Telehealth Jobs

RN Telehealth Full-time
UnitedHealthcare

Health & Social Services RN - Remote in Michigan

UnitedHealthcare Southfield, MI
$28.94 - $51.83 / hour
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. In this autonomous Health and Social Services Coordinator role, you will be an essential element of an Integrated Care Model by relaying pertinent information about member needs and advocating for the best possible care available, and ensuring the members have the right services to meet their individualized needs. If you are located in the state of Michigan , you will have the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities Analyze, assess, plan and implement care strategies that are adapted to the patient and directed toward the most appropriate, least restrictive level of care Actively identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services Act as a champion of member care plans throughout the continuum of care and act as a single point of contact Confidently communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members Courageously advocate for patients and families to ensure the patient's needs and choices are fully represented and supported by the health care team Assess members' current health status by making outbound calls and receiving inbound calls Recognize gaps or barriers in treatment plans Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, lease restrictive level of care Manage the care plan throughout the continuum of care as a single point of contact Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications Registered Nurse license in the state of MI 4+ years of clinical experience/community health in a healthcare setting 2+ years of Case Management experience 2+ years of Medicaid experience 1+ years of experience working with MS Word, Excel and Outlook Must reside in the state of Michigan Preferred Qualifications Certified Case Manager (CCM) Experience working with the needs of vulnerable populations who have chronic or complex conditions Experience with electronic charting Experience with arranging community resources Medicare experience Experience or exposure to discharge planning Experience in utilization review, concurrent review or risk management Background in managing populations with complex medical or behavioral needs Acute care experience All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.94 to $51.83 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #GREEN
RN Manager/Supervisor Telehealth Full-time
Texas Health Resources

Virtual Care Nursing Supervisor- Full Time, Nights

Texas Health Resources Dallas, TX
26004665 Virtual Care Nursing Supervisor – Virtual Care Command Center Department Bring your passion to Texas Health so we are Better + Together Work location: Virtual Care Command Center, Texas Health Dallas, 8200 Walnut Hill Lane, Dallas, TX Work hours: Full-time, 40 hours per week; four nights per week, consisting of two 8-hour shifts (10:45 PM – 7:15 AM) and two 12-hour shifts (6:45 PM – 7:15 AM), with a rotating schedule for nights worked. Virtual Care Command Center Department Highlights Virtual care is expanding services across Texas Health Supportive environment and innovative team High degree of collaboration with THR entities Opportunity to participate in new models of care delivery Here’s What You Need Associate's Degree Nursing is required Bachelor's Degree Nursing is preferred 2 Years experience as a registered nurse with previous experience as a charge nurse or similar leadership role (i.e. Charge nurse, committee chair, preceptor) is required and 4 Years experience as a registered nurse with previous experience as a charge nurse or similar leadership role (i.e. Charge nurse, committee chair, preceptor) is preferred RN - Registered Nurse Upon Hire is required And CPR - Cardiopulmonary Resuscitation Every 2 years 30 Days is required A high degree of confidentiality, positive interpersonal skills, and ability to function in a fast-paced environment. What You Will Do Quality/Performance Improvement: Collaborates with Leadership, UBC, and appropriate team members to establish, implement, and monitor department policies/procedures, facilitate unit goals, evaluate and individualize patient care and provide direction to staff to promote quality outcomes. Shared decision making: This role provides leadership on a particular unit or units and shift, coordinating patient flow, patient care and assignments. Responsible for assisting the manager/director with human resource management to include evaluations, coaching, mentoring, recruitment, retention, education and orientation. Works with manager/director to control costs and manage department budget and productivity. Patient and Family Centered Care: Effectively communicates with patients, families and other healthcare team members by incorporating the 8 caring factors in the Quality Caring Model which include: basic human needs, human respect, encouraging manner, affiliation needs, mutual problem solving, healing environment, attentive reassurance and appreciation of unique meaning. Teamwork: Incorporates THR philosophy in working with peers, and other members of the health care team. Partners with physicians to advance physician engagement. Professional Development: Assimilates leadership responsibilities on the unit and throughout the entity and/or system. Promotes a positive image of Texas Health Nursing. Commits to autonomous maintenance and continuous improvement of competence and serves as a role model to other healthcare team members. Holds self and other accountable for highly reliable behavior. Additional perks of being a Texas Health Virtual Care Nursing Supervisor Benefits include 401k, PTO, medical, dental, Paid Parental Leave, flex spending, tuition reimbursement, student loan repayment programs as well as several other benefits. Delivery of high quality of patient care through nursing education, nursing research and innovations in nursing practice. Strong Unit Based Council (UBC). A supportive, team environment with outstanding opportunities for growth. Texas Health Presbyterian Hospital Dallas is one of North Texas's most established hospitals. As an 875 bed, full service hospital, we've served the Dallas community and surrounding areas including Lakewood, White Rock, and Highland Park since 1966 with a commitment to high quality, compassionate care. We specialize in cancer care, cardiology, neurosciences, women's services, and emergency medicine. Our hospital is home to a renowned Level III Neonatal Intensive Care Unit (NICU), a Comprehensive Stroke Center, and a Bariatric Surgery Center of Excellence. We also offer a wide range of outpatient services, including surgery, wellness programs, and advanced women's imaging. Our Women's Robotic Surgery program holds accreditation as a Center of Excellence in Robotic Surgery by the Surgical Review Corporation (SRC), reflecting our commitment to innovation in women's health and patient safety in surgery. Texas Health Dallas is a Joint Commission certified Comprehensive Stroke Center, Level I Trauma Center, and Comprehensive Heart Attack Center. We are proud to be a designated Magnet hospital and a top choice in North Texas for cancer treatment, emergency services, cardiac care, and bariatric surgery. If you’re ready to join us in our mission to improve the health of our community, then let’s show the world how we’re even better together! Learn More About Our Culture, Benefits, And Recent Awards. Do you still have questions or concerns? Feel free to email your questions to recruitment@texashealth.org
RN Telehealth Full-time
Temple Health

Nurse Navigator

Temple Health Philadelphia, PA
Hybrid Remote schedule: mostly work from home position, with varying travel time required to meet the patient Facilitates communication between the patient, their primary care physician and specialists to improve clinical outcomes. Works collaboratively with the patient to foster self-management and compliance to their clinical plan of care. Works collaboratively with physician, hospital and community resources to support the patient's clinical plan of care. Education Bachelor's Degree in Nursing Required Master's Degree in Nursing Preferred Experience 3 years experience in disease or case management services with focus on telephonic management, medical reconciliation and ambulatory care coordination Required General Experience with clinical, hospital-based information systems Required Licenses PA Registered Nurse License Required Multi State Compact RN License Required
RN Telehealth Full-time
McLaren Health Care

Clinical Quality Specialist, RN - Michigan

McLaren Health Care Flint, MI
McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a Clinical Quality Specialist RN, to join in leading the organization forward. MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA). MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members. Learn more about McLaren Health Plan at https://www.mclarenhealthplan.org Position Summary: The Clinical Quality Specialist RN is responsible for clinical elements of the PQI process for the Plan, participating in the HEDIS process, participating in NCQA activities, as well as implementing quality interventions and conducting evaluation to ensure on-going feedback and program effectiveness. Essential Functions and Responsibilities: Provides clinical knowledge (i.e. clinical standards of care, best practices) and support for Potential Quality Issues (PQI) for all lines of business for the Plan. Investigates and responds timely to Potential Quality Issues (PQIs). Participates in the annual HEDIS process. Serves as subject matter expert on the certified HEDIS software system for support of the HEDIS process and other quality projects/reporting. Works with manager in developing and promoting HEDIS initiatives, participating in applicable Quality Committees, and work groups as needed or required. Serves a clinical reviewer of all quality documents. Required: Associate degree in nursing or related field. Current valid RN License in state doing business in. Five (5) years’ clinical or managed care health plan experience with at least two (2) years’ demonstrated experience in clinical quality improvement processes, including HEDIS and NCQA. Preferred: Bachelor’s degree in nursing or related field. Project management experience. CPHQ. Healthcare data management and analysis experience. Additional Information Schedule: Full-time Requisition ID: 26003085 Daily Work Times: 8:30 am - 5:00 pm Hours Per Pay Period: 80 On Call: No Weekends: No
NP Telehealth Full-time
Planned Parenthood of Greater Texas

Nurse Practitioner / Physician Assistant

Planned Parenthood of Greater Texas Mesquite, TX
Overview The official job title for this position at PPGT is “Clinician”. The Clinician provides comprehensive reproductive healthcare services to patients at Planned Parenthood of Greater Texas (PPGT). Works as part of the Health Services team in collaboration with Health Services and other team members to meet the clinical needs of patients as outlined in affiliate protocols. Orders, interprets, and records results of clinical tests and consults with supervising physicians as needed. Prescribes medications and makes recommendations for other forms of treatment, including contraception. The Clinician is part of the medical services team providing sexual and reproductive healthcare as outlined in affiliate protocols. Provides services by telehealth and/or in-person visits including: history review, health education, physical exam, counseling, diagnosis, and treatment according to protocols. The Clinician works in partnership with management, Health Services and Chief Operating and Medical Services Officer (COMSO) to provide the highest quality of patient care and excellent patient experience. Participates as a member of a team providing confidential, quality healthcare services, allowing patients to maintain a sense of dignity, trust and safety. There is a dual reporting structure for clinicians. Clinicians report directly to the Health Services Regional Director and clinical supervision is provided by the Director of Clinical Services. Performs duties to ensure productivity expectations, patient satisfaction, customer service, and compliance standards are maintained. Supports the organization’s strategic plan and workplace inclusion initiatives. Abides by the organization’s mission in performing job duties. Demonstrates an understanding and commitment to PPGT’s culture of quality, safety and risk awareness. Responsibilities • Performs physical examinations with special emphasis on the reproductive system including breast examinations, pelvic/genital, cancer screening tests, diagnosis of sexually transmitted infections (STIs), and other types of more specialized services or procedures as may be indicated by medical policy or protocols (e.g. gender affirming hormone therapy-GAHT). • Orders, and interprets diagnostic studies as indicated and permitted by medical protocols. Performs lab testing per Clinical Laboratory Improvement Amendments (CLIA) regulations and according to PPGT’s lab manual or manufacturer’s directions. • Provides patient care according to all Medical Standards and Guidelines and/or the specific direction of a supervising physician. Consults with organization COMSO or designee when deviates from PPGT Medical Standards and Guidelines (MS&Gs). • Provides relevant health instruction and education to include family planning, sexual counseling, and principles of health promotion • and maintenance. • Documents exam findings and other clinical aspects of direct patient care into the medical record accurately. • Codes billable services accurately based on medical record documentation using accepted practices, i.e. Evaluation and Management (E&M), Current Procedural Terminology (CPT) and diagnosis codes (ICD-10). • Ensures conformity with the policies and procedures of the affiliate, Texas Medical Practice Act, Physician Assistant Licensing Act, Texas Nurse Practice Act, and rules promulgated under those acts. • Recognizes ethical, legal, and professional issues inherent in providing care to health center patients throughout the life cycle. • Initiates and monitors appropriate follow-up according to PPGT Medical Standards and Guidelines on all abnormal test results and referrals. • Remains well informed about current contraceptive technology and reproductive and sexual healthcare issues. • Develops and maintains a collaborative working relationship with the Health Center Manager and support staff resulting in a team effort in meeting center goals. • Develops a level of time management that is conducive to seeing 3-4 clinician visits per hour meeting productivity goals and expectations. • Takes an active role in managing patient satisfaction by practicing patient centered care and providing exemplary customer service to patients. • Responds to medical emergencies as provided in the medical protocols and is responsible for maintenance of emergency box • May assist in supervising and participating in the orientation and proctoring of new clinicians. • Administers, supplies, or prescribes medications/devices, including injections, per delegated orders of the Pharmacist-in-charge and the Chief Medical Officer as outlined in The Manual of Medical Standards and Guidelines and Pharmacy Manual and as per Title 22, Part 11, Chapter 22 of the Texas Administrative Code. • Maintains an active Prescriptive Authority Agreement which is reviewed with authorizing physician annually. Holds Quality Assurance and Improvement meetings and chart reviews as required by the PAA between the authorizing physician and the clinician. • Has unrestricted access to patient protected health information (PHI) on paper and electronic forms health records for purposes of treatment, payment, and/or healthcare operations. The use of a patient’s protected health information should be limited to information needed for the specific task that is being performed or requested by the individual patient. Disclosure of any patient information must be for purposes of treatment, payment or healthcare operation OR must be accompanied by a valid patient authorization. Must adhere to minimum necessary rule. • Embraces the organization’s In This Together customer service standards and uses them with internal and external customers, every person, every time. • Duties and responsibilities may be added, deleted or changed at any time at the discretion of management, formally or informally, either verbally or in writing. Qualifications Minimum Education Master’s degree (or equivalent) and certification in specialty as a Family Nurse Practitioner (FNP), Women’s Health Nurse Practitioner (WHNP), Certified Nurse Midwife (CNM), Primary Care Nurse Practitioner, or Physician Assistant (PA). Minimum Experience Experience as a Nurse Practitioner, Nurse Midwife, or Physician Assistant in reproductive healthcare or women’s health strongly preferred. In the absence of advance practice experience, candidates must have direct patient care experience (in addition to clinical rotation/externship/internship hours) such as a RN, LVN, Medical Assistant, laboratory technician in a supervised clinical setting such as: hospital, ambulatory surgery center, clinic, nursing home or other related medical setting (excluding home care). Required Licenses or Certifications License to practice as an Advanced Practice Nurse with prescriptive authority in the State of Texas or License to practice as a Physician Assistant by the Texas Medical Board. Must be able to obtain and maintain appropriate licenses listed above and appropriate national certification (NCC, AMCB, AANP, ANCC, or NCCPA) and basic cardiopulmonary resuscitation (CPR) BLS certification course taught by the either American Heart Association (AHA) or American Red Cross (ARC). Agency Standards Must have excellent computer skills with knowledge of Microsoft Word, Excel, PowerPoint, Outlook, and Internet. Must have the willingness and ability to adapt to change including advances or new technology. Must have excellent customer service skills and be committed to providing the highest level of customer satisfaction. Other PPGT is an equal opportunity employer. We strictly prohibit unlawful discrimination of any kind, including discrimination on the basis of age; race, color, ancestry, national origin, or ethnicity; citizenship status; sex or gender; gender identity or gender expression or transgender status (including the individual's actual or perceived sex and the individual's gender identity, self-image, appearance, behavior, or expression); sexual orientation (including actual or perceived heterosexuality, homosexuality, bisexuality and asexuality); mental or physical disability; AIDS, AIDS Related Complex, or HIV status; perception of risk of HIV infection; or association with individuals who are believed to be at risk; religion or creed; genetic information; pregnancy status, including related medical conditions; marital status; past, current, or prospective service in the uniformed services; or any other basis protected by law. We are a drug-free and tobacco-free workplace. Applicants have rights under the Federal Employment Laws. To view these notices, please click on the following links: Family and Medical Leave Act (FMLA) poster: Equal Employment Opportunity (EEO) poster; and Employee Polygraph Protection Act (EPPA) poster. Required Knowledge, Skills, and Abilities • Must be able to work all health center hours of operation including evenings and weekends. • Performance of job duties in a health center and/or virtual telehealth environment as defined by position requirements. • Must be able and willing to travel to other locations as needed to provide clinician coverage to centers. • Bilingual in Spanish/English desired. • Demonstrates continued competency in meeting educational and professional standards. • Ability to adhere to the medical protocols of the organization and Planned Parenthood Federation of America (PPFA). • Ability to think strategically and achieve organization’s goals relating to position. • Ability to adhere to the compliance and regulatory requirements pertaining to position. • Possess effective analytical skills. • Strong organizational skills and ability to multi-task. • Ability to manage details and complexity, to handle a variety of tasks simultaneously and to work under pressure. • Ability to exercise initiative, sound judgment, and problem-solving techniques in the decision-making process. • Ability to effectively use organization’s computer systems. • Skilled in verbal and written communications. • Be discreet and safeguard confidential information. • Possess integrity and compliance – can be relied upon to act ethically. • Ability to provide effective, equitable, understandable, and respectful quality care and services that are responsive to the diverse cultural health beliefs and practices, preferred language, health literacy and other communication needs. • Ability to work effectively as a team member. • Ability to lead, manage, direct, and motivate diverse groups of people and possess the skills to delegate and supervise subordinates. • Organizational Awareness: Demonstrates a comprehensive awareness of the impact and implications of decisions and actions on other areas (departments or clinics) within the organization. • Industry Awareness: Remains aware PPFA accreditation standards and of the reproductive health environment’s regulatory compliance requirements. Understands how accreditation standards, regulatory agencies, funding, the external marketplace and competitive environment drives change within the organization. • Work Management: Effectively manages time as a resource; establishes realistic priorities; schedules own time and activities effectively; gives balanced focus and attention to appropriate long- and short-term priorities. Develops action plans and budgets; leverages technology; anticipates obstacles; establishes check points and monitors progress. • Recovery Skills: Responds effectively and acknowledges responsibilities when clients (internal or external) experience problems or mistakes; rectifies the situation to restore client satisfaction; seeks information and collaborates with others to take action to implement permanent fixes. Maintains stable performance and emotions when faced with opposition, pressure, and or stressful conditions. • Interpersonal Sensitivity: Acts in a way that indicates understanding and accurate interpretation of others’ concerns, feelings, strengths and limitations. Uses interpersonal understanding to shape one’s own response. • Building Relationships: Shows genuine interest in others’ needs and opinions; establishes rapport; earns the confidence and trust of others; demonstrates consistency between words and actions; delivers on commitments. • Adaptability or Flexibility: Responds with flexibility to shifting priorities and changing work situations; recovers quickly from problems and setbacks; develops new skills to remain competitive. Adapts easily to change, sees the merits of differing positions, and adapts own positions and strategies in response to new information or changes to a situation. • Coping with Demands of the Position: Uses effective problem solving while working under stress, high volume of work demands and/or time demands; regularly meets deadlines. • Exemplify the organization’s In This Together values: We Tend to the Team; We Respect and Honor All People; We Jump In; We Try and We Learn; We Care for our Business; and We Return to our Mission. Essential Physical Requirements/Working Conditions Must be able to bend, stoop, kneel, crouch, reach, and grasp. Must be able to stand, particularly for sustained periods of time. Must be able to move about on foot to accomplish tasks, such as moving from one work site to another. Must be able to push/pull. Must be able to work primarily with fingers such as picking, pinching, or typing. Must be able to perceive attributes of objects such as size, shape, temperature or texture by touching with skin, particularly that of fingertips. Must be able to communicate effectively. Will have substantial movements of the wrists, hands, and/or fingers. Must be able to lift and/or exert up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or negligible amount of force constantly to move objects. Subject to hazards including a variety of physical conditions such as proximity to moving mechanical parts, moving vehicles, electrical current, or exposure to infectious diseases. Must be able to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading; visual inspection involving small defects, small parts, and/or operation of machines (including inspection); using measurement devices. Health Center environment.
RN Pediatric Telehealth Full-time
Advocate Aurora Health

Call Center Registered Nurse (RN) - Atrium Health Mint Hill Pediatric Extended Care Evenings FT

Advocate Aurora Health Mint Hill, NC
$35.50 - $53.25 / hour
Department: 01450 GCMG Pediatric Extended Care: Concord - Pediatrics: General Status: Full time Benefits Eligible: Yes Hou rs Per Week: 40 Schedule Details/Additional Information: Evenings and EOW Pay Range: $35.50 - $53.25 Essential Functions Performs telephone triage with diverse patient population. Assesses needed care and collaborates with patients, and others, to provide clinical solutions. Provides comprehensive nursing assessment in an untraditional nursing environment. Actively participates in team conferences and helps assess patient education needs. Notifies each practice, physician, and/or managed care client of all encounters with patients, parents or managed care clients regardless of follow-up needs before office opening. Notifies designated leadership of operational concerns. Physical Requirements Work requires long periods of sitting and utilizing a telephone headset. Work requires walking, standing, lifting, reaching, stooping, bending, pushing and pulling. Must be able to lift 25 pounds. Must speak English and adapt to fit the patient audience while conveying information. Intact sense of sight, hearing, smell, and touch. Good finger dexterity. Critical thinking skills and ability to concentrate in a fast-paced environment with numerous interruptions. Must be able to respond quickly to changes in patient or call center conditions. Education, Experience and Certifications Graduate from an accredited School of Nursing required. BSN preferred. Current license to practice as a Registered Nurse in the state of applicable state required. Must apply for and maintain a South Carolina Registered Nurse license and any other Registered Nurse licenses from states that new clients may reside in. Experience in telephone triage, pediatrics and ED triage is desired.BLS required per policy guidelines. Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance Benefits and more Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and paid parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview. About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.
RN Telehealth Full-time
UnitedHealthcare

Transition of Care Telephonic Case Manager RN - Daytona Beach, FL, and surrounding areas

UnitedHealthcare Daytona Beach, FL
$29 - $52 / hour
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together Employee must reside in the state of Florida within the Daytona Beach, FL and surrounding metro areas. If you are located in the state of Florida, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities Making outbound calls to assess members' current health status and ensuring members receive the necessary services and resources Identifying gaps or barriers in treatment plans Providing patient education to assist with self-management Coordinating care for members Making referrals to outside sources Coordinating services as needed (home health, DME, etc.) Educating members on disease processes Encouraging members to make healthy lifestyle changes Documenting and tracking findings What Are The Reasons To Consider Working For UnitedHealth Group? Put It All Together - Competitive Base Pay, a Full And Comprehensive Benefit Program, Performance Rewards, And a Management Team Who Demonstrates Their Commitment To Your Success. Some Of Our Offerings Include Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays Medical Plan options along with participation in a Health Spending Account or a Health Saving account Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage 401(k) Savings Plan, Employee Stock Purchase Plan Education Reimbursement Employee Discounts Employee Assistance Program Employee Referral Bonus Program Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications Current Florida Registered Nurse license 2+ years of experience in a hospital setting, acute care, or direct care 1+ years of case management experience Intermediate level of proficiency with MS Word, Teams, Excel and Outlook Reside in the Daytona Beach and surrounding metro Areas Preferred Qualifications Bachelor's Degree Experience with electronic charting Experience with arranging community resources Field-based work experience Telephonic Case Management experience Background in managing populations with complex medical needs Bilingual - Spanish Soft Skill Demonstrated solid organizational skills All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $29.00 - $52.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
RN Telehealth Full-time
WakeMed Health

Registered Nurse (RN) eICU

WakeMed Health Raleigh, NC
Overview The Clinical Nurse in the TeleICU monitors the adult ICU patients remotely via two-way audio and video cameras. The Clinical Nurse serves as a member of the of nursing team providing comprehensive nursing to patients and their families through the implementation of a plan of care. The plan is based upon the patient's developmental and health care needs identified through the assessment of the patient's physical, psychological, socioeconomic status, and physician orders regarding care, treatment, and education. The plan is based upon the patient's developmental and health care needs identified through the assessment of the patient's physical, psychological, socioeconomic status, and physician orders regarding care, treatment, and education. The Clinical Nurse understands the needs of the organization and supports the mission, values, and management of patient care services. The Clinical Nurse actively supports and incorporates ANA Scope and Standards of Nursing Practice, North Carolina Board of Nursing Practice Act, WakeMed's Division of Nursing Professional Practice model, and WakeMed's Patient & Family Centered Care (PFCC) model. The four key concepts of PFCC are: Dignity and Respect = Listen to and honor patient and family perspectives and choices; Information Sharing = Communicate and share complete and unbiased information with patients and families in ways that are affirming and useful; Participation = Patients and families are encouraged and supported in participating in care and decision-making at the level they choose; Collaboration = Patients and families and the Clinical Nurse collaborate in the delivery of care. Department Description Serving the community since 1961, WakeMed Health & Hospitals is the leading provider of health services in Wake County. With a mission to improve the health and well-being of our community, we are committed to providing outstanding and compassionate care. For more information, visit www.wakemed.org . EOE Licensure Registered Nurse Required Education Diploma Nursing Required - Or Associate's Degree Nursing Required - And Bachelor's Degree Nursing Preferred Experience 5 Years Nursing - Related Area Required
NP Telehealth Full-time
OrangeTwist

Wellness/Longevity Nurse Practitioner / Physician Assistant (Full-time)

OrangeTwist Newport Beach, CA
$90 - $150 / hour
We want people to look + feel amazing. “Look good feel good” isn’t just a cute phrase around here. We make it happen, in real life, every single day. It’s all about innovation, personalization, and connection. No two people are ever alike, and neither are their treatments. We have high standards. Our treatments are curated from nothing but the best. We believe chic and high-end should still be friendly and approachable. This is OrangeTwist. Your treatment shop. 24 locations and growing 7 different types of treatments in 1 shop Our current eNPS (Employee Net Promoter Score) score of 75—Exceptional, world-class score— Extremely high employee's satisfaction and loyalty, showcasing a strong and positive work culture. We are seeking an experienced, client-focused Physician Assistant (PA-C) or Nurse Practitioner (NP) to serve as the clinical lead for our Wellness & Longevity Program. This provider will be the central point of care for clients seeking peptide therapies and, as the program expands, Hormone Replacement Therapy (HRT). The Wellness & Longevity PA/NP will conduct comprehensive client intakes and clinical assessments, determine clinical appropriateness for treatment, prescribe therapies within their scope of practice, and develop individualized treatment plans. As the primary prescribing provider for the Wellness & Longevity Program, this individual will create comprehensive care plans that are executed by the center's providers, ensuring a coordinated, personalized client experience from evaluation through ongoing treatment. This role is instrumental in maintaining clinical excellence, ensuring client safety, and delivering exceptional outcomes within a collaborative, concierge-style wellness practice. Location: Remote, Need to live in California or Texas Schedule: 5 days a week, minimum 4 weekend days a month Compensation: Total compensation of $90-$150 hourly, based on performance What You Will Do: Clinical Assessment & Treatment Planning Serve as the primary clinical provider for the Wellness & Longevity Program. Conduct comprehensive client consultations, medical history reviews, and clinical assessments. Evaluate clients for peptide therapies and, as services expand, Hormone Replacement Therapy (HRT). Order, review, and interpret laboratory testing and diagnostic evaluations. Determine client eligibility for treatment based on clinical findings, laboratory results, and health goals. Prescribe peptide therapies, hormone replacement therapy, and other wellness treatments within the provider's scope of practice and applicable state regulations. Develop individualized treatment plans that guide each client's care throughout the program. Educate clients on recommended therapies, expected outcomes, potential risks, and lifestyle modifications that support long-term wellness. Care Coordination & Clinical Leadership Serve as the central point of prescribing and clinical decision-making for the Wellness & Longevity Program. Create comprehensive treatment plans that are implemented by the center's providers during ongoing client care. Collaborate with physicians, nurses, and other clinical team members to ensure seamless execution of prescribed treatment plans. Monitor client progress through follow-up visits and laboratory review, modifying treatment plans as clinically indicated. Ensure continuity of care and maintain high standards of documentation, client safety, and regulatory compliance. Program Development Assist in developing and refining standardized clinical protocols for peptide therapies and hormone optimization. Support the implementation and growth of new longevity and regenerative medicine services. Stay current on emerging research and evidence-based practices in longevity medicine, peptide therapies, hormone optimization, and preventive health. Participate in quality improvement initiatives and help establish best practices for client outcomes. Qualifications: Valid State license to practice as a Physician Assistant Valid State license to practice as a Registered Nurse and Nurse Practitioner DEA registration required. Minimum 2 years experience in functional medicine, integrative medicine, anti-aging medicine, wellness, longevity, endocrinology, weight management, or regenerative medicine. Minimum 2 years experience prescribing peptide therapies and/or Hormone Replacement Therapy. Strong clinical assessment, diagnostic, and treatment planning skills. Excellent communication and client education abilities. Ability to practice independently within state scope and collaborative practice requirements. Proficiency in interpreting comprehensive laboratory panels. Perks Forward-thinking, transparent, and inclusive company culture Competitive salary, incentive plan, generous paid time off, sick time, and paid holidays Comprehensive benefits package including medical, dental & vision insurance 401k employee contributions, FSA, and dependent care options Continuing education with our own University Employee referral bonus program, employee resource groups, and professional development All benefits dependent on role and eligibility We’re accepting applications on an ongoing basis and will continue reviewing candidates until the role is filled. All candidate email communication will be done through an @orangetwist.com email address. If you ever receive communication regarding a job posting from an entity that does not match that or seems concerning, please contact Recruiting@orangetwist.com. OrangeTwist is a leading national Aesthetic treatment with a mission to make our clients look + feel amazing. OrangeTwist is “your treatment shop for body, face, and skin,” offering curated treatments including Botox + fillers, CoolSculpting, HydraFacial, lasers, micro-needling, skin and scalp care, and more. We recognize that the key to success lies in valuing the minds, experiences and perspectives of people from all walks of life. OrangeTwist is proud to value diversity and be an equal opportunity employer. Pursuant to the San Francisco Fair Chance Ordinance and the Los Angeles Fair Chance Initiative for Hiring, we will consider for employment qualified applicants with arrest and conviction records. OrangeTwist is an E-Verify employer. GDPR & CCPA disclosure notice here.
NP Telehealth Telehealth Full-time
Vitability Health

Per Diem Remote Telehealth Physician Assistant (PA) or Nurse Practitioner (NP) Vitability Health of New Jersey

Vitability Health Union, NJ
About Us: Vitability Health of New Jersey is dedicated to providing high-quality, patient-centered care to individuals with chronic health conditions. Our mission is to enhance the well-being of our patients through comprehensive, personalized care management. **Job Description:** As a PA/NP in our telehealth practice, you will provide virtual healthcare services to patients, conducting remote consultations, and offering guidance on preventive care and health management. **Qualifications:** - Certified as a Physician Assistant (PA) or Nurse Practitioner (NP) with current licensure in NJ. - Experience in telehealth or a strong interest in virtual patient care. - Proficiency in using telemedicine platforms and electronic health records (EHR). - Excellent communication skills and ability to build rapport with patients remotely. - Dedication to providing high-quality, patient-centered care. **Benefits:** - Competitive compensation package with options for full-time or part-time employment. - Flexible scheduling to accommodate work-life balance. - Supportive team environment focused on innovation and patient care.
CNA Telehealth Full-time
UnitedHealthcare

Field Care Coordinator - Remote in Ada County, ID and Surrounding Areas

UnitedHealthcare Boise, ID
$29 - $52 / hour
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together. As a part of the care management team, the Care Coordinator will be the primary care manager for a panel of members with chronic and complex health care needs. This position will provide support to the broader team with clinical and non-clinical activities to support a person-centered approach to care coordination. Care coordination activities will focus on supporting member's medical, behavioral, and socioeconomic needs to promote appropriate utilization of services and improved quality of care. This is a fast-paced working environment that requires the ability to multitask with attention to detail and excellent organizational skills. If you reside within the state of Idaho and live within one of the following counties ( Ada, Boise, Elmore, or Valley County), you will have the flexibility to work remotely* as you take on some tough challenges. This is a hybrid- based position up to 50% of time in field when business requires with a home - based office. You will work from home when not in the field. Primary Responsibilities Serve as the primary care manager for dual eligible members Engage people face-to-face and/or telephonically to complete a comprehensive needs assessment or wellness assessment (as appropriate), including assessment of medical, behavioral, functional, cultural, and social drivers of health (SDoH) Develop and implement individualized, person-centered care plans inclusive of goals, opportunities and interventions aligned with a person's readiness to change to support the best health and quality of life outcomes by meeting them where they are in their health journey Partner and collaborate with the internal care team, providers, and community resources/partners to implement care plans and remove obstacles so the member can successfully stay in or return to the community (when appropriate Assist members with obtaining necessary HCBS supports and services Provide referral and linkage as appropriate and accepted by the individual being served (may include internal consult opportunities such as Housing Navigator, Pharmacy Team, Peer Specialist, etc. or community-based provider referrals such as PCP, specialists, medication assisted therapy referrals, etc.) Support proactive discharge planning and manage/coordinate care transition following ER visit, inpatient or Skilled Nursing Facility Provide education and coaching to support member self-management of care needs and lifestyle changes to promote health Advocate for people and families, as needed, to ensure that the member's needs and choices are fully represented and supported by the health care team Support Provider and Facility nonclinical questions (credentialing, claims, etc.) connecting them to the correct Health Plan and/or UHC resources You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications Must meet one of the following: Current and unrestricted Idaho license in one of the below: RN LCSW, LMSW, LSW, LCPC, LPC, LMFT, LAMFT LPN/LVN 2-year degree (or higher) AND 2+ years of experience in Healthcare or Healthcare related industry 1+ years of experience working with people that have Medicaid / Medicare or who have significant social drivers of health (SDoH) needs 1+ years of experience with MS Office, including Word, Excel, and Outlook Reliable transportation and the ability to travel within assigned territory to meet with members and providers up to 50% of time depending on member and business needs Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI) Reside in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service Preferred Qualifications CCM certification If individual with 2-year degree and 2+ years of experience, preferably as a Healthcare Paraprofessional Experience working with an Electronic Health Record (EHR) system for documentation Demonstrated experience / additional training or certifications in care in rural settings homelessness, food insecurity, behavioral health, co-occurring conditions, IDD, Person Centered Care, Motivational Interviewing, Stages of Change, Trauma-Informed Care Experience supporting individuals with complex and chronic conditions including those residing in a nursing facility or that meet nursing facility level of care within the community Background in Managed Care Experience working in team-based care Bilingual in Spanish or other language specific to market populations Live in Idaho Physical Requirements Ability to transition from office to field locations multiple times per day Ability to navigate multiple locations/terrains to visit employees, members and/or providers Ability to transport equipment to and from field locations needed for visits (ex. laptop, stethoscope, etc.) Ability to remain stationary for long periods of time to complete computer or tablet work duties All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $29.00 to $52.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
RN Telehealth Full-time
UnitedHealthcare

DRG/Clinical Validation Auditor RN,

UnitedHealthcare Plymouth, MN
$34.23 - $61.15 / hour
$10,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. In this position as a Clinical DRG RN auditor , you will apply your expert knowledge of the MS-DRG and APR-DRG coding/reimbursement methodology systems, ICD-10 Official Coding Guidelines, and AHA Coding Clinic Guidelines in the auditing of inpatient claims. Employing both industry and Optum proprietary tools, you will validate ICD-10 diagnosis and procedure codes, DRG assignments, and discharge statuses billed by hospitals to identify overpayments. Utilizing excellent communications skills, you will compose rationales supporting your audit findings. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities Conduct MS-DRG and APR-DRG coding reviews to verify the accuracy of DRG assignment and reimbursement with a focus on overpayment identification Utilize expert knowledge to identify the ICD-10-CM/PCS code assignment, appropriate code sequencing, present on admission (POA) assignment, and discharge disposition, in accordance with CMS requirements, ICD-10 Official Guidelines for Coding and Reporting, and AHA Coding Clinic guidance Apply current ICD-10 Official Coding Guidelines and AHA Coding Clinic citations and demonstrate working knowledge of clinical criteria documentation requirements used to successfully substantiate code assignments Perform clinical coding review to ensure accuracy of medical coding and utilize clinical expertise and judgment to determine correct coding and billing Utilize solid command of anatomy and physiology, diagnostic procedures, and surgical operations developed from specialized training and extensive experience with ICD-10-PCS code assignment Write clear, accurate and concise rationales in support of findings using ICD-10 CM/PCS Official Coding Guidelines, and AHA Coding Clinics Utilize proprietary workflow systems and encoder tool efficiently and accurately to make audit determinations, generate audit rationales and move claims through workflow process correctly Demonstrate knowledge of and compliance with changes and updates to coding guidelines, reimbursement trends, and client processes and requirements Maintain and manage daily case review assignments, with a high emphasis on quality Provide clinical support and expertise in the other investigative and analytical areas Work in a high-volume production environment that is matrix driven What Are The Reasons To Consider Working For UnitedHealth Group? Put It All Together - Competitive Base Pay, a Full And Comprehensive Benefit Program, Performance Rewards, And a Management Team Who Demonstrates Their Commitment To Your Success. Some Of Our Offerings Include Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays Medical Plan options along with participation in a Health Spending Account or a Health Saving account Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage 401(k) Savings Plan, Employee Stock Purchase Plan Education Reimbursement Employee Discounts Employee Assistance Program Employee Referral Bonus Program Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) More information can be downloaded at: http://uhg.hr/uhgbenefits You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications Associate's Degree (or higher) Unrestricted RN (Registered Nurse) license CCS/CIC or willing to obtain certification within 6 months of hire 3+ years of MS DRG/APR DRG coding experience in a hospital environment with expert knowledge of ICD-10 Official Coding Guidelines and DRG reimbursement methodologies 2+ years of ICD-10-CM coding experience including but not limited to expert knowledge of principal diagnosis selection, complications/comorbidities (CCs) and major complications/comorbidities (MCCs), and conditions that impact severity of illness (SOI) and risk of mortality (ROM) 2+ years of ICD-10-PCS coding experience including but not limited to expert knowledge of the structural components of PCS such as selection of appropriate body systems, root operations, body parts, approaches, devices, and qualifiers Preferred Qualifications Experience with prior DRG concurrent and/or retrospective overpayment identification audits Experience working with Utilization Management Experience with readmission reviews of claims Experience with DRG encoder tools (ex. 3M) Experience using Microsoft Excel with the ability to create / edit spreadsheets, use sort / filter function, and perform data entry Healthcare claims experience Managed care experience Knowledge of health insurance business, industry terminology, and regulatory guidelines Soft Skills Ability to use a Windows PC with the ability to utilize multiple applications at the same time Ability to work independently in a remote environment and deliver exceptional results Demonstrate excellent written and verbal communication skills, solid analytical skills, and attention to detail Excellent time management and work prioritization skills Physical Requirements And Work Environment Frequent speaking, listening using a headset, sitting, use of hands / fingers across keyboard or mouse, handling other objects, long periods working at a computer Have a secluded office area in which to perform job duties during the work day Have reliable high-speed internet access and a work environment free from distractions All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $34.23 to $61.15 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #GREEN #RPOLinkedin
CMA Telehealth Full-time
BayCare Health System

Care Partner - Medical Assistant

BayCare Health System Tampa, FL
At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that’s built on a foundation of trust, dignity, respect, responsibility and clinical excellence. The Care Partner-Medical Assistant Responsibilities Include Works collaboratively with the Licensed Practical Nurse (LPN) Care Partner to review patient chart data, identify open Healthcare Effectiveness Data and information Set (HEDIS) gaps and facilitates gap closure. Partners with BayCare Medical Group (BMG) physicians and office medical staff to ensure gaps are addressed and closed. Performs telephonic outreach to patients to discuss needed care, assess and document barriers to accessing medical services and support care coordination efforts for Population Health Services Organization (PHSO). Places standing orders for open quality gaps in accordance with BMG policy to facilitate timely gap closures. Position Details Location: Hybrid Status: Full time; 40 hours per week Schedule: Monday - Friday; days. Times may vary. Weekend Requirement: No On Call: No Education Required High School Diploma or Equivalent (GED) Experience Required 1 year experience Medical Assistant Benefits Benefits (Health, Dental, Vision) Paid time off Tuition reimbursement 401k match and additional yearly contribution Yearly performance appraisals and team award bonus Community discounts and more Equal Opportunity Employer Veterans/Disabled
RN Telehealth Full-time
Astrana Health

Care Manager - RN (ACM)

Astrana Health Houston, TX
$80,000 - $94,000 / year
Care Manager - RN (ACM) Department: HS - ACM Employment Type: Full Time Location: 19500 HWY 249, Suite 570 Houston, TX 77070 Compensation: $80,000 - $94,000 / year Description We are looking for a compassionate and experienced Care Manager - RN to join our Houston team. In this role, you will provide comprehensive care management and coordination for members across the continuum of care, partnering with providers, interdisciplinary teams, and community resources to improve clinical outcomes, enhance quality of care, and support members with complex medical, behavioral, and psychosocial needs. Our Values: Put Patients First Empower Entrepreneurial Provider and Care Teams Operate with Integrity & Excellence Be Innovative Work As One Team What You'll Do Care Management & Coordination Conduct comprehensive health assessments, including medical, behavioral, and social determinants of health (SDOH). Develop, implement, and evaluate individualized care plans based on member needs, goals, and risk level. Coordinate care across multiple settings, including inpatient, outpatient, and community-based services. Facilitate transitions of care, including hospital discharge planning and post-discharge follow-up. Clinical Oversight Utilize clinical expertise to identify gaps in care, potential risks, and opportunities for early intervention. Monitor member progress and adjust care plans accordingly. Provide education to members and caregivers regarding disease management, medications, and treatment plans. Apply evidence-based guidelines and best practices in care management. Utilization Management & Cost Containment Support appropriate utilization of healthcare services to ensure cost-effective care delivery. Collaborate with utilization management teams to reduce avoidable hospitalizations and emergency department visits. Identify high-risk members and implement strategies to improve outcomes and reduce healthcare costs. Collaboration & Communication Partner with physicians, specialists, behavioral health providers, and community agencies to coordinate care. Serve as a liaison between members, providers, and health plan resources. Participate in interdisciplinary team meetings and case conferences. Maintain effective communication to ensure continuity of care. Quality & Compliance Ensure timely and accurate documentation in accordance with regulatory, CMS, and organizational requirements. Support quality improvement initiatives, including HEDIS, STAR ratings, and other performance measures. Maintain compliance with accreditation standards and internal policies. Member Engagement Conduct outreach to engage members in care management programs. Promote self-management and adherence to treatment plans. Address barriers to care, including social, economic, and cultural factors. Qualifications Bachelor of Science in Nursing (BSN) preferred; Associate degree in Nursing required Texas RN unrestricted active license At least 2 years of clinical nursing experience (case management, acute care, medical group, health plan, or managed care preferred) Certifications & Licensure Active, unrestricted Registered Nurse (RN) license Strong clinical background must be familiar with developing care plans and assessments Experience with Microsoft Office Word Understanding of regulatory standards (CMS, NCQA, etc.). Ability to assess and manage complex clinical and psychosocial situations Excellent communication, collaboration, and critical-thinking skills Proficiency in electronic health records (EHR) and care management documentation systems Ability to manage multiple priorities in a fast-paced environment You'll be a great for the role if: Able to work independently and make independent decisions Ability to work prioritize and multi-task Excellent written and verbal communication skills Maintain courteous professional attitude when working with internal and external customers Maintains member confidence and protects operations by keeping claim information confidential in compliance with HIPAA requirements Environmental Job Requirements and Working Conditions This role follows a hybrid work structure where the expectation is to work on the field and at home on a weekly basis. The office is located at 19500 HWY 249, Suite 570 Houston, TX 77070. This position requires up occasional travel for onsite visits or team meetings. The target pay range for this role is between $80,000 - $94,000 annually. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors. Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided based on qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation. Additional Information: The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
RN Telehealth Full-time
Guthrie

Virtual Acute Care Registered Nurse - Full Time - nights

Guthrie Big Flats, NY
$39 - $54.12 / hour
Acute Care Virtual Registered Nurse - the office and position is located in Big Flats, NY! This position is Full Time nights 6p-6a- 36 hours a week. This position is eligible for a $25,000 sign on bonus! Position Details: This Virtual Acute Care Registered Nurse must work out of the Big Flats NY office and will provide virtual support to bedside nurses at all Guthrie Hospital inpatient acute care (non-critical care) units. The Virtual Registered Nurse (RN) provides professional nursing care for patients in an acute care environment utilizing telecommunication technology. Collaborates with the bedside nurse to provide coordinated, safe, compassionate, therapeutic, evidence-based quality care to patients and families, based on individual physical, emotional, and spiritual needs, and appropriate care strategies throughout the lifespan. Practices in accordance with the Nurse Practice Act in the state of employment, the American Nurses Association (ANA) Code of Ethics for Nurses, and the ANA scope and standards of practice. Essential functions and specific skills for the job are found in the unit specific onboarding checklist and in standards that are applicable to the specialty. Education, License, & Certification - • Graduate from an accredited School of Nursing. BSN in Nursing preferred. - • Any previously agreed upon effective date for obtaining a bachelor's degree in nursing between individuals and facilities will remain in effect. - • Any contract with specific time frames for obtaining a bachelor's degree in nursing will supersede the above point and will remain in effect. - • Registered Nurse licensed in both the States of New York and Pennsylvania - • Specialty Certification is preferred - • Current BLS / ACLS required within 6 months - • Proficient with Windows-based computer skills and operation - • Proficient with EPIC documentation Experience - • 5 years of experience in acute care bedside nursing - • Specialty Certification required within 1 year - • Must maintain BLS / ACLS required within 6 months - • The Registered Nurse must meet the individual nursing unit specifications regarding educational requirements during employment. Essential Functions Employs Nursing Professional Practice: Utilizes clinical assessment skills and knowledge of EPIC and Sickbay functionality or designated software application, to monitor patients effectively and efficiently in collaboration with the patient's primary nurse. Utilize critical thinking skills and the specialized software to assess patients, and preemptively address subtle signs and symptoms of clinical deterioration or status changes. Develops updates and coordinates the patients' plan of care to achieve patient goals and to optimize outcomes and transitions across the continuum. Monitors, records, and communicates patient condition as appropriate. Advocates: Effectively advocates for ethical and holistic care by partnering in care planning to promote the autonomy, dignity, rights, values, and beliefs of those we serve. Communicates effectively to inform, coach, and support onsite nurses/clinicians, cultivating a therapeutic team approach. Facilitates Learning: Fosters a learning environment for patients/families, nursing, and other members of the healthcare team, including students. Facilities formal and informal learning for patients/families, nursing, other members of the healthcare team, and community. Serves as a clinical resource, coaches and mentors clinical nurses in areas of clinical and professional practice. Models' professional behaviors as a representative of the nursing profession. Aligns Practice with Safety and Quality: Manages assignment of complex patients and other unit demands. Proactively recognizes, determines a plan of action, and responds to routine, urgent, and emergent patient situations utilizing direct observation via videoconferencing, proactive surveillance of adverse physiological trends, medical chart review, and clinical alarms. Provides follow-up to ensure problem resolution. Engages in Professional Development: Engages in ongoing professional development; practices at the top of license within the legal parameters of the Nurse Practice Act, the ANA Code of Ethics for Nurses, and specialty standards. Promotes a culture of inquiry that explores, integrates, and disseminates research and evidence-based practice. Leader in Practice Setting & Community demonstrates leadership as change agents using the collaborative leadership skills of advocacy, influence, and innovation. Provides high level contributions to the onsite nurses' knowledge of pathophysiology, pharmacology, hemodynamics, bedside technology, and nursing care. It is understood that this description is not intended to be all-inclusive and that other duties may be assigned as necessary in the performance of the position. Other Duties 1. Proficiency in Information Technology, such as electronic health records, communication systems, computers, and equipment necessary to perform essential functions of the position. 2. Skilled to work with a wide range of staff as part of an interdisciplinary team, including physicians, nurses, and ancillary staff. 3. Ability to use independent, critical judgment in all aspects of patient care delivery. 4. Demonstrated interpersonal skills that convey a positive and supportive attitude. 5. Ability to effectively manage multiple responsibilities, urgent responses, and challenging situations. 6. Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of the job, especially regarding activities impacting patient or employee safety or security. 7. Hearing / Visual requirement The pay for this position ranges from $39.00-$54.12 per hour.
RN Pediatric Telehealth Part-time
Mercy

Peds vAcute Specialty RN II

Mercy Town and Country, MO
Find your calling at Mercy! Join Mercy Virtual and Transform Healthcare! Mercy Virtual is seeking experienced and compassionate Specialty Registered Nurses (RNs) to join our Mercy Kids Connect vAcute Triage Program. In this innovative virtual care setting, you will provide expert triage, patient education, care coordination, and clinical support to patients and families through advanced telehealth technology. This role is ideal for nurses with strong clinical expertise in Pediatrics who are passionate about delivering high-quality patient care in a virtual environment. Location: Remote after training period-must be within driving distance to Chesterfield, MO Schedule: PRN for evenings and weekends Position Details: Position Summary The vAcute Specialty RN performs nursing duties in accordance with all applicable federal, state, and Mercy regulations, policies, and procedures. Working under the direction of the Medical Director and as part of the Mercy Virtual care team, you will assess patient needs, coordinate care, provide education, and deliver virtual triage services for patients requiring specialty support. Pediatrics Specialty Supporting pediatric patients through assessment, triage, care coordination, and family-centered care. Key Responsibilities Utilize the Mercy Nursing Conceptual Framework and nursing process to provide exceptional patient care. Perform virtual assessment, triage, and care coordination for patients using Mercy Virtual technology. Prioritize patients based on acuity and patient needs utilizing Mercy Virtual software. Communicate and coordinate care plans with patients, families, physicians, and interdisciplinary team members. Maintain professional accountability for assigned patient care. Ensure patient rights, privacy, and confidentiality are upheld at all times. Document all patient interactions and required chart entries accurately and timely. Educate patients and families regarding care plans, treatment processes, and virtual care technology. Utilize video-based patient communication platforms to support patient engagement and assessment. Collaborate with internal and external providers to facilitate continuity of care. Support Mercy's family-centered care philosophy by actively involving patients and families in care planning and decision-making. Coordinate workflow and communicate patient needs promptly with appropriate personnel. Assist in directing departmental activities consistent with patient needs and team capabilities. Participate in Shared Governance and Mercy Virtual Quality Assurance initiatives. Perform all clinical duties within the RN scope of practice and credentialed privileges. Demonstrate behaviors consistent with Mercy's Mission, Vision, and Service Standards. Required Qualifications Education Graduate of an accredited Registered Nursing program. Bachelor of Science in Nursing (BSN) required. Experience Minimum of 5 years of diversified direct clinical nursing experience required. Licensure Current RN license in state of practice or eligibility for licensure. Ability to obtain additional state licensure as required. Certification BLS Certification required within 6 months of hire. Why Mercy Virtual? At Mercy, we're pioneering the future of healthcare through innovative virtual care solutions. You'll have the opportunity to leverage your clinical expertise while improving access to care and creating meaningful patient experiences—all from a remote work environment after completing training. Apply today and help redefine healthcare delivery through Mercy Virtual's vAcute program. Why Mercy? From day one, Mercy offers outstanding benefits - including medical, dental, and vision coverage, paid time off, tuition support, and matched retirement plans for team members working 32+ hours per pay period. Join a caring, collaborative team where your voice matters. At Mercy, you'll help shape the future of healthcare through innovation, technology, and compassion. As we grow, you'll grow with us. keyword(s): Nursing, Nurse, RN, Peds RN, Pediatric Nurse, Peds Nurse, Pediatric RN, Nurse, Virtual Nursing
RN Telehealth Full-time
UnitedHealthcare

Senior Clinical Quality RN - Eastern Missouri - Remote

UnitedHealthcare St. Louis, MO
$72,800 - $130,000 / year
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. This role reports to Quality Leadership and is responsible for ongoing provider education related to HEDIS and pay for performance (P4P) measures, as well as state-mandated and accreditation-related quality requirements. The Sr. Clinical Quality RN will serve as a liaison to establish trusting relationships with MO C&S providers to problem-solve and provide resources to support improved member quality outcomes. This role will also support additional health plan initiatives such as medical record reviews, external quality audits, and clinical data integration. If you live in Missouri , and willing to travel 25% of the time to cover Eastern Missouri , you will have the flexibility to work hybrid* as you take on some tough challenges. Primary Responsibilities Representing the health plan in meetings with healthcare providers to promote health plan quality initiatives and Value-Based care programs, and to provide needed resources to support improved member quality outcomes Monitoring and reviewing Patient Care Opportunity Reports (PCOR) with providers to facilitate member preventative wellness and closure of care gaps Supporting health plan initiatives to maximize HEDIS rates and achieve P4P targets both prospectively and during the medical record chase process retrospectively Coordinating remote and onsite provider medical record reviews to assess compliance with documentation standards, service delivery, billing and coding practices, and quality standards Collaborating with internal health plan partners on clinical quality initiatives, such as those related to Performance Improvement Projects (PIPs), data integration efforts with providers, CAHPS, and NPS improvement Representing the health plan at community events when needed You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications Current unrestricted RN licensure in Missouri 5+ years of clinical experience in any setting 3+ years of quality experience (performance improvement, HEDIS performance measures, chart review, team facilitation, etc.) Knowledge of one or more of the following: clinical standards of care OR preventive health standards, OR HEDIS, OR NCQA, OR regulatory requirements Intermediate proficiency in software applications that include, but are not limited to, Microsoft PowerPoint, Microsoft Word, Microsoft Excel, Microsoft Outlook, and Internet browsers Proven ability to interact with internal and external customers in a professional manner Proven ability to develop provider relationships Proven effective presentation skills and experience providing outcomes data to senior leadership Proven self-motivated and have ability to work well both independently and with others as a team Willing or ability to travel up to 25% of the time to provider locations within a designated area, as well as other areas when needed to meet the needs of the team Reside in or within commutable driving distance to St. Louis, MO area, surrounding county in state of Missouri, or the Missouri Eastern Region Preferred Qualifications Master's degree Managed care experience Experience working with Medicaid and/or Medicare populations in a managed care setting Experience with Clinical Informatics Advanced proficiency in Excel (i.e., pivot charts, graphs, &/or data manipulation and analysis) Proficiency in software applications that support HEDIS activities, including but not limited to, Tableau, and vendor platforms Proven bilingual - English/Spanish All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
RN Telehealth Full-time
L.A. Care Health Plan

Clinical Policy 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 Clinical Policy Nurse RN II is responsible for analytical research, trending, and assessment based on legislation, regulatory and accreditation requirements that impact claims, Utilization Management (UM) department and healthcare services policies. Reviews and analyzes clinical financial data to assess the effectiveness of existing and proposed policies to identify opportunities for improvement, cost containment, and quality enhancement. This position plays a key role in translating regulatory impacts into operational strategies and works collaboratively with internal and external stakeholders to ensure clinical policies support safe, effective, and compliant care delivery. Assists in development of policies and programs that improve health outcomes and target Fraud, Waste and Abuse (FWA). This position works cross functionally with other departments to develop end to end operational strategies of policy content and roll out timeframes. The Clinical Policy Nurse II serves as a liaison to ensure the ongoing maintenance of clinical coding for the authorization matrix. Duties Assess federal, state, and local legislation, regulatory guidance, and health care policies to identify potential impacts on clinical practice, reimbursement and organizational operations that impact healthcare services policies. Review and interpret clinical, utilization, and financial data to identify trends, opportunities for policy improvement and cost-savings. Research, develop, and evaluate clinical and health policy designed to improve patient outcomes, detect and mitigate Fraud, Waste, and Abuse (FWA), and streamline organizational processes. Monitor the implementation of health programs, clinical initiatives, and community action plans to assess effectiveness, compliance, and impact on patient outcomes. Collaborate with internal stakeholders to evaluate utilization trends and anomalies and contribute to policy development aimed at improving efficiency and compliance identified during risk assessments. Prepare analytical reports, summaries, and analyses assessing policy performance, regulatory impact, and communicate insights and recommendations to stakeholders to drive evidence-based policy and impacted outcomes. Present findings, recommendations, and action plans to key stakeholders. Participate in work groups related to healthcare services clinical policies and procedures including efforts to improve department processes, as needed. 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 active participation in state regulatory audits such as Department of Health Care Services (DHCS), Department of Managed Health Care (DMHC), Centers for Medicare and Medicaid Services (CMS), and/or National Committee for Quality Assurance (NCQA) audits. At least 1 year of experience in clinical health services policies with a managed care plan. Skills Required: Demonstrated strong reporting skills by preparing clear, concise reports and presentations that communicate findings and performance. Working knowledge of clinical policies. Strong analytical and critical thinking skills with the ability to interpret regulatory requirements and legislation. Ability to translate regulatory requirements into auditable tools. Ability to perform independent research on complex medical topics. Excellent verbal and written communication skills. Strong problem solving and team building skills. Ability to work independently with strong self-direction. Advanced proficiency in Microsoft Word, Excel, and PDF documentation tools. Ability to work effectively with diverse teams in cross-functional work groups. Ability to multitask, re-prioritize tasking, and streamline day-to-day operations. Strong organizational and time-management skills. Preferred: Advanced skills in assessing clinical policy deficiencies through literature searching and clinical research analysis based on the best available evidence. Understanding of the managed care industry and market conditions. 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
L.A. Care Health Plan

Clinical Policy Clinical Coder RN II

L.A. Care Health Plan Los Angeles, CA
$102,183 - $163,492 / year
Salary Range: $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (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 Clinical Policy Clinical Coder RN II is responsible for analyzing, interpreting, and operationalizing medical and utilization management policies to ensure accurate coding, appropriate authorization requirements, compliant claims processing, and effective utilization oversight. This position serves as a key clinical and coding resource, translating medical policy requirements into diagnosis, procedure, and service code logic, including determining which codes require prior authorization. Conducts in-depth research and analysis of legislation and regulatory requirements, clinical outcomes, utilization, claims, and financial data to identify utilization trends, fiscal risk, and opportunities for policy enhancement and cost containment. This position works cross-functionally with internal teams to ensure policies are codified, consistently applied, and monitored through reporting and data analysis. This position collaborates closely with internal stakeholders and external entities to support standardized benefit administration, effective program implementation, and organizational compliance with state, federal, and accreditation requirements. Duties Translate approved clinical policies and utilization management criteria into clear, codified claims rules and system logic to support accurate claims adjudication. Develop, revise, and recommend clinical policies and internal utilization management criteria when standard clinical guidelines are insufficient to support appropriate decision-making based on codified claim rules. Assess the downstream claims impact of new or revised clinical policies prior to implementation and recommend configuration updates to mitigate operational or financial risk. Participate in validation of claims configuration changes to ensure policies are applied correctly and consistently across all lines of business. Monitor post-implementation claims activity to identify configuration issues, unintended denials, or payment discrepancies related to clinical policy application. Support remediation of claims configuration defects by identifying root causes and coordinating corrective actions with internal teams. Participate in and lead specialty and cross-functional workgroups and committees focused on healthcare services clinical policies, utilization management processes, strategic initiatives, policy governance, operational alignment, and continuous improvement efforts. Ensure timely dissemination of accurate and consistent policies and procedures across departments. Promote collaboration, engagement, and a positive work environment while supporting departmental initiatives and team-based activities. Manage assigned projects from concept through implementation, ensuring timelines, quality standards, and deliverables are met. Analyze and interpret medical and utilization management policies to identify applicable diagnosis, procedure, and service codes and determine authorization, pre-payment, or post-payment review requirements. Define and maintain code lists that require prior authorization or other utilization management controls based on clinical evidence, regulatory guidance, utilization trends, and financial risk. Duties Continued Collaborate with internal teams to ensure authorization requirements and coding logic are accurately configured in authorization and claims systems based on authorization matrix requirements. Support accurate claims processing by validating codified authorization and policy requirements are correctly applied and aligned with approved medical policies. Provide clinical and coding recommendations to support the development, revision, and implementation of new or updated medical and utilization management policies. Investigate and resolve coding and authorization related issues, including claim denials, coding edits, authorization discrepancies, and policy interpretation questions. Review and assess claims edits, authorization matrixes, and coding rules to identify root causes of errors or inconsistencies and recommend corrective actions. Ensure coding, authorization requirements, and claims-related guidance align with medical necessity criteria, benefit structures, and applicable state, federal, and regulatory requirements. Develop, review, and maintain reporting related to authorization required codes, approval and denial rates, utilization patterns, claims payment outcomes, and policy effectiveness. Prepare reports, summaries, and presentations and communicate findings, recommendations, and action plans to internal and external stakeholders. Analyze claims, authorization, and utilization data to identify trends, measure policy impact, and recommend opportunities for policy refinement, cost containment, or reduction of administrative burden. Monitor post-implementation performance of authorization-required codes and recommend additions, removals, or modifications to authorization requirements based on regulatory thresholds and utilization outcomes. Perform other duties as assigned. Education Required Associate's Degree in Nursing Education Preferred Bachelor's Degree in Nursing Experience Required: At least 8 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. Experience with medical coding systems. Preferred: At least 1 year of experience in editing and writing clinical health services policies within a managed care health plan. Skills Required: Proficient with clinical policy through skills in literature searching and clinical research analysis based on the best available evidence. Working knowledge of clinical policies. Working knowledge of CPT/HCPC codes and claims. Ability to translate regulatory requirements into auditable tools. Ability to perform independent research on complex medical topics. Excellent verbal and written communication skills. Strong analytical, problem solving, and team building skills. Ability to work independently with strong self-direction. Advanced proficiency in Microsoft Word, Excel, and PDF documentation tools. Ability to work effectively with diverse teams in cross-functional work groups. Ability to multitask, re-prioritize tasking, and streamline day-to-day operations. Ability to identify discrepancies, assess risk, and recommend actionable solutions. Knowledge of medical coding systems, including ICD-10-CM, CPT, and HCPCS, and their application in authorization and claims environments. Strong organizational and time-management skills. Preferred: Advanced skills in assessing clinical policy deficiencies through literature searching and clinical research analysis based on the best available evidence. Proficient in claims configuration, including claims adjudication workflows, configuration of claims edits and rules, and the translation of clinical and utilization management policies into system-based claims logic to support accurate, compliant payment outcomes. Understanding of the managed care industry and market conditions. Licenses/Certifications Required Registered Nurse (RN) - Active, current and unrestricted California License Licenses/Certifications Preferred Certified Professional Coder (CPC) 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)
Surgical Tech Telehealth Full-time
UnitedHealthcare

Network Pricing Consultant - Remote PST/MST/CST

UnitedHealthcare Phoenix, AZ
$72,800 - $130,000 / year
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together. This opportunity is all about complexity and meaningful impact. You will play a key role in accurately and effectively pricing our provider network across the West Region markets, including Arizona, Nevada, Utah, and Idaho. Success in this role requires strong analytical thinking, creativity in interpreting contract structures, and the ability to leverage available resources to develop accurate and reliable pricing. As a Network Pricing Consultant, you will support and validate Provider Network (hospital, physician, ancillary facilities, etc.) contracting and unit cost management activities through financial modeling, analysis, and reporting. You will conduct unit cost and contract valuation analysis to support negotiations and unit cost management strategies, while managing unit cost budgets, targets, and performance reporting. Challenge can often be its own reward, but why settle for challenge alone when you can also be supported, mentored, and developed in a fast-paced and impactful career? With UnitedHealth Group, you can expect all of the above, every day. Here's your opportunity to combine analytical expertise and collaborative problem-solving as you strike the balance between health care costs and resources. In this role, you'll ensure that health care contracts are priced accurately and fairly for all involved, backed by the resources and stability of a Fortune 5 leader. While this role primarily supports West Region markets, you'll enjoy the flexibility to work remotely from anywhere in the U.S. For hires residing in the Minneapolis or Washington, D.C. areas, on-site work is required at least four days per week. Primary Responsibilities Support network pricing strategies and tactics in collaboration with local network field leaders and network managers Analyze financial impact of provider contracts Evaluate financial impact of corporate initiatives and external regulations Review payment appendices and develop options for various contracting approaches and methodologies Communicate financial impact findings and insights to stakeholder groups Conduct financial and network pricing modeling, analysis, and reporting Provide mentorship and engage in detailed peer review activities Perform unit cost and contract valuation analysis to support network contracting and unit cost management strategies Lead large and complex analytical projects to support key business objectives Influence pricing strategies and rate development by identifying opportunities or safeguarding favorable structures Collaborate with Network Management to strategize rates or contract methodologies Review competitive analysis to determine appropriate provider pricing You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications Undergraduate degree in Math, Statistics, Finance, Economics, or related field 4+ years of analytical experience 3+ years of experience with provider payment methodologies and healthcare products Experience presenting to internal or external stakeholders Financial impact analysis and data manipulation skills Advanced proficiency in Microsoft Excel Demonstrated ability to interpret financial modeling results and develop forecasts Demonstrated ability to manage multiple projects simultaneously Demonstrated ability to research and solve problems independently Preferred Qualifications Experience with advanced statistical functions for financial modeling Experience with various payment methodology types Knowledge of commercial, Medicare, and Medicaid PPO/HMO revenue and expense patterns Solid interpersonal, collaboration, negotiation, and communication abilities All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
RN Telehealth Full-time
L.A. Care Health Plan

Delegation Oversight Clinical Auditor 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 Delegation Oversight Clinical Auditor RN II is responsible for ensuring that delegates contracted to perform Utilization Management (UM) functions on behalf of L.A. Care (LAC) is in compliance with all UM regulatory requirements and new legislation through the maintenance of required policies/procedures/workflows/ processes/audit tools necessary to meet the requirements. This position utilizes a rapid team approach for needed improvements identified through external audits of delegated entities. This position assist in maintaining continuous quality improvement in the Delegation Oversight Clinical Audit unit ensuring that departmental/divisional and organizational goals are accomplished through overseeing and facilitating compliance of the Plan Partners, Participating Provider Groups (PPG), Specialty Health Plans (SHP), and contracted provider network as managed by the Delegation Oversight Department. This position is responsible, as part of the oversight team, for ensuring compliance of the Plan Partners and/or Participating Physician Groups (PPG) to regulatory, contractual and L.A. Care requirements. This position is responsible for performing annual and focused audits. This position also acts as a liaison between the Plan Partners and PPGs and L.A. Care Health Plan regarding UM issues. The position assists in improving access and utilization performance of Plan Partners and PPGs by being a resource for best practices and providing continuous feedback. Additionally, the oversight responsibility of this position includes reporting to management and providing consultation/instructional/coaching recommendations to improve overall compliance of Plan Partners and PPGs with all regulations and standards. Duties Continually ensures delegate compliance with UM Policies/Procedures, Letter Templates, Workflows, Processes, and Audit Tools in compliance with all regulatory requirements/new legislation. Works collaboratively with Regulatory Affairs & Compliance. Stay abreast of new UM legislation, regulations, or other changes impacting UM in order to put processes in place for compliance. Prepares the Delegation Oversight Clinical Audit team for internal audits and for conducting PP/PPG audits, developing mechanisms for tracking/ trending of progress for --UM/PPG (internal) and PP (external) for compliance with UM standards, and identities system/individual areas for improvement through these processes. Prepares the Delegation Oversight Department for review by external regulatory bodies. Ensures that the Delegation Oversight Department is continually prepared for external review with staff daily work conducted in a manner that meets regulatory requirements. Ensures that the Delegation Oversight Clinical Audit unit functions as a team in preparing needed documents for an external review. Completes annual, focused and periodic audit activities timely and thoroughly including identification of deficiencies, response to mitigation, review and response to CAPs. Identifies repeat deficiencies. Assures audit documentation is clear, complete and accurate. Completes periodic monitoring of PP or PPG performance in critical deficiency areas. Completes follow-up audits and related reports and recommendations. Identifies options to assist PP or PPGs with continued or significant deficiencies. Updates audit tools to meet regulatory, contractual and L.A. Care requirements. Develops and conducts ongoing monitoring activities including but not limited to file reviews and letters and supplemental reports. Present summary results to L.A. Care's UM Committee. Communicates with assigned PP and PPGs on an ongoing basis. Develop mechanism to track and trend progress of PP and PPG's compliance to UM standards and identify system wide issues. Maintains confidentiality in compliance with all Health Insurance Portability and Accountability Act (HIPAA) requirements. Assists co-workers with special projects or work volume as required. Actively identifies and implements efforts to improve the quality, effectiveness and efficiency of job functions. Actively identifies and makes recommendations to supervisor ideas to improve the quality effectiveness and efficiency of departmental and health services functions. Communicates to supervisors any barriers to completing assignments or daily work in an efficient and effective manner. Duties Continued Provides training, education and consultation as necessary to PP and PPGs. Collaborates with other Clinical Auditors on identifying topics and developing agendas for the JOM's and PP visits/communication. Develops and implements procedures to assure compliance with care coordination and documentation of linked and carved out services. Conducts Interrater Reliability Testing (referral management and oversight) for new staff/physicians and annually or as needed for existing staff/physicians. Works with other departments as necessary to facilitate teamwork for creating and/or improving interdepartmental processes to meet regulatory requirements. Clinical Auditor (Performance Monitoring): In addition to the responsibilities above, the Clinical Auditor (Performance Monitoring) position ensures compliance of the delegates (Participating Physician Groups, Plan Partners and Vendors) with regulatory, contractual and L.A. Care business requirements. This position is responsible for delegation oversight continuous monitoring activities and monitoring corrective action plans from the annual and focused audits. The position also acts as a liaison between the Plan Partners, PPGs and Vendors regarding Utilization Management (UM) issues; assists in improving access and utilization performance of PPGs by being a resource for best practice and providing continuous performance feedback. Additionally, the oversight responsibility of this position includes attendance at UM Committee, Delegation Oversight Committee, Sanctions Committee, Internal Compliance Committee, and Joint Operation Meetings. It includes monitoring supplemental UM reports, reporting to management as well as consultation/coaching/instructional activities to improve overall compliance with all regulations and standards. Clinical Auditor (Behavioral Health): In addition to the duties above, the Clinical Auditor (Behavioral Health) designs an audit program specific to ensuring delegates are meeting behavioral health regulatory requirements. This ensures Specialty Health Plans and Plan Partners are in compliance with regulatory, contractual, and L.A. Care business requirements. This position is responsible for developing and maintaining annual audit tools, policy requirements specific to delegates, and a monitoring program to continually receive and aggregate Behavioral Health specific performance requirements. The position acts as a liaison between Specialty Health Plans and Plan Partners regarding Behavioral Health issues, assists in improving access and Behavioral Health performance by being a resource for best practice and providing continuous performance feedback. Additionally, the oversight responsibility includes liasing with internal Behavioral Health units, the Medical Director of Behavioral Health, attendance at UM Committee, Delegation Oversight Committee, Sanctions Committee, Internal Compliance Committee, and Joint Operation Meetings. It includes monitoring supplemental UM reports, reporting to management as well as consultation/coaching/instructional activities to improve overall compliance with all regulations and standards. Performs other duties as assigned. Education Required Associate's Degree in Nursing Education Preferred Bachelor's Degree in Nursing Experience Required: At least 7 years in a clinical setting with at least 3 years in a managed care setting in Utilization Management/Case Management. Skills Required: Knowledge of issues pertaining to Medi-Cal and other HMO & IPA contracts, & payers. Ability to manage and organize large volumes of data. Knowledge of accreditation entities and their requirements. Excellent verbal and written communication skills and excellent interpersonal skills. Good working knowledge of regulatory requirements/standards. Ability to work independently. Ability to solve complex issues and identify creative solutions. Computer ease & literacy with Word, Excel, PowerPoint Skills. 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
UnitedHealthcare

Transition of Care Telephonic Case Manager RN - Jacksonville, FL, and surrounding areas

UnitedHealthcare Jacksonville, FL
$29 - $52 / hour
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together Employee must reside in the state of Florida within the Jacksonville and surrounding metro areas. If you are located in the state of Florida, you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities Making outbound calls to assess members' current health status and ensuring members receive the necessary services and resources Identifying gaps or barriers in treatment plans Providing patient education to assist with self-management Coordinating care for members Making referrals to outside sources Coordinating services as needed (home health, DME, etc.) Educating members on disease processes Encouraging members to make healthy lifestyle changes Documenting and tracking findings What Are The Reasons To Consider Working For UnitedHealth Group? Put It All Together - Competitive Base Pay, a Full And Comprehensive Benefit Program, Performance Rewards, And a Management Team Who Demonstrates Their Commitment To Your Success. Some Of Our Offerings Include Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays Medical Plan options along with participation in a Health Spending Account or a Health Saving account Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage 401(k) Savings Plan, Employee Stock Purchase Plan Education Reimbursement Employee Discounts Employee Assistance Program Employee Referral Bonus Program Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications Current Florida Registered Nurse license 2+ years of experience in a hospital setting, acute care, or direct care 1+ years of case management experience Intermediate level of proficiency with MS Word, Teams, Excel and Outlook Reside in the Jacksonville/Gainesville Metro Areas Preferred Qualifications Bachelor's Degree Experience with electronic charting Experience with arranging community resources Field-based work experience Telephonic Case Management experience Background in managing populations with complex medical needs Bilingual - Spanish Soft Skill Demonstrated solid organizational skills All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $29 - $52 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
RN Psych Telehealth Full-time
UnitedHealthcare

Clinical Grievances RN - Behavioral Health (PST, MST, CST or AZ)

UnitedHealthcare Colorado Springs, CO
$60,200 - $107,400 / year
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. As the new Clinical Grievances Nurse, you will be responsible for reviewing incoming member cases to determine if the appropriate care was given. In providing consumer - oriented health benefit plans to millions of people; our goal is to create higher quality care, lower costs and greater access to health care. Join us and you will be empowered to achieve new levels of excellence and make a profound and personal impact as you contribute to new innovations in a vital and complex system. This role is a fully remote position but must be located in PST, MST, CST or AZ and able to work Monday-Friday 8A-5P within their time zone . Primary Responsibilities Perform clinical assessment of healthcare services provided to our members for appropriateness Understand relevant state and federal grievance and peer review requirements and accreditation standards applicable for processes supported Facilitate telephonic discussion with health care providers and/or members to obtain additional clinical information Provide timely, quality service to members and providers while upholding UnitedHealthcare culture values Act as a resource for others with less experience Work independently and collaborating with Medical Directors and non-clinical partners Function as a member of a self-directed team to meet specific individual and team performance metrics Manage and maintain quality and productivity metrics You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications Current, unrestricted RN license in the state of residency Experience working in the Behavioral Health field as an RN 3+ years of total RN experience including clinical experience in an inpatient / acute setting Demonstrated clinical documentation skills and critical thinking skills Demonstrated proficiency in computer skills - Windows, Instant Messaging, Clinical Platforms, Microsoft Suite including Word, Excel, and Outlook Designated workspace and access to install secure high speed internet via cable / DSL in home Live in CST, PST, MST or AZ and work 8-5 in their time zone Preferred Qualifications Bachelor's in Nursing or higher Experience with Managed Care Clinical Quality Programs Case management experience Clinical appeals and grievances experience Audit / chart review experience Experience in a telecommuting role Demonstrated ability to effectively utilize UHG applications, including but not limited to authorization applications, auto correspondence, and member & provider demographic systems Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
RN Telehealth Other
MaineHealth

Care Manager (RN) - Complex Care

MaineHealth Portland, ME
Description MaineHealth Corporate Nursing Req #: 77658 For a limited time MaineHealth is offering a $10,000 Sign on bonus for all eligible Registered Nurses with up to 2 years of RN experience and $20,000 for Registered Nurses with greater than 2 years of RN work experience! Eligible candidates are hired (offer accepted) into a Full or Part time RN position. Bonus amount prorated for Part time hires, per diem hires are ineligible. Current MaineHealth member employees are ineligible; former MaineHealth Members are ineligible until greater than 6 months’ separation from employment. MaineHealth Corporate has a unique opportunity for a registered nurse to join their team as a Care Manager. This role will support Maine Behavioral Health patients at two locations: Brunswick, Maine and Portland, Maine. In this important role, the RN partners with the Case Manager coordinating specialty care needs for complex patients. Interactions with patients may be telephonic, and/or via Zoom. This is a Monday-Friday, day-shift position working a hybrid schedule. Two days per week will be in the Portland office and one day in the Brunswick office. The remaining 2 days are working from home. The position offers an 8 am-4:30 pm schedule. Summary The Registered Nurse - Care Manager role is responsible for managing high-risk patients to promote effective education, self-management support, and timely healthcare delivery to achieve optimal quality and financial outcomes, as well as ensuring safe and effective transfers in the movement of patients across the health care continuum, serving as the bridge between the professional staff in a care setting (e.g. hospital) and the patient and/or family. Required Minimum Knowledge, Skills, And Abilities (KSAs) Education: Graduate of an accredited School of Nursing required; BSN preferred. License/Certifications: Current applicable state(s) license as a Registered Professional Nurse required. Current BLS certification required or must obtain within 30 days of start date. Experience: Three years of direct clinical care experience preferred. Hiring Scam Alert MaineHealth will never request financial information during the interview or pre-hiring process. All legitimate communications will come from an email address ending in @mainehealth.org. If you suspect fraudulent activity, please report it immediately to mhcareers@mainehealth.org. Additional Information With a career at any of the MaineHealth locations across Maine and New Hampshire, you’ll be working with health care professionals that truly value the people around them – both within the walls of the organization and the communities that surround it. We offer benefits that support an individual's needs for today and flexibility to plan for tomorrow – programs such as paid parental leave, a flexible work policy, student loan assistance, training and education, along with well-being resources for you and your family. MaineHealth remains focused on investing in our care team and developing an inclusive environment where you can thrive and feel supported to realize your full potential. If you’re looking to build a career in a place where people help one another deliver best-in-class care, apply today. If you have questions about this role, please contact amanda.oliveira@mainehealth.org
NP Telehealth Aesthetic Telehealth Full-time
LaserAway

Telehealth Good Faith Exam Nurse Practitioner (Remote - CA or TX preferred))

LaserAway
Join LaserAway as a Telehealth Good Faith Exam Nurse Practitioner – Elevate Your Career in Aesthetic Dermatology! About the Role: Telehealth Good Faith Exam Nurse Practitioner The Good Faith Exam (GFE) Telehealth Clinician provides Good Faith Exams in licensed states, per state rules and regulations, in collaboration with medical directors, if applicable, in that state. Compensation This role is a remote role, with a starting hourly rate of $60 plus weekend differential. You must reside in a compact state to be considered! Key Responsibilities Full Time: 4-5 Days a week with weekend requirement of 4-6 weekend shifts per month, dependent on business need. Provide excellent customer service in a timely manner to patients and colleagues alike: Provide Good Faith Exams for patients in states where licensed and in accordance with our protocols. Sending in Prescriptions per protocol under our Medical Directors. Apply for licensure in states assigned by Senior Director Fielding 8x8 calls from sales and patients Answer Slack posts on #remotemedical #remotesales #medical2 #gfe-and-va-team channels Complete 5 Medallia responses each shift. Must be willing to work afternoon/evening shifts (PST) What We’re Looking For Education: Graduate of an accredited NP program with current board certification Must have CA NP license upon application Multi-Licensed Preferred: CA + (HI WA OR AZ NV CO UT ID NM TX IL OK KS TN MN MO WI NY VA MA GA DC NC MD NJ PA CT OH IN NE MI LA) Open availability including evenings and weekends (PST) Compact license or multi-licensed preferred Physical Requirements/Working Conditions Work-from-home in a quiet private office Must have strong internet connection Must be able to FaceTime/Doximity patients and have a phone from which to speak with patients and a computer on which to chart. Why You'll Love It Here Professional Growth: We invest in your success. Enjoy comprehensive training and endless opportunities to advance in your career. Collaborative Culture: Work with a passionate, patient-focused team that values innovation, safety, and excellence. Competitive Rewards: We offer a generous compensation package, benefits, and an inspiring work environment that celebrates your achievements. Free and Discounted Treatments: Enjoy exclusive access to our aesthetic services to look and feel your best! Why LaserAway? At LaserAway, we redefine excellence in aesthetic dermatology. Every treatment is performed by licensed medical professionals supported by 25 board-certified dermatologists who craft and monitor our protocols for unmatched safety and effectiveness. With state-of-the-art technology and premium products, we treat all skin types with precision and care, combining clinical expertise with cutting-edge innovation. Our 160+ locations and growing footprint make life-changing treatments accessible to everyone. Open seven days a week, we prioritize convenience and self-care. Guided by a patient-first approach, we deliver exceptional experiences that build trust and loyalty. Join Our Team At LaserAway, we’re committed to empowering our Nurses to thrive in a dynamic, patient-first environment. If you are passionate about aesthetics, driven to deliver excellence, and ready to grow with an industry leader, we want to hear from you. Take the next step in your career—apply today and help us shape the future of aesthetic medicine! Benefits Summary LaserAway provides competitive compensation packages and a comprehensive range of benefits, including Medical, Dental, Vision, Disability and Life Insurance, a 401(k) plan with a company match, and additional ancillary benefits. We also offer Paid Time Off (PTO) in compliance with state and federal requirements, ensuring our employees are supported both professionally and personally. LaserAway also provides incentive compensation, including potential bonuses and commissions, depending on role and performance. Disclaimer This job description is not exhaustive and may be updated at any time. LaserAway is an Equal Opportunity Employer and will provide reasonable accommodations for employees with disabilities to perform essential functions, barring undue hardship. Duties may be reassigned as needed.