Telehealth Jobs

NP Telehealth Telehealth Contract
Allara Health

1099 Telemedicine Nurse Practitioner | Flexible Schedule

Allara Health Denver, CO
Allara is a comprehensive women’s health provider that specializes in expert, longitudinal care that supports women through every life stage. Trusted by over 60,000 women nationwide, Allara makes expert healthcare accessible by connecting patients with multidisciplinary care teams that have a deep understanding of hormonal, metabolic, and reproductive care. Allara provides ongoing support for hormonal conditions like PCOS, chronic conditions like insulin resistance, and life stages like perimenopause, helping patients see improved health outcomes . As one of the fastest-growing women’s health platforms in the U.S., Allara is bridging long-overlooked gaps in healthcare for women. The Opportunity We're hiring board-certified Nurse Practitioners who want to focus on what matters most: delivering exceptional care to women with complex hormonal and metabolic conditions. To learn more about our mission and clinical approach, visit allarahealth.com . Location: Fully remote within the U.S. Your Impact Conduct thorough patient assessments and develop personalized treatment plans via video visits Collaborate with a multidisciplinary care team to deliver the highest standards of care Complete required trainings and uphold Allara's clinical policies, standards, and best practices Educate patients on preventive care and wellness using evidence-based strategies Maintain accurate, up-to-date patient records and complete charting in a timely manner Respond to patient questions and administrative messages with clarity and care Dedicate a minimum of 10 patient-facing hours per week , including consultations and medical guidance, with prescribing when clinically appropriate Required Qualifications Board Certification: Active national board certification as a WHNP, FNP, or similar Experience: Minimum of 2 years of consecutive clinical experience as a Nurse Practitioner, with a focus on chronic and complex women's health conditions including PCOS, Endometriosis, Hypothyroidism, Hashimoto's, Metabolic Syndrome, Menopause, Fertility, Postpartum, PMDD, and Obesity Clinical Independence: Proven ability to function as an autonomous provider with strong diagnostic judgment and critical thinking skills Communication: Exceptional written and verbal communication, with an emphasis on compassion and clarity Webside Manner: A natural ability to build trust and connection with patients in a virtual setting Evidence-Based Practice: A genuine commitment to delivering care rooted in current clinical research Technical Proficiency: Comfortable working across multiple platforms including EMR systems, text expanders, Gmail, Google Calendar, Zoom, and scheduling tools Telemedicine Experience: Prior telehealth experience is a plus State License Requirements and Hiring Considerations: An active, unrestricted, and unencumbered professional license in at least one U.S. state is required A note on state licensing: All active and pending licenses held at the time of application are collected and reviewed during our process. Hiring decisions reflect current state-level needs, which evolve over time. Applicants may not move forward immediately if there is no active need in their licensed states. We regularly revisit candidates as needs expand and when experience, licensure, and role requirements align. What Allara Offers 1099 Contract: The flexibility and autonomy of an independent contractor arrangement Competitive Compensation: Per-visit rates plus additional pay for charting, administrative tasks, and other patient-related work Fully Remote: Work from anywhere in the U.S. Flexible Scheduling: Set hours that fit your life, not the other way around Malpractice Insurance: Comprehensive coverage provided at no cost to you Mission-Driven Work: Help transform the standard of care for women living with conditions that have historically been underdiagnosed and undertreated Collaborative Provider Network: Connect with and learn from a community of skilled, like-minded Allara clinicians Inclusive Culture: Join a supportive, diverse team that values innovation, equity, and belonging #LI-JB1 At Allara , we believe in celebrating everything that makes us human and are proud to be an equal-opportunity workplace. We embrace diversity and are committed to building a team that represents a variety of backgrounds, perspectives, and skills. We believe that the more inclusive we are, the better we can serve our members. We’re an Equal Opportunity Employer and do not discriminate against candidates or patients based on race, color, gender, sexual orientation, gender identity or expression, age, religion, disability, national origin, protected veteran status, or any other status protected by applicable federal, state, or local law.
RN Telehealth Full-time
Oak Street Health

Registered Nurse

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

Registered Nurse

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

Field Care Coordinator - Remote in Canyon, Washington, Payette, Gem, Adams, Owyhee County, ID or Surrounding areas

UnitedHealthcare Nampa, ID
$28.94 - $51.63 / 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 Canyon, Washington, Payette, Gem, Adams, Owyhee County, ID or Surrounding, you will enjoy the flexibility to telecommute* 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 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 Experience working in team-based care Background in Managed Care Bilingual in Spanish or other language specific to market populations Lives 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 $28.94 to $51.63 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.
CNA Telehealth Full-time
UnitedHealthcare

Field Care Coordinator RN or LSW - Remote Idaho Falls, ID and surrounding areas (locations in description)

UnitedHealthcare Idaho Falls, ID
$28.94 - $51.63 / 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 are located in Lemhi, Custer, Butte, Clark, Jefferson, Madison, Fremont, Teton, Bonneville, Bingham County, ID or Surrounding areas, you will have the flexibility to work remotely* as you take on some tough challenges. 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 Current and unrestricted Idaho license in one of the below: RN LCSW, LMSW, LSW, LCPC, LPC, LMFT, LAMFT 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 Driver's license, access to 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 Two-year degree and 2+ years of experience, preferably as a Healthcare Paraprofessional CCM certification Experience working with an electronic health records (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 Demonstrated background in Managed Care Experience working in team-based care Bilingual in Spanish or other language specific to market populations Reside in Idaho 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 $28.94 to $51.63 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.
Surgical Tech Telehealth Full-time
UnitedHealthcare

Network Pricing Consultant - Remote in CST/EST preferred

UnitedHealthcare Independence, OH
$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 East Region markets, including Kentucky, Indiana, and Ohio. 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 East Region markets, you'll enjoy the flexibility to work remotely from anywhere in the U.S. 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 Ability to interpret financial modeling results and develop forecasts Ability to manage multiple projects simultaneously 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 Manager/Supervisor Utilization Review Telehealth Full-time
Centene

Supervisor, Utilization Management (RN)

Centene North Sacramento, CA
$75,300 - $135,400 / year
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Supervises Prior Authorization, Concurrent Review, and/or Retrospective Review Clinical Review team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. Monitors and tracks UM resources to ensure adherence to performance, compliance, quality, and efficiency standards Collaborates with utilization management team to resolve complex care member issues Maintains knowledge of regulations, accreditation standards, and industry best practices related to utilization management Works with utilization management team and senior management to identify opportunities for process and quality improvements within utilization management Educates and provides resources for utilization management team on key initiatives and to facilitate on-going communication between utilization management team, members, and providers Monitors prior authorization, concurrent review, and/or retrospective clinical review nurses and ensures compliance with applicable guidelines, policies, and procedures Works with the senior management to develop and implement UM policies, procedures, and guidelines that ensure appropriate and effective utilization of healthcare services Evaluates utilization management team performance and provides feedback regarding performance, goals, and career milestones Provides coaching and guidance to utilization management team to ensure adherence to quality and performance standards Assists with onboarding, hiring, and training utilization management team members Leads and champions change within scope of responsibility Performs other duties as assigned Complies with all policies and standards Education/Experience: Requires Graduate of an Accredited School Nursing or Bachelor's degree and 4+ years of related experience. Knowledge of utilization management principles preferred. License/Certification: RN - Registered Nurse - State Licensure and/or Compact State Licensure required CA RN LICENSE REQUIRED Pay Range: $75,300.00 - $135,400.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
RN Telehealth Full-time
Baptist Health (AR)

OB Hub RN - ONSITE

Baptist Health (AR) Little Rock, AR
Video Testimonial Job Details Department: Fetal Heart Monitoring Shift: Night Working Hours: 1730-2000 Summary The RN in the Neonatal Escalation Safety Telemetry (NEST) program is responsible for remote monitoring of fetal tracings for obstetric patients across all BH hospitals. The nurse provides continuous vigilance and tele-nursing focused on early prevention/intervention of abnormal fetal heart rate tracing within Baptist Health. This remote operation is staffed by skilled labor and delivery RNs, providing essential remote monitoring of fetal tracings for obstetric patients across multiple healthcare facilities. As an RN in this role, you will collaborate with bedside teams across various Labor and Delivery units within our system to provide additional observation of fetal tracings. Your primary responsibilities will include early identification, notification, and escalation of concerning tracings, while advocating for evidence-based practices and guiding fellow nurses in their professional growth. Other Information MINIMUM REQUIREMENTS Active and unencumbered licensure as a Registered Nurse in Arkansas or eligibility through Compact state agreements is required. BSN is preferred. A minimum of 3 years of labor and delivery experience in a level 2,3, or 4 facility is required. Current Healthcare Provider CPR/BLS is required Must hold certification through NCC as RNC-EFM or obtain within 6 months of hire. Electronic Fetal Monitoring Certification is required within 1 year of hire. Completion of an AWHONN Advanced or Intermediate Fetal Monitoring course within the last three years is required. Applicants without a recent course must complete the Intermediate and/or Advanced Fetal Monitoring course within six months of hire. Must obtain 20 contact hours annually, fifty percent of which must be clinically focused. Academic course credits can be substituted for contact hours on a one-to-one (1:1) credit hour exchange basis. KNOWLEDGE, SKILLS, AND ABILITIES Demonstrated evidence of professional growth through certification or education. Proficiency in interpreting fetal tracings and identifying physiological abnormalities. Effective communication skills, both written and verbal Strong clinical leadership abilities This job will be authorized 72.00 hours bi-weekly. "> Department: Fetal Heart Monitoring Shift: Night Working Hours: 1730-2000 Minimum Requirements Active and unencumbered licensure as a Registered Nurse in Arkansas or eligibility through Compact state agreements is required. BSN is preferred. A minimum of 3 years of labor and delivery experience in a level 2,3, or 4 facility is required. Current Healthcare Provider CPR/BLS is required Must hold certification through NCC as RNC-EFM or obtain within 6 months of hire. Electronic Fetal Monitoring Certification is required within 1 year of hire. Completion of an AWHONN Advanced or Intermediate Fetal Monitoring course within the last three years is required. Applicants without a recent course must complete the Intermediate and/or Advanced Fetal Monitoring course within six months of hire. Must obtain 20 contact hours annually, fifty percent of which must be clinically focused. Academic course credits can be substituted for contact hours on a one-to-one (1:1) credit hour exchange basis. KNOWLEDGE, SKILLS, AND ABILITIES Demonstrated evidence of professional growth through certification or education. Proficiency in interpreting fetal tracings and identifying physiological abnormalities. Effective communication skills, both written and verbal Strong clinical leadership abilities This job will be authorized 72.00 hours bi-weekly.
NP Telehealth Psych Telehealth Contract
Seasoned Recruitment

Telehealth Psychiatric Mental Health Nurse Practitioner

Seasoned Recruitment
Are you a passionate PMHNP looking to make a significant impact from the comfort of your home? Seasoned Recruitment is seeking a dedicated and compassionate Remote PMHNP to join our growing team. In this role, you'll have the opportunity to provide high-quality mental healthcare to diverse populations, utilizing your expertise to improve lives. We value autonomy, professional development, and a supportive work environment. Responsibilities: Conduct comprehensive psychiatric evaluations and assessments. Develop and implement individualized treatment plans. Provide medication management and psychotherapy as appropriate. Collaborate with interdisciplinary teams to ensure holistic patient care. Maintain accurate and timely electronic health records. Qualifications: Current, unrestricted PMHNP license in at least 1 US State. Master's or Doctoral degree from an accredited nursing program. Active/Clean DEA Strong clinical assessment and diagnostic skills. Excellent communication and interpersonal abilities. Proficiency with telehealth platforms and electronic health records. Why Apply to this Job Posting? Flexible remote work schedule. Competitive compensation with guaranteed pay for last-minute cancellations and no-shows. Ready to Make a Difference? We'd love to connect with you! Schedule a time to chat with our team: https://calendly.com/seasoned-recruitment/telephone-screening For any questions, please email us at: gethired@seasonedrecruitment.com Current PMHNP license in the state(s) you wish to practice. DEA license or willingness to obtain one. NPI Number CAQH Medical Malpractice Insurance Guaranteed Pay: You are fully compensated for cancellations and no-shows. Set Your Schedule: You can work as much or as little as you want; you have complete control over your schedule. Full Back-Office Support: We handle all administrative tasks, including credentialing, billing, and marketing, so you can focus on providing quality care to your patients.
RN Telehealth Other
MaineHealth

Temporary Registered Nurse (RN) - Virtual Nursing

MaineHealth Portland, ME
Description MaineHealth Corporate Nursing Req #: 80130 Temporary/Full Time Days This is a Registered Nurse II vacancy open to candidates with greater than 5 year of RN work experience MaineHealth’s Virtual Nursing team is seeking a Temporary Full Time Registered Nurse (RN) to join our innovative virtual care program. This onsite role provides virtual discharge education and support to patients, ensuring a smooth and safe transition from hospital to home. The RN will collaborate with the interdisciplinary team, review discharge instructions and medications, and use telehealth technology to deliver high-quality patient education. Ideal candidates have an active Maine RN license, acute care experience, strong communication skills, and comfort with technology. Join us in advancing patient-centered care through virtual innovation. This is a temporary position (less than 6 months) Summary The Virtual Nurse will be a member of a new team at MaineHealth responsible for supporting hospital-based care teams, focused on improving quality, patient and family experience, bedside care team experience, and improving hospital efficiency of care. The Virtual Nurse will use virtual communication channels including synchronous video conferencing, secure asynchronous chat, and telephonic tools to interact with patients admitted to a MaineHealth hospital. The Virtual Nurse is also responsible for providing patients with virtual health assessments and treatment solutions through virtual rounds. This position requires collaboration with clinical staff and other care team members across MaineHealth to meet the diverse and continually changing challenges of the healthcare environment. Required Minimum Knowledge, Skills, And Abilities (KSAs) EducationBachelor of Science Degree in Nursing (BSN) preferred. Must matriculate to a BSN program within 1 year of hire with completion attained within 5 years of hire. Evidence of 10 hours of ongoing education per year. License/Certifications:Current license to practice as a Registered Professional Nurse in the State of Maine. BLS certification is also required. Experience:At least 5 years of Acute Care RN work experience. Additional Skills/Requirements Required:Demonstrates the skills necessary to interact effectively with patients, families, and healthcare team members. Additional Skills/Requirements Preferred:Proficiency in the use ofACLS, PALS,and EPIC systems. 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.
NP Pediatric Psych Telehealth Full-time
Kennedy Community Health Center

Psychiatric Nurse Practitioner (Child, Adolescent and Adult)

Kennedy Community Health Center Worcester, MA
$120,000 - $140,000 / year
Are you looking for a meaningful career caring for our communities most vulnerable populations? The Edward M. Kennedy Community Health Center is one of the largest community health centers in Massachusetts serving Worcester, Framingham, Milford and the surrounding communities. We are a thriving and growing organization, and our team is expanding across sites to support this growth. As an employer of choice, our inclusive workplace environment fosters teamwork, accountability and respect and supports the growth and development of each employee. We are an equal opportunity employer and embrace the richness of the cultures of our staff and community. You are a good fit for our team if you’re passionate about helping people live healthier lives and enjoy working in a supportive, team-based environment. Summary To provide comprehensive services to psychiatric patients in an ambulatory setting and coordinate care of patients together with supervising physician(s). The Psychiatric Nurse Practitioner is a member of the clinical practice team and works collaboratively with other team members in providing patient care. As part of the team-based approach to care, the Psychiatric Nurse Practitioner will participate in coordinating care for individual patients, will support patients and families in self-management, through evidenced-based approaches as may be appropriate, will engage in health center projects that are aimed at specific patient population needs, and will utilize effective and appropriate communication strategies, such as health literacy approaches when working with patients. Essential Duties & Responsibilities 1 Provides psychiatric care to children, adolescents, and adults with acute psychiatric problems. Provides Preventive Health Services according to Practice Standards. 2 Provides telehealth services to patients. 3 Evaluates, diagnoses, treats and makes appropriate use of diagnostic testing and consultation according to delineated clinical privileges and approved MH Clinical Protocols. 4 Collaborates care with primary care providers of EMKCHC patients. 5 Collaborates care and referral to other specialty medical and mental health services. 6 Consults or refers patients with complex or dynamic medical problems to their physician partner. Required Qualifications: Active, Unrestricted License in Massachusetts as an Advanced Practice Nurse. Active, Unrestricted Controlled Substance Number in Massachusetts 3+ Years of prior experience working with Children and Adolescents as a Psychiatric Nurse Practitioner. Ability to work a hybrid schedule of both remote and onsite appointments. Salary, depending on experience level, is between $120,000-$140,000
RN Telehealth Full-time
CommonSpirit Health

Command Center Virtual RN

CommonSpirit Health Greenwood Village, CO
Job Summary and Responsibilities As a Command Center Virtual RN, you will provide expert clinical oversight and real-time guidance using advanced telehealth technologies, ensuring seamless patient care coordination and rapid response from a centralized virtual environment. Every day you will expertly monitor patient data streams, identify early warning signs, provide remote clinical consultation, and meticulously coordinate interventions with on-site care teams to prevent critical events and optimize patient outcomes. To be successful, you will demonstrate outstanding clinical judgment, strong technological proficiency, and a proactive, decisive demeanor, contributing significantly to patient safety, operational efficiency, and innovative healthcare delivery. Ability to function in the roles of (% of time in each role will depend on the area of need each shift): Virtual Registered Nurse (vRN), Cardio-Pulmonary Technician, Virtual Companion, Connection Specialist, Patient Logistics RN, Patient Logistics LVN, Patient Logistics Sr. PLC and PLC Will function as a lead and resource for all Clinical Command Center functions and to float to the role needed to support patient care, throughput, and transitions. Will work well in a matrixed reporting structure Will identify areas of opportunity and work with leadership to develop and implement solutions Will observe processes and utilize the PDCA Cycle, (Plan, Do, Check, Adjust) to make rapid improvement to workflow, and to effectively communicate these changes to the teams. Assists with departmental orientation including, teaching and mentoring new and incumbent staff to ensure understanding of policies, procedures and workflow. Job Requirements Minimum of 5+ years of recent experience as a licensed nurse and knowledge of care transitions Knowledge and ability to facilitate patient care across the continuum Experience and knowledge in the use of Electronic Medical Records (EMR) Basic Life Support (American Heart Association) Preferred Bachelors Of Nursing Cardiac monitoring experience Where You'll Work Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs. Together with our patients, physicians, partners, and communities, we are creating a more just, equitable, and innovative healthcare delivery system.
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
VNS Health

Clinical Specialist, RN - Contact Center

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

Advice RN - Nurse Advice Call Center

Providence Brea, CA
$48.03 - $74.56 / hour
Description This posting is for multiple openings of a Call Center Advice RN at The Nurse Advice Call Center in Brea, CA! We offer Part Time and Full Time positions, based on availability. Please ask at the time of interview! Under the direction of the Supervisor/Manager, this position is responsible for triaging incoming calls, assessing needs and providing appropriate healthcare options including facilitating referral to primary providers, health care facilities and community resources. In addition, this position will be responsible for educating the caller regarding immediate health care advice, possible health related risks, as well as wellness/prevention behaviors and opportunities. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Medical Foundation and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Required Qualifications: Graduate of an accredited school of nursing. California Registered Nurse License upon hire. Case management or acute care experience in a healthcare setting; 2 years preferred. 2 years - Acute or ambulatory nursing experience; 7 years preferred. Preferred Qualifications: Bachelor's Degree - Nursing or related field. Why Join Providence? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. About Providence At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at providence.jobs/benefits . Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act . About the Team Providence Clinical Network (PCN) is a service line within Providence serving patients across seven states with quality, compassionate, coordinated care. Collectively, our medical groups and affiliate practices are the third largest group in the country with over 11,000 providers, 900 clinics and 30,000 caregivers. PCN is comprised of Providence Medical Group in Alaska, Washington, Montana and Oregon; Swedish Medical Group in Washington’s greater Puget Sound area, Pacific Medical Centers in western Washington; Kadlec in southeast Washington; Providence’s St. John’s Medical Foundation in Southern California; Providence Medical Institute in Southern California; Providence Facey Medical Foundation in Southern California; Providence Medical Foundation in Northern and Southern California; and Covenant Medical Group and Covenant Health Partners in west Texas and eastern New Mexico. Providence is proud to be an Equal Opportunity Employer . We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. Requsition ID: 433988 Company: Providence Jobs Job Category: Clinical Administration Job Function: Clinical Support Job Schedule: Part time Job Shift: Multiple shifts available Career Track: Nursing Department: 7520 NURSE ADVICE CALL CENTER CA HERITAGE SERVICES Address: CA Brea 955 W Imperial Hwy Work Location: St Jude Heritage Medical Grp-W Imperial Hwy Brea Workplace Type: On-site Pay Range: $48.03 - $74.56 The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
RN Telehealth Full-time
Molina Healthcare

Auditor, Healthcare Services (RN) (Remote) Must Live In Nebraska

Molina Healthcare Omaha, NE
$27.59 - $56.63 / hour
JOB DESCRIPTION This position will offer remote work flexibility, but the selected candidate must reside in Nebraska. Opportunity for a Registered Nurse who has a US license in good standing to join our Medicaid Team as a Clinical Auditor. The person filling this role will be an instrumental part of the team work to align the Medicaid Team compliance guidelines with those followed by our corporate teams. Knowledge and experience working with NCQA standards is vital to success in this role. The preferred candidate will have 3 – 5 years of experience in a MCO and at least 2 years of clinical auditing and/or review experience. Mastery of Microsoft Office, especially Excel, PowerPoint will also be skill sets we are seeking. Hours are Monday – Friday, 8AM – 5PM in your time zone. Job Summary Provides support for healthcare services clinical auditing activities. Performs audits for clinical functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Performs audits in care management, member assessment, behavioral health, and/or other clinical teams, and monitors clinical staff for compliance with National Committee for Quality Assurance, Centers for Medicare and Medicaid Services (CMS), and state/federal guidelines and requirements. May also perform non-clinical system and process audits as needed. • Audits for clinical gaps in care from a medical and/or behavioral health perspective to ensure member needs are being met. • Assesses clinical staff regarding appropriate clinical decision-making. • Reports monthly outcomes, identifies areas of re-training for staff, and communicates findings to leadership. • Ensures auditing approaches follow a Molina standard in approach and tool use. • Maintains member/provider confidentiality in compliance with the Health Insurance Portability and Accountability Act (HIPAA), and professionalism in all communications. • Adheres to departmental standards, policies and protocols. • Maintains detailed records of auditing results. • Assists healthcare services training team with developing training materials or job aids as needed to address findings in audit results. • Meets minimum production standards related to clinical auditing. • May conduct staff trainings as needed. • Communicates with quality and/or healthcare services leadership regarding issues identified and works collaboratively to subsequently resolve/correct. Required Qualifications • At least 2 years health care experience, with at least 1 year experience in care management, and/or managed care, or equivalent combination of relevant education and experience. • Registered Nurse (RN). License must be active and restricted in state of practice. • Strong attention to detail and organizational skills. • Strong analytical and problem-solving skills. • Ability to work in a cross-functional, professional environment. • Ability to work on a team and independently. • Excellent verbal and written communication skills. • Microsoft Office suite/applicable software program(s) proficiency. Preferred Qualifications • Care management, behavioral health and/or long-term services and supports (LTSS) clinical review/auditing experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $27.59 - $56.63 / HOURLY *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
NP Telehealth Telehealth Per Diem
HarmonyCares

PRN Nurse Practitioner, Homevisits/Telehealth

HarmonyCares Lexington, KY
Overview HarmonyCares is a leading national value-based provider of in-home primary care services for people with complex healthcare needs. Headquartered out of Troy, Michigan, HarmonyCares operates home-based primary care practices in 14 states. HarmonyCares employs more than 200+ primary care providers to deliver patient-centered care under an integrated, team-based, physician-driven model. Our Mission – To bring personalized, quality-based healthcare to the home of patients who have difficult accessing care. Our Shared Vision – Every patient deserves access to quality healthcare. Our Values – The way we care is our legacy. Every interaction counts. Go the extra mile. Empower and support each other. Why You Should Want to Work with Us Accountable Care Organization 401K Retirement Plan Paid Orientation and Training Established in 11 states A+ rated malpractice coverage with tail coverage No holidays, no hospital rounds More details about the benefits we offer can be found at https://careers.harmonycares.com/benefits . Responsibilities The Nurse Practitioner delivers annual risk assessment in a residential setting or telehealth, within the scope of practice for a Nurse Practitioner, as delegated by the Collaborative Physician. Essential Duties and Responsibilities Conduct comprehensive in-home health risk assessments to identify all active and chronic disease conditions, as well as determine all physical, mental, and social needs present at the time of the visit Takes history, examines, determines diagnoses. Provides written documentation of patient visit, per NCQA standards Takes patient vital signs, as necessary. Places case management referrals and communicates with PCP as necessary. Communicates with patients, caregivers, agency nurses, other providers and vendors as necessary to assure proper diagnosis. Performs all clinical duties while observing OSHA Universal Precautions Maintains patient confidentiality Attends required meetings and in-services and participates in committees, as requested Participates in professional development activities and maintains professional licenses and affiliations In this role you may work with. . . Teammates Physicians Medical Staff Patients Caregivers Agency Nurses Providers Vendors Qualifications Required Knowledge, Skills, and Experience Active/unrestricted nurse practitioner license to practice in coverage states Board certification in one of the following: American Nurses Credentialing Center (ANCC), American Association of Nurse Practitioners (AANP) or National Commission on Certification of Physician Assistants (NCCPA) Active BLS Certification Current enrollment in Medicare/Medicaid Must maintain a valid driver’s license and good driving record Outstanding EHR skills Preferred Knowledge, Skills and Experience Geriatric training/experience Skill in teamwork and maintaining effective working relationships with patients, medical staff, and the public Conditions of this role to be aware of. . . Adaptability to differing weather conditions and patients’ home/residential environments Full range of body motion including handling/lifting patients. Manual and finger dexterity, eye-hand coordination, normal visual acuity, normal hearing, standing, bending, walking and stair climbing Regular lifting/carrying items weighing up to 50 pounds Ability to ride in automobile or van up to 150 miles daily in urban and/or rural settings. Ability to drive, if necessary Pay Transparency Individual compensation packages are based on various factors unique to each candidate, including skill set, experience, qualifications, and other job-related considerations.
RN Telehealth Full-time
Pacific Health Group

Registered Nurse - Clinical Case Consultant - ECM

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

Senior Clinical Long Term Care Quality of Care RN - Remote in Arizona

UnitedHealthcare Phoenix, AZ
$72,800 - $130,000 / year
At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together If you are located in Arizona, you will have the flexibility to work remotely* as you take on some tough challenges. This role requires travel up to 25% in Arizona. Primary Responsibilities Perform clinical documentation review of inpatient and outpatient care delivered to adults and children with Medicaid, Medicare health care benefits through Arizona United Health Care Community Plans for peer review and internal investigations of Quality of Care concerns Create professionally written case investigation summaries for Peer Review, present case summaries at the Provider Advisory Committee as applicable Review plans of correction from providers in response to a substantiated QOC occurrence Effectively interface with external customers, facilities and providers to resolve quality of care concerns, obtain medical records and other information Conduct delegated oversight reviews of contractors that perform work on behalf of UnitedHealthcare. This includes reviewing samples of contractor work against an audit tool or information found in medical charts Collaborate internally with Medical Directors and staff in other UHCCP departments Manage multiple tasks and projects and changing priorities; prioritize work products effectively Maintain timeliness for deliverables and regulator requests Work independently while utilizing good critical thinking skills, as well as excellent verbal and written communication skills Occasional on-site provider visits may be required for potential Quality of Care concerns You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications Active, unrestricted RN license in the state of Arizona 5+ years of experience working as a Registered Nurse 1+ years of hospital experience as a Registered Nurse Long-term care nursing experience Experience evaluating and auditing medical records Intermediate skills in Microsoft Office, Word, and Excel ability to work with multiple databases to retrieve and enter information Reside in Arizona Ability to travel 25% of the time within the state of Arizona, as needed Driver's License and access to reliable transportation Preferred Qualifications Quality Management experience in a healthcare setting Experience analyzing information and preparing written summaries Experience working in a deadline driven environment prioritizing responsibilities Knowledge of Medicare/Medicaid regulations 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
Allegheny Health Network

RN Nurse Navigator- Weekends, AHN

Allegheny Health Network Pittsburgh, PA
$34.29 - $54.25 / hour
Company Allegheny Health Network Job Description 4 10-hour shifts (8a-6p) Friday-Monday Preferred candidates will live within 50 miles of the Pittsburgh or Erie PA region General Overview Serves as the consistent point of contact for referring physicians, patients, caregivers, families, and the community. Facilitates patient flow, including coordination of appointments and assists the patient with accessing clinical and supportive care services within the Network. The RN Nurse Navigator coordinates all aspects of care in collaboration with the multidisciplinary team for all adult patients within specialized disease state to ensure they receive quality and comprehensive services. Identifies community needs and provides education, screening, support, referrals, coordination of care, and any other assistance identified as necessary. Essential Responsibilities Oversees community outreach, high risk populations and disease specific sites to establish and sustain working relationships within the network (health plan, physicians, office staff, social services staff, financial counselor, dietician, etc.). Educates and coordinates care regarding patient's diagnosis, treatment options, course of treatment, clinical trial information and resources available. Works with health care team to ensure safe handoff, coordination of care between facilities as well as inpatient to outpatient or outpatient to inpatient coordination of care. Works with High-Risk Care Teams to reduce re-admissions. May work with and/or assist Registry staff with data collection, patient outcomes and updates care delivery models. Coordinates appointments including all aspects of the multi-disciplinary team (physicians, consults, supportive care services, etc. and accompanies patients as needed to appointments. Ensures that medication adherence issues are addressed. Works with AHN physician offices/facilities to identify at-risk patients and assists in facilitating appropriate screening processes. Trends data and outcomes as established for the navigation program. Identifies gaps to improve patient care across the continuum. Develops or attends an existing clinical care conference to report out on active patients to the multidisciplinary team. May identify bereavement needs of families and develop plan of care. Performs other duties as assigned or required. Qualifications Minimum Current State of PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) 1-3 year(s) nursing experience in the specialty required. CPR – American Heart Association Act 34 Criminal Background Clearance Certificate Act 33 Child Abuse Clearance Certificate Act 73 FBI Fingerprinting Criminal Background Clearance Certificate Preferred Bachelor's Degree in Nursing Certification in area of expertise. Valid PA driver's license may be required. Older Adults Protective Services Act (OAPSA) clearance may be required depending on location. Disclaimer The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job. Compliance Requirement This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements. Pay Range Minimum $34.29 Pay Range Maximum $54.25 Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets. Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org California Consumer Privacy Act Employees, Contractors, and Applicants Notice
RN Telehealth Full-time
Oak Street Health

Registered Nurse

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

Clinical Appeals RN - Remote in EST or CST Time Zone

UnitedHealthcare Cypress, CA
$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 equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. If you are located within Eastern Standard time zone, you will have the flexibility to work remotely* as you take on some tough challenges. The work schedule is generally Monday-Friday, 8-5 EST or 8-5 CST- you will work within the time zone hours you reside in. Primary Responsibilities Perform initial assessment review of appeals, medical records, and CMS/State Policies to determine if care/services provided meets coverage and billable criteria to be paid Identify if additional information is required to process an appeal Ability to adapt to changes that require cross training on appeal types as they are identified Ability to work independently Utilize Clinical nursing judgment assessment and critical thinking skills, guided by regulatory policy, to make decision on administrative nurse level cases Ability to navigate multiple computer programs, moving from one system to another, while managing multiple tasks and priorities 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, valid, and unrestricted RN licensure in your state of residence 2+ years of clinical experience in an acute care or an outpatient setting 1+ years of direct experience within one (or more) of the following areas: Utilization Review Medicaid and/or Medicare appeals experience LOC assessment planning and Discharge SNF Planning including understanding of Denial Notice and NOMNC Proven experience/understanding of billable services and claims in a managed care environment Solid Microsoft Office (Word, Excel & Outlook) Basic computer skills Access to high-speed internet Ability to work 8-5 within EST or CST (Eastern standard time zone/ Central Standard time zone) Preferred Qualifications 5+ years of Medical Appeal experience working with Medicare and Medicaid Solid coding experience or Certified Coder (CPC) 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
Oak Street Health

Registered Nurse

Oak Street Health Cleveland, OH
$60,522 - $129,615 / year
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Title: Registered Nurse Company: Oak Street Health Role Description: The purpose of a Registered Nurse at Oak Street Health is to build strong relationships with Oak Street Health patients by coordinating their care and providing a seamless experience to patients and their support team. At Oak Street Health you will use an integrated approach toward achieving desired patient outcomes by utilizing standards, guidelines and pathways for care delivery. Through clinical assessment, intervention and education you will ensure our patients are provided competent nursing care in a timely manner. Our Registered Nurses drive quality care, it is of vital importance that our nurses incorporate data and information to improve care and enhance our patient outcomes. You will work to create an engaging and welcoming environment through team communication and delegation to empower other members of the care team to deliver the best care to our patients. Our Registered Nurses report to the Practice Manager or Nurse Supervisor (where applicable). Core Responsibilities: Provide competent nursing care by displaying proficiency in this role and executing job responsibilities in a safe and consistent manner Respond to incoming telephonic requests in a dependable manner, ensuring we are responsive to their needs and exceeding expectations Provide clinically competent triage and symptom management to patients who may or may not be physically present Utilize standardized protocols for medication management, prescription refills and prior authorizations. Conduct thorough and accurate reviews of patient medications and update as needed Provide comprehensive education and direct patient care, particularly around chronic conditions; may occur in person, over the phone or in group settings Actively collaborate and monitor the implementation and progress of the care plan for patients on multiple provider panels Form relationships with patients and their caregivers to support preventative care and ED/hospital diversion where appropriate Create a welcoming and engaging environment to meet the needs of our patients, communities, families and teams where they are Delegation of activities to other clinical care team members to support the needs of our patients Participate in care team meetings to discuss patient care and clinic operations Deliver an exceptional patient experience through service, responsiveness and respectful care Perform point of care testing, procedures and specimen collection (including phlebotomy) as needed Performs other related duties as assigned What we're looking for Required Qualifications: Active Registered Nurse (RN) Licensure in good standing with the applicable state BLS Certification Electronic Medical Record (EMR) experience Ability to maintain patient confidentiality and process information in a confidential manner US work authorization Ability to assess patients without face-to face interaction, strong communication and assessment skill Strongly Preferred Qualifications: Ability to collaborate and communicate with members of an interdisciplinary care team Excellent computer skills with ability to read, interpret and analyze data from various computer systems Effective problem solving and prioritization skills 2+ years of healthcare experience, working as an RN Preferred Qualifications: Previous experience in clinic setting Ability to work independently Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $60,522.00 - $129,615.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments . We anticipate the application window for this opening will close on: 11/08/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
RN Telehealth Full-time
Oak Street Health

Registered Nurse

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