Clinical Analytics Monitor and evaluate member outcomes, utilization trends, and care coordination effectiveness. Provide clinical insights and recommendations to leadership regarding program performance. Assist with reporting related to quality metrics, care management outcomes, and compliance indicators. Identify opportunities to improve member engagement, healthcare utilization, and clinical outcomes. Key Performance Indicators (KPIs) Success in this role may be measured through: Reduction in avoidable emergency department utilization. Reduction in hospital admissions and readmissions. Improvement in member engagement and care plan completion. Timely completion of clinical reviews and consultations. Compliance with CalAIM ECM documentation standards. Audit readiness and documentation quality. Staff training completion and clinical competency development. Successful oversight and development of LVN staff. Quality outcomes identified through field visits and shadowing activities. Improved interdisciplinary collaboration and care coordination. Positive member outcomes and stabilization metrics. Achievement of organizational quality and performance goals. Minimum Qualifications Active and unrestricted Registered Nurse (RN) license in the State of California. Minimum two (2) years of direct clinical experience in community health, managed care, acute care, post-acute care, public health, behavioral health, or substance use disorder treatment settings. Experience working with Medi-Cal populations and individuals with complex medical, behavioral health, and social needs. Experience supporting populations experiencing homelessness, justice involvement, serious mental illness (SMI), substance use disorders (SUD), or multiple chronic conditions. Experience providing clinical guidance, consultation, mentoring, or supervision to interdisciplinary care teams preferred. Strong understanding of care coordination, population health, and interdisciplinary team-based care. Excellent communication, organizational, and problem-solving skills. Ability to work independently and collaboratively in a fast-paced environment. Proficiency with electronic health records (EHRs), care management platforms, and Microsoft Office applications. Valid California Driver's License, reliable transportation, and ability to travel throughout hiring county. Preferred Qualifications Experience working within CalAIM Enhanced Care Management (ECM), Whole Person Care (WPC), Health Homes Program (HHP), or similar care management models. Case Management Certification (CCM, ACM, or equivalent). Experience supervising LVNs or other clinical support staff. Experience working with managed care plans and value-based care programs. Experience in community-based healthcare delivery. Bilingual proficiency in Spanish, Mandarin, Vietnamese, Tagalog, or other languages commonly spoken within the communities served. Experience mentoring interdisciplinary care teams. Requirements Valid California Driver's License and active auto insurance meeting CA requirements Reliable personal vehicle for daily work use Successful completion of background check (including MVR)| Must be able to travel up to 60-70% within the county to conduct in person visits Must successfully complete a Testlify skills assessment Must have a reliable working laptop for the first 21 days of employment (personal equipment stipend) until company issues laptop is received Must have effective Time Management skills Must have internet speed of - 300+ mbps download and 25+mbps upload Must be proficient in technology, including documentation systems, case management platforms, and communication tools Work Environment & Travel Requirements This is a hybrid position requiring a combination of remote work, office-based work, and extensive field-based activities. Approximately 50% of work time will involve travel throughout hiring county to conduct field visits, shadow Lead Care Managers and other care team members, provide clinical supervision and coaching, support member care coordination activities, participate in community-based meetings, collaborate with healthcare providers and community partners, and conduct quality assurance reviews. The position may require attendance at case conferences, provider meetings, health plan meetings, leadership meetings, training events, and community-based activities. Frequent local travel is required. Must be willing to work occasional evenings and weekends as needed. Compensation & Benefits Salary Range: $85,000.00 - $95,000.00 annually Compensation is commensurate with experience, licensure, certifications, qualifications, and demonstrated clinical expertise. Time Off & Leave 160 Hours of Paid Time Off (PTO) 12 Paid Holidays, including Birthday Holiday One Floating Holiday after one year of employment Four (4) Paid Volunteer Hours per Month Bereavement Leave, including Pet Bereavement Leave Health & Wellness 90% Employer-Paid Employee-Only Medical Coverage Dental and Vision Insurance Flexible Spending Account (FSA) Short-Term Disability, Long-Term Disability, and AD&D Coverage Employee Assistance Program (EAP) Financial & Professional Growth 401(k) with Company Match Monthly Stipend Professional Development Opportunities Career Advancement and Internal Growth Opportunities Culture & Employee Experience Hybrid Work Environment Quarterly In-Person Team and Company Events Employee Discount Programs through Great Work Perks and Perks at Work Mission-Driven Culture Focused on Compassion, Innovation, Accountability, Collaboration, and Growth Equal Opportunity Employer Pacific Health Group is an Equal Opportunity Employer committed to fostering an inclusive workplace where all employees are treated with dignity and respect. We celebrate diversity and are committed to creating an environment where individuals from all backgrounds can thrive. All qualified applicants will receive consideration for employment without regard to any protected characteristic protected under applicable federal, state, or local law.
RN Telehealth Full-time
Oak Street Health

Registered Nurse

Oak Street Health Eastgate, WA
$60,522 - $129,615 / year
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Registered Nurse Company: Oak Street Health Role Description: The purpose of a Registered Nurse at Oak Street Health is to build strong relationships with Oak Street Health patients by coordinating their care and providing a seamless experience to patients and their support team. At Oak Street Health you will use an integrated approach toward achieving desired patient outcomes by utilizing standards, guidelines and pathways for care delivery. Through clinical assessment, intervention and education you will ensure our patients are provided competent nursing care in a timely manner. Our Registered Nurses drive quality care, it is of vital importance that our nurses incorporate data and information to improve care and enhance our patient outcomes. You will work to create an engaging and welcoming environment through team communication and delegation to empower other members of the care team to deliver the best care to our patients. Our Registered Nurses report to the Practice Manager or Nurse Supervisor (where applicable). Core Responsibilities: Provide competent nursing care by displaying proficiency in this role and executing job responsibilities in a safe and consistent manner Respond to incoming telephonic requests in a dependable manner, ensuring we are responsive to their needs and exceeding expectations Provide clinically competent triage and symptom management to patients who may or may not be physically present Utilize standardized protocols for medication management, prescription refills and prior authorizations. Conduct thorough and accurate reviews of patient medications and update as needed Provide comprehensive education and direct patient care, particularly around chronic conditions; may occur in person, over the phone or in group settings Actively collaborate and monitor the implementation and progress of the care plan for patients on multiple provider panels Form relationships with patients and their caregivers to support preventative care and ED/hospital diversion where appropriate Create a welcoming and engaging environment to meet the needs of our patients, communities, families and teams where they are Delegation of activities to other clinical care team members to support the needs of our patients Participate in care team meetings to discuss patient care and clinic operations Deliver an exceptional patient experience through service, responsiveness and respectful care Perform point of care testing, procedures and specimen collection (including phlebotomy) as needed Performs other related duties as assigned What we're looking for Required Qualifications: Active Registered Nurse (RN) Licensure in good standing with the applicable state BLS Certification Electronic Medical Record (EMR) experience Ability to maintain patient confidentiality and process information in a confidential manner US work authorization Ability to assess patients without face-to face interaction, strong communication and assessment skill Strongly Preferred Qualifications: Ability to collaborate and communicate with members of an interdisciplinary care team Excellent computer skills with ability to read, interpret and analyze data from various computer systems Effective problem solving and prioritization skills 2+ years of healthcare experience, working as an RN Preferred Qualifications: Previous experience in clinic setting Ability to work independently Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $60,522.00 - $129,615.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 12/25/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.
RN Telehealth Full-time
Oak Street Health

Registered Nurse - Bilingual Spanish

Oak Street Health Rockford, IL
$60,522 - $129,615 / year
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Registered Nurse Company: Oak Street Health Role Description: The purpose of a Registered Nurse at Oak Street Health is to build strong relationships with Oak Street Health patients by coordinating their care and providing a seamless experience to patients and their support team. At Oak Street Health you will use an integrated approach toward achieving desired patient outcomes by utilizing standards, guidelines and pathways for care delivery. Through clinical assessment, intervention and education you will ensure our patients are provided competent nursing care in a timely manner. Our Registered Nurses drive quality care, it is of vital importance that our nurses incorporate data and information to improve care and enhance our patient outcomes. You will work to create an engaging and welcoming environment through team communication and delegation to empower other members of the care team to deliver the best care to our patients. Our Registered Nurses report to the Practice Manager or Nurse Supervisor (where applicable). Core Responsibilities: Provide competent nursing care by displaying proficiency in this role and executing job responsibilities in a safe and consistent manner Respond to incoming telephonic requests in a dependable manner, ensuring we are responsive to their needs and exceeding expectations Provide clinically competent triage and symptom management to patients who may or may not be physically present Utilize standardized protocols for medication management, prescription refills and prior authorizations. Conduct thorough and accurate reviews of patient medications and update as needed Provide comprehensive education and direct patient care, particularly around chronic conditions; may occur in person, over the phone or in group settings Actively collaborate and monitor the implementation and progress of the care plan for patients on multiple provider panels Form relationships with patients and their caregivers to support preventative care and ED/hospital diversion where appropriate Create a welcoming and engaging environment to meet the needs of our patients, communities, families and teams where they are Delegation of activities to other clinical care team members to support the needs of our patients Participate in care team meetings to discuss patient care and clinic operations Deliver an exceptional patient experience through service, responsiveness and respectful care Perform point of care testing, procedures and specimen collection (including phlebotomy) as needed Performs other related duties as assigned What we're looking for Required Qualifications: Active Registered Nurse (RN) Licensure in good standing with the applicable state BLS Certification Electronic Medical Record (EMR) experience Ability to maintain patient confidentiality and process information in a confidential manner US work authorization Ability to assess patients without face-to face interaction, strong communication and assessment skill Strongly Preferred Qualifications: Ability to collaborate and communicate with members of an interdisciplinary care team Excellent computer skills with ability to read, interpret and analyze data from various computer systems Effective problem solving and prioritization skills 2+ years of healthcare experience, working as an RN Preferred Qualifications: Previous experience in clinic setting Ability to work independently Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $60,522.00 - $129,615.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 10/09/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.
RN Telehealth Full-time
Oak Street Health

Registered Nurse-OSH

Oak Street Health Norco, CA
$60,522 - $129,615 / year
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Registered Nurse Company: Oak Street Health Role Description: The purpose of a Registered Nurse at Oak Street Health is to build strong relationships with Oak Street Health patients by coordinating their care and providing a seamless experience to patients and their support team. At Oak Street Health you will use an integrated approach toward achieving desired patient outcomes by utilizing standards, guidelines and pathways for care delivery. Through clinical assessment, intervention and education you will ensure our patients are provided competent nursing care in a timely manner. Our Registered Nurses drive quality care, it is of vital importance that our nurses incorporate data and information to improve care and enhance our patient outcomes. You will work to create an engaging and welcoming environment through team communication and delegation to empower other members of the care team to deliver the best care to our patients. Our Registered Nurses report to the Practice Manager or Nurse Supervisor (where applicable). Core Responsibilities: Provide competent nursing care by displaying proficiency in this role and executing job responsibilities in a safe and consistent manner Respond to incoming telephonic requests in a dependable manner, ensuring we are responsive to their needs and exceeding expectations Provide clinically competent triage and symptom management to patients who may or may not be physically present Utilize standardized protocols for medication management, prescription refills and prior authorizations. Conduct thorough and accurate reviews of patient medications and update as needed Provide comprehensive education and direct patient care, particularly around chronic conditions; may occur in person, over the phone or in group settings Actively collaborate and monitor the implementation and progress of the care plan for patients on multiple provider panels Form relationships with patients and their caregivers to support preventative care and ED/hospital diversion where appropriate Create a welcoming and engaging environment to meet the needs of our patients, communities, families and teams where they are Delegation of activities to other clinical care team members to support the needs of our patients Participate in care team meetings to discuss patient care and clinic operations Deliver an exceptional patient experience through service, responsiveness and respectful care Perform point of care testing, procedures and specimen collection (including phlebotomy) as needed Performs other related duties as assigned What we're looking for Required Qualifications: Active Registered Nurse (RN) Licensure in good standing with the applicable state BLS Certification Electronic Medical Record (EMR) experience Ability to maintain patient confidentiality and process information in a confidential manner US work authorization Ability to assess patients without face-to face interaction, strong communication and assessment skill Strongly Preferred Qualifications: Ability to collaborate and communicate with members of an interdisciplinary care team Excellent computer skills with ability to read, interpret and analyze data from various computer systems Effective problem solving and prioritization skills 2+ years of healthcare experience, working as an RN Preferred Qualifications: Previous experience in clinic setting Ability to work independently Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $60,522.00 - $129,615.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 06/30/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.
RN Telehealth Full-time
Oak Street Health

Registered Nurse - OSH

Oak Street Health Greenville, SC
$54,095 - $116,760 / year
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Registered Nurse Company: Oak Street Health Role Description: The purpose of a Registered Nurse at Oak Street Health is to build strong relationships with Oak Street Health patients by coordinating their care and providing a seamless experience to patients and their support team. At Oak Street Health you will use an integrated approach toward achieving desired patient outcomes by utilizing standards, guidelines and pathways for care delivery. Through clinical assessment, intervention and education you will ensure our patients are provided competent nursing care in a timely manner. Our Registered Nurses drive quality care, it is of vital importance that our nurses incorporate data and information to improve care and enhance our patient outcomes. You will work to create an engaging and welcoming environment through team communication and delegation to empower other members of the care team to deliver the best care to our patients. Our Registered Nurses report to the Practice Manager or Nurse Supervisor (where applicable). Core Responsibilities: Provide competent nursing care by displaying proficiency in this role and executing job responsibilities in a safe and consistent manner Respond to incoming telephonic requests in a dependable manner, ensuring we are responsive to their needs and exceeding expectations Provide clinically competent triage and symptom management to patients who may or may not be physically present Utilize standardized protocols for medication management, prescription refills and prior authorizations. Conduct thorough and accurate reviews of patient medications and update as needed Provide comprehensive education and direct patient care, particularly around chronic conditions; may occur in person, over the phone or in group settings Actively collaborate and monitor the implementation and progress of the care plan for patients on multiple provider panels Form relationships with patients and their caregivers to support preventative care and ED/hospital diversion where appropriate Create a welcoming and engaging environment to meet the needs of our patients, communities, families and teams where they are Delegation of activities to other clinical care team members to support the needs of our patients Participate in care team meetings to discuss patient care and clinic operations Deliver an exceptional patient experience through service, responsiveness and respectful care Perform point of care testing, procedures and specimen collection (including phlebotomy) as needed Performs other related duties as assigned What we're looking for Required Qualifications: Active Registered Nurse (RN) Licensure in good standing with the applicable state BLS Certification Electronic Medical Record (EMR) experience Ability to maintain patient confidentiality and process information in a confidential manner US work authorization Ability to assess patients without face-to face interaction, strong communication and assessment skill Strongly Preferred Qualifications: Ability to collaborate and communicate with members of an interdisciplinary care team Excellent computer skills with ability to read, interpret and analyze data from various computer systems Effective problem solving and prioritization skills 2+ years of healthcare experience, working as an RN Preferred Qualifications: Previous experience in clinic setting Ability to work independently Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $54,095.00 - $116,760.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 07/09/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.
RN Telehealth Full-time
Oak Street Health

Registered Nurse

Oak Street Health Gate City, VA
$60,522 - $129,615 / year
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Registered Nurse Company: Oak Street Health Role Description: The purpose of a Registered Nurse at Oak Street Health is to build strong relationships with Oak Street Health patients by coordinating their care and providing a seamless experience to patients and their support team. At Oak Street Health you will use an integrated approach toward achieving desired patient outcomes by utilizing standards, guidelines and pathways for care delivery. Through clinical assessment, intervention and education you will ensure our patients are provided competent nursing care in a timely manner. Our Registered Nurses drive quality care, it is of vital importance that our nurses incorporate data and information to improve care and enhance our patient outcomes. You will work to create an engaging and welcoming environment through team communication and delegation to empower other members of the care team to deliver the best care to our patients. Our Registered Nurses report to the Practice Manager or Nurse Supervisor (where applicable). Core Responsibilities: Provide competent nursing care by displaying proficiency in this role and executing job responsibilities in a safe and consistent manner Respond to incoming telephonic requests in a dependable manner, ensuring we are responsive to their needs and exceeding expectations Provide clinically competent triage and symptom management to patients who may or may not be physically present Utilize standardized protocols for medication management, prescription refills and prior authorizations. Conduct thorough and accurate reviews of patient medications and update as needed Provide comprehensive education and direct patient care, particularly around chronic conditions; may occur in person, over the phone or in group settings Actively collaborate and monitor the implementation and progress of the care plan for patients on multiple provider panels Form relationships with patients and their caregivers to support preventative care and ED/hospital diversion where appropriate Create a welcoming and engaging environment to meet the needs of our patients, communities, families and teams where they are Delegation of activities to other clinical care team members to support the needs of our patients Participate in care team meetings to discuss patient care and clinic operations Deliver an exceptional patient experience through service, responsiveness and respectful care Perform point of care testing, procedures and specimen collection (including phlebotomy) as needed Performs other related duties as assigned What we're looking for Required Qualifications: Active Registered Nurse (RN) Licensure in good standing with the applicable state BLS Certification Electronic Medical Record (EMR) experience Ability to maintain patient confidentiality and process information in a confidential manner US work authorization Ability to assess patients without face-to face interaction, strong communication and assessment skill Strongly Preferred Qualifications: Ability to collaborate and communicate with members of an interdisciplinary care team Excellent computer skills with ability to read, interpret and analyze data from various computer systems Effective problem solving and prioritization skills 2+ years of healthcare experience, working as an RN Preferred Qualifications: Previous experience in clinic setting Ability to work independently Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $60,522.00 - $129,615.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 06/30/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.
RN Utilization Review Telehealth Full-time
L.A. Care Health Plan

Utilization Management Claims Review Nurse RN II

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) Claims Review Nurse RN II is responsible for conducting clinical review of medical claims to ensure services were medically necessary, appropriately documented, accurately billed, and compliant with established clinical policies and regulatory standards. This position supports payment integrity initiatives through retrospective and pre-payment review processes, helps reduce unnecessary denials, and monitors for potential fraud, waste, and abuse (FWA). The UM Claims Review Nurse RN II collaborates closely with internal teams to ensure accurate adjudication and compliance. This position collaborates closely with internal stakeholders and external entities to support compliance with state, federal, and accreditation requirements. Duties Perform claims pre-payment review by supporting the Claims team in evaluating flagged claims prior to adjudication to ensure services are medically necessary, documentation supports billed services, coding is accurate and aligned with authorization when applicable, and unnecessary denials are reduced through accurate clinical validation. Conduct comprehensive retrospective reviews, applying established clinical criteria, policies, and regulatory guidelines to determine medical necessity and appropriateness of services rendered. Complete Provider Dispute Review (PDR) clinical evaluations for disputed claims requiring medical necessity scrutiny and clinical determination. Apply internal and external clinical policies, including those developed by the Clinical Policy team, to ensure compliance with guidelines intended to limit fraud, waste, and abuse (FWA). Ensure adherence to federal and state regulations, and accreditation standards. Monitor trends related to contested claims and identify potential FWA concerns; escalate findings in accordance with organizational compliance protocols. Collaborate with internal teams to support payment integrity initiatives. Provide clear, well-documented clinical rationales supporting approval, denial, or adjustment decisions. Maintain productivity and quality standards consistent with departmental expectations. Participate in audits, regulatory readiness activities, and quality improvement initiatives as assigned. Document review outcomes clearly and accurately within designated systems, ensuring audit readiness and traceability. Remain current with evolving clinical guidelines, coding standards, reimbursement methodologies, and regulatory requirements. Perform other duties as assigned. Duties Continued Education Required Associate's Degree in Nursing Education Preferred Bachelor's Degree in Nursing Experience Required: At least 5 years of experience in Clinical Nursing. At least 3 years of experience with Medi-Cal and Medicare in a managed care environment. Experience in performing and creating clinical documentation. Experience in regulatory compliance for a health plan. Preferred: Experience with Provider Dispute Review (PDR) processes. Experience applying clinical guidelines (e.g., InterQual, MCG, or internally developed criteria) in processes. Prior experience in payment integrity, compliance, or fraud, waste, and abuse (FWA) monitoring. Skills Required: Knowledge of medical necessity criteria, reimbursement principles, and managed care operation. Working knowledge of clinical policies. Working knowledge of CPT/HCPC Codes, and ICD-10. Proficient in claims processing systems and electronic medical record platforms. Strong problem-solving skills and the ability to identify discrepancies, assess risk, and recommend actionable solutions. Strong verbal and written communication skills. Ability to work independently with a high degree of initiative, organization, and self-direction. Ability to work effectively with diverse teams in cross-functional work groups. Ability to multitask, re-prioritize tasking, and streamline day-to-day operations. Familiarity with regulatory and accreditation standards (e.g., CMS, Medi-Cal, NCQA). Understanding of the managed care industry and market conditions. High organizational and time-management skills. Preferred: Strong analytical and investigative skills with the ability to synthesize clinical and claims information into clear, defensible determinations are highly valued. Advanced knowledge of medical necessity criteria tools such as InterQual or MCG. Extensive knowledge in claims reviews includes retrospective reviews, pre-payment claims review, and medical necessity determinations. Licenses/Certifications Required Registered Nurse (RN) - Active, current and unrestricted California License Licenses/Certifications Preferred Required Training Physical Requirements Light Additional Information 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
Anchor Health

RN Triage Nurse

Anchor Health CA
Anchor Health is looking for a compassionate RN Triage Nurse (Full-Time) to join a strong supportive team of professionals that provide hospice/palliative care. Position Purpose: Under the general supervision of the Nurse Manager, the Triage Nurse is responsible for patient triage via the nurse phone line and Call Center agents, in collaboration with Clinic Administrators, providers, and other departments. The Triage Nurse provides quality patient care in compliance with local, state, and federal regulations, as well as accreditation standards. Principal Responsibilities: Responds to triage calls on the nurse phone line, assessing patient needs and providing appropriate guidance. Manages inquiries on the pharmacy phone line, ensuring timely and accurate responses. Conducts patient assessments over the phone Determines urgency based on a telephone assessment and the patient’s medical history in the electronic medical record (EMR). Utilizes clinical decision-making tools, including algorithms that replicate physician logic, to guide scheduling decisions. Escalates high-risk cases involving symptoms such as chest pain, abdominal pain, or severe headaches, ensuring immediate ER referral or ambulance coordination. Provides home care guidance to patients who do not require emergency services. Maintains thorough documentation of consultations and treatments in the NextGen Electronic Health Record system. Coordinates appointments for non-emergency patients and consults with physicians as necessary. Acts as a resource for patient inquiries when designated as "Ask a Nurse," addressing routine questions such as vaccination schedules. Serves as a clinical resource and role model for nursing staff, promoting best practices. Manages workload effectively, prioritizing tasks and completing them promptly. Assists with medical chart reviews and compiles data for audits and reports. Supports policy development, collaborating with the Managing Nurse to establish nursing protocols and procedures. Ensures clear, concise, and accurate triage documentation. Provides patient education, offering guidance on self-care and medical conditions. Communicates professionally with staff, consultants, patients, families, and the community. Resolves conflicts proactively, improving patient satisfaction through timely responses. Participates in team meetings, training sessions, and planning discussions as needed. Performs additional duties as assigned to support clinical operations. Requirements: Licensed by the State of California as a Registered Nurse. Current BLS certification from the American Heart Association or the American Red Cross. At least one year of experience in an ambulatory care setting. Excellent verbal and written communication skills, including strong organizational, detail-oriented, and interpersonal skills. Proficiency in computer skills and word processing. Employee Benefits: At Anchor Health, we believe in taking care of those who take care of others. If you work 30+ hours per week, you’ll enjoy competitive pay and a robust benefits package that includes: Medical, Dental, Vision Paid time off (vacation, sick leave) 401(k) Short- and long-term disability plans (LTD/STD). Life insurance policy REMOTE position
RN Telehealth Full-time
Anchor Health

RN Triage Nurse

Anchor Health Petaluma, CA
Anchor Health is looking for a compassionate RN Triage Nurse (Full-Time) to join a strong supportive team of professionals that provide hospice/palliative care. Position Purpose: Under the general supervision of the Nurse Manager, the Triage Nurse is responsible for patient triage via the nurse phone line and Call Center agents, in collaboration with Clinic Administrators, providers, and other departments. The Triage Nurse provides quality patient care in compliance with local, state, and federal regulations, as well as accreditation standards. Principal Responsibilities: Responds to triage calls on the nurse phone line, assessing patient needs and providing appropriate guidance. Manages inquiries on the pharmacy phone line, ensuring timely and accurate responses. Conducts patient assessments over the phone Determines urgency based on a telephone assessment and the patient’s medical history in the electronic medical record (EMR). Utilizes clinical decision-making tools, including algorithms that replicate physician logic, to guide scheduling decisions. Escalates high-risk cases involving symptoms such as chest pain, abdominal pain, or severe headaches, ensuring immediate ER referral or ambulance coordination. Provides home care guidance to patients who do not require emergency services. Maintains thorough documentation of consultations and treatments in the NextGen Electronic Health Record system. Coordinates appointments for non-emergency patients and consults with physicians as necessary. Acts as a resource for patient inquiries when designated as "Ask a Nurse," addressing routine questions such as vaccination schedules. Serves as a clinical resource and role model for nursing staff, promoting best practices. Manages workload effectively, prioritizing tasks and completing them promptly. Assists with medical chart reviews and compiles data for audits and reports. Supports policy development, collaborating with the Managing Nurse to establish nursing protocols and procedures. Ensures clear, concise, and accurate triage documentation. Provides patient education, offering guidance on self-care and medical conditions. Communicates professionally with staff, consultants, patients, families, and the community. Resolves conflicts proactively, improving patient satisfaction through timely responses. Participates in team meetings, training sessions, and planning discussions as needed. Performs additional duties as assigned to support clinical operations. Requirements: Licensed by the State of California as a Registered Nurse. Current BLS certification from the American Heart Association or the American Red Cross. At least one year of experience in an ambulatory care setting. Excellent verbal and written communication skills, including strong organizational, detail-oriented, and interpersonal skills. Proficiency in computer skills and word processing. Employee Benefits: At Anchor Health, we believe in taking care of those who take care of others. If you work 30+ hours per week, you’ll enjoy competitive pay and a robust benefits package that includes: Medical, Dental, Vision Paid time off (vacation, sick leave) 401(k) Short- and long-term disability plans (LTD/STD). Life insurance policy REMOTE position
RN Telehealth Full-time
Anchor Health

RN Triage Nurse

Anchor Health Petaluma, CA
Anchor Health is looking for a compassionate RN Triage Nurse (Full-Time) to join a strong supportive team of professionals that provide hospice/palliative care. Position Purpose: Under the general supervision of the Nurse Manager, the Triage Nurse is responsible for patient triage via the nurse phone line and Call Center agents, in collaboration with Clinic Administrators, providers, and other departments. The Triage Nurse provides quality patient care in compliance with local, state, and federal regulations, as well as accreditation standards. Principal Responsibilities: Responds to triage calls on the nurse phone line, assessing patient needs and providing appropriate guidance. Manages inquiries on the pharmacy phone line, ensuring timely and accurate responses. Conducts patient assessments over the phone Determines urgency based on a telephone assessment and the patient’s medical history in the electronic medical record (EMR). Utilizes clinical decision-making tools, including algorithms that replicate physician logic, to guide scheduling decisions. Escalates high-risk cases involving symptoms such as chest pain, abdominal pain, or severe headaches, ensuring immediate ER referral or ambulance coordination. Provides home care guidance to patients who do not require emergency services. Maintains thorough documentation of consultations and treatments in the NextGen Electronic Health Record system. Coordinates appointments for non-emergency patients and consults with physicians as necessary. Acts as a resource for patient inquiries when designated as "Ask a Nurse," addressing routine questions such as vaccination schedules. Serves as a clinical resource and role model for nursing staff, promoting best practices. Manages workload effectively, prioritizing tasks and completing them promptly. Assists with medical chart reviews and compiles data for audits and reports. Supports policy development, collaborating with the Managing Nurse to establish nursing protocols and procedures. Ensures clear, concise, and accurate triage documentation. Provides patient education, offering guidance on self-care and medical conditions. Communicates professionally with staff, consultants, patients, families, and the community. Resolves conflicts proactively, improving patient satisfaction through timely responses. Participates in team meetings, training sessions, and planning discussions as needed. Performs additional duties as assigned to support clinical operations. Requirements: Licensed by the State of California as a Registered Nurse. Current BLS certification from the American Heart Association or the American Red Cross. At least one year of experience in an ambulatory care setting. Excellent verbal and written communication skills, including strong organizational, detail-oriented, and interpersonal skills. Proficiency in computer skills and word processing. Employee Benefits: At Anchor Health, we believe in taking care of those who take care of others. If you work 30+ hours per week, you’ll enjoy competitive pay and a robust benefits package that includes: Medical, Dental, Vision Paid time off (vacation, sick leave) 401(k) Short- and long-term disability plans (LTD/STD). Life insurance policy REMOTE position
RN Telehealth Full-time
Anchor Health

RN Triage Nurse

Anchor Health CA
Anchor Health is looking for a compassionate RN Triage Nurse (Full-Time) to join a strong supportive team of professionals that provide hospice/palliative care. Position Purpose: Under the general supervision of the Nurse Manager, the Triage Nurse is responsible for patient triage via the nurse phone line and Call Center agents, in collaboration with Clinic Administrators, providers, and other departments. The Triage Nurse provides quality patient care in compliance with local, state, and federal regulations, as well as accreditation standards. Principal Responsibilities: Responds to triage calls on the nurse phone line, assessing patient needs and providing appropriate guidance. Manages inquiries on the pharmacy phone line, ensuring timely and accurate responses. Conducts patient assessments over the phone Determines urgency based on a telephone assessment and the patient’s medical history in the electronic medical record (EMR). Utilizes clinical decision-making tools, including algorithms that replicate physician logic, to guide scheduling decisions. Escalates high-risk cases involving symptoms such as chest pain, abdominal pain, or severe headaches, ensuring immediate ER referral or ambulance coordination. Provides home care guidance to patients who do not require emergency services. Maintains thorough documentation of consultations and treatments in the NextGen Electronic Health Record system. Coordinates appointments for non-emergency patients and consults with physicians as necessary. Acts as a resource for patient inquiries when designated as "Ask a Nurse," addressing routine questions such as vaccination schedules. Serves as a clinical resource and role model for nursing staff, promoting best practices. Manages workload effectively, prioritizing tasks and completing them promptly. Assists with medical chart reviews and compiles data for audits and reports. Supports policy development, collaborating with the Managing Nurse to establish nursing protocols and procedures. Ensures clear, concise, and accurate triage documentation. Provides patient education, offering guidance on self-care and medical conditions. Communicates professionally with staff, consultants, patients, families, and the community. Resolves conflicts proactively, improving patient satisfaction through timely responses. Participates in team meetings, training sessions, and planning discussions as needed. Performs additional duties as assigned to support clinical operations. Requirements: Licensed by the State of California as a Registered Nurse. Current BLS certification from the American Heart Association or the American Red Cross. At least one year of experience in an ambulatory care setting. Excellent verbal and written communication skills, including strong organizational, detail-oriented, and interpersonal skills. Proficiency in computer skills and word processing. Employee Benefits: At Anchor Health, we believe in taking care of those who take care of others. If you work 30+ hours per week, you’ll enjoy competitive pay and a robust benefits package that includes: Medical, Dental, Vision Paid time off (vacation, sick leave) 401(k) Short- and long-term disability plans (LTD/STD). Life insurance policy REMOTE position
RN Telehealth Full-time
Oak Street Health

Registered Nurse

Oak Street Health Fort Wayne, IN
$54,095 - $116,760 / year
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Registered Nurse Company: Oak Street Health Role Description: The purpose of a Registered Nurse at Oak Street Health is to build strong relationships with Oak Street Health patients by coordinating their care and providing a seamless experience to patients and their support team. At Oak Street Health you will use an integrated approach toward achieving desired patient outcomes by utilizing standards, guidelines and pathways for care delivery. Through clinical assessment, intervention and education you will ensure our patients are provided competent nursing care in a timely manner. Our Registered Nurses drive quality care, it is of vital importance that our nurses incorporate data and information to improve care and enhance our patient outcomes. You will work to create an engaging and welcoming environment through team communication and delegation to empower other members of the care team to deliver the best care to our patients. Our Registered Nurses report to the Practice Manager or Nurse Supervisor (where applicable). Core Responsibilities: Provide competent nursing care by displaying proficiency in this role and executing job responsibilities in a safe and consistent manner Respond to incoming telephonic requests in a dependable manner, ensuring we are responsive to their needs and exceeding expectations Provide clinically competent triage and symptom management to patients who may or may not be physically present Utilize standardized protocols for medication management, prescription refills and prior authorizations. Conduct thorough and accurate reviews of patient medications and update as needed Provide comprehensive education and direct patient care, particularly around chronic conditions; may occur in person, over the phone or in group settings Actively collaborate and monitor the implementation and progress of the care plan for patients on multiple provider panels Form relationships with patients and their caregivers to support preventative care and ED/hospital diversion where appropriate Create a welcoming and engaging environment to meet the needs of our patients, communities, families and teams where they are Delegation of activities to other clinical care team members to support the needs of our patients Participate in care team meetings to discuss patient care and clinic operations Deliver an exceptional patient experience through service, responsiveness and respectful care Perform point of care testing, procedures and specimen collection (including phlebotomy) as needed Performs other related duties as assigned What we're looking for Required Qualifications: Active Registered Nurse (RN) Licensure in good standing with the applicable state BLS Certification Electronic Medical Record (EMR) experience Ability to maintain patient confidentiality and process information in a confidential manner US work authorization Ability to assess patients without face-to face interaction, strong communication and assessment skill Strongly Preferred Qualifications: Ability to collaborate and communicate with members of an interdisciplinary care team Excellent computer skills with ability to read, interpret and analyze data from various computer systems Effective problem solving and prioritization skills 2+ years of healthcare experience, working as an RN Preferred Qualifications: Previous experience in clinic setting Ability to work independently Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $54,095.00 - $116,760.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 10/17/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.
RN Telehealth Full-time
Florida Medical Center

Registered Nurse-Neuro Tele-Full Time-Nights - 1618016

Florida Medical Center Fort Lauderdale, FL
WE ARE FLORIDA MEDICAL WHAT WE OFFER Essential/stable and growing company with many opportunities for training and advancement within the medical field that all employees and team members (including Full-Time and Part-Time) can benefit from. Hourly pay is negotiable based on experience. We offer competitive market pay and opportunities for bonus depending on great work performance Comprehensive Employee Benefits: Full and Part Time employees are eligible for various plans for medical, dental, and vision insurance. POSITION SUMMARY: Delivers professional and technical nursing to adult and geriatric patients admitted to the Neuro Telemetry unit with real or potential life threatening illnesses. Monitors, interprets and intervenes for patients experiencing cardiac arrhythmia, working under the direction of, and in collaboration with the medical staff. Performs nursing techniques for the comfort and well being of the patient. Nursing care delivered complies with the objectives and policies of the hospital utilizing the nursing process of assessment, planning, implementation, and evaluation. Prepares equipment and assists physician during treatments and examinations of patients. Collaborates with multidisciplinary team members to provide age/developmentally appropriate care in accordance with unit specific standards. Assists in planning, supervising, and instructing Patient Care Assistants, thereby providing nursing care to a number of patients. Knowledge of adherence to monitoring of and compliance with all regulatory and licensing agency guidelines including but not limited to TJC, OSHA, AHCA, CMS, etc. CUSTOMER SERVICE RESPONSIBILITIES: Performs duties and conducts interpersonal relationships in a manner designed to project a positive image of the department and the hospital. Works with supervisor/manager and other members of section or department to promote a harmonious work environment. Ensures that all contacts with patients, the public, physicians and other hospital personnel are carried out in a friendly, courteous, helpful and considerate manner. Answers telephones in a prompt and courteous manner. Displays concern and provides assistance or explains procedures as appropriate to callers or in face-to-face situations. Dedicated to meeting the expectations and requirements of internal and external customers. Works with customers to identify problem areas and recommend solutions. POSITION QUALIFICATIONS (including required licenses/certifications, education and job knowledge/experience): Current Florida RN License Education: Technical School/2 years college/Associates Degree Current BLS Certification Current ACLS Certification Neuro Experience preferred Basic Arrhythmia skills Completion of a Telemetry/Critical Care course preferred Computer Skills Ability to communicate in English
RN Utilization Review Telehealth Full-time
Gainwell Technologies LLC

Utilization Review Nurse- Remote

Gainwell Technologies LLC Arkansas City, AR
$65,000 - $78,000 / year
It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary We are seeking a skilled Utilization Review Nurse to conduct prior authorization, prospective, concurrent, and retrospective reviews for medical necessity and appropriateness of services, following clinical criteria, coverage policies, and contract guidelines. This involves reviewing medical documentation, accurately documenting findings, and ensuring policy compliance. Your role in our mission Review admissions, procedures, services, and supplies for medical necessity and appropriateness, meeting quality and production goals. Use clinical criteria for decision-making, referring complex cases to Medical Directors when needed. Engage with providers to gather clinical information, apply guidelines, and make determinations. Document findings and rationale in medical management systems. Assist in training new nurses, provide feedback, and stay updated on clinical guidelines. Maintain RN license and meet continuing education requirements. What we're looking for Active RN license. 3+ years of inpatient clinical experience. 1+ year in prior authorization reviews using InterQual or MCG. Strong written communication skills in a fast-paced setting. Proficient in Microsoft Office and other computer applications. What you should expect in this role Home-based position. High-speed internet and a distraction-free workspace required. Core hours: 8:00 AM - 6:00 PM ET, with potential for extended hours. Occasional travel (up to 10%) based on business needs. This position is for pipeline purposes, and we welcome applications on an ongoing basis. The pay range for this position is $65,000.00 - $78,000.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits , and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities. We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings. Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
RN Utilization Review Telehealth Full-time
Gainwell Technologies LLC

DRG Nurse Reviewer Appeals and Hearings- Remote

Gainwell Technologies LLC Tampa, FL
$90,000 - $99,000 / year
It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary We are seeking a talented individual for a DRG Nurse Reviewer Appeals and Hearings to coordinate and perform all appeal related duties including analyzing and responding appropriately to appeals from providers; reviewing documentation to ensure all aspects of the appeal have been addressed properly and accurately; prepare case files and case summaries for hearings; and participate in in virtual and on-site hearings. Your role in our mission Reviews provider appeals and redeterminations using approved clinical and coding guidelines and documents appeal determinations clearly and concisely. Analyzes and reviews appeal documentation to ensure all aspects of the appeal have been addressed properly and accurately while maintaining production goals and quality standards. Prepares case files and case summaries for hearings and actively participates in hearings in conjunction with the Medical Director. Assists management with training new reviewers to include daily monitoring, mentoring, feedback and education. Maintains current knowledge of clinical criteria guidelines and/or coding guidelines; successfully completes required CEUs to maintain RN license and/or coding certification. Responsible for attending training and scheduled meetings to enhance skills and working knowledge of clinical policies, procedures, rules, and regulations. Actively cross-trains to perform reviews of multiple claim types to provide a flexible workforce to meet client needs. What we're looking for Active, Unrestricted RN license from the United States and in the primary home residency, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC), required Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Professional Medical Auditor (CPMA) required 5+ years clinical experience or 5+ years medical record coding experience preferred Working knowledge of the appeals and hearings process Excellent written communication skills including ability to write clear, concise, accurate, and fact-based rationales in support of appeal determinations. Excellent oral communication skills with particular emphasis on verbally presenting case summaries and decisions. Ability to multi-task in a fast-paced production environment. What you should expect in this role Remote (Work from Home) Up to 25% Travel for onsite hearing testimony This position is for pipeline purposes, and we welcome applications on an ongoing basis. The pay range for this position is $90,000.00 - $99,000.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits , and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities. We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings. Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.