Agency Nurse Jobs Near Me

Virtual Clinical Nurse (RN) - onsite inpatient role Doctors Community Medical Center, Lanham, MD PRN/Supplemental - Day/Evening shift (M-F, 10:00am-7:30pm or 1:00pm-10:30pm, rotating weekends) Contributes to the provision of high-quality, cost-effective healthcare as a provider of direct and indirect patient care and by effective of the health care team. Functions as a competent member of the health care team. Essential Job Duties: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions: 1. Clinical Decision Making/Judgment Demonstrates clinical nursing knowledge and skill based upon the needs of the patient population. Demonstrates the ability to apply the nursing process effectively in the care of culturally diverse patients and families. Demonstrates the ability to utilize all applicable laws, policies, standards, guidelines and evidence-based practice in the provision of patient/family care. Organizes and reprioritizes patient care activities based on subtle and overt and/or environmental changes. Consistently and thoroughly assesses patients to collect data and identify learning needs according to established standards and policies. Utilizes a systematic, continuous and complete analysis of assessment data to develop individualized problem lists for assigned patients. Develops and individualizes a plan of care for each patient in accordance with established standards, appropriate prioritization of problems/needs, and mutually agreed upon goals. Efficiently implements the patient's plan of care in accordance with applicable standards, policies, procedures and guidelines. Demonstrates clinical proficiency in patient education and nursing practice related to medication administration, medication side effects, pain management, drains, wounds, ostomy care, post-operative care, and other specific skills as needed for virtual clinical care. Continuously evaluates the effectiveness of the plan(s) of care, making revisions and recommendations based on analysis of patient responses to interventions. 2. Nurse-Patient Family Relationships Demonstrates the ability to assess the patient's/family's learning needs, readiness to learn, learning style, and presence of barriers to learning. Demonstrates the ability to develop, implement and evaluate teaching plans for patient populations in accordance with applicable standards. Demonstrates the ability to apply knowledge of growth and development across the life span to the care of patients. Provides virtual patient care to patients and families in a culturally, developmentally and ethically appropriate manner. Plans of care address the physical, psychosocial, spiritual, social determinants of health, and learning needs of the patient/family. 3. Clinical Scholarship Participates in Quality reviews or initiatives. Participates in QI, CPI, and risk management activities at the unit, department, or organizational level. Collaborate with healthcare team to ensure effective quality care delivery Supports the use of evidence-based guidelines and organizational policies and procedures to promote safe patient care and a safe practice environment. Enhance the patient experience by utilizing appropriate communication, providing patient centered care, and collaborating with the care team to ensure patient concerns are addressed. 4. Clinical Leadership Promotes shared governance by actively participating in Luminis Health Nursing Practice committees. Participates in the education and/or orientation of new staff. Delegates patient care activities as appropriate; evaluates delegated activities for expected patient care outcomes. Employs real time computer documentation when completing patient record. Participate in daily dyad rounds with physician, nurse, and other care team members. Utilize the appropriate resources to ensure patient centered quality care is provided. 5. Role Specific Responsibilities Provide nursing care to the adult medical patients ranging in age from 18 years to the elderly. Demonstrates the ability to utilize various forms of technology to effectively deliver appropriate nursing care and patient education to desired population. Demonstrates the ability to utilize telemetry as an assessment tool and manage the patient care. Identifies and treats in conjunction with the primary care team the following nursing diagnoses that frequently occur in the medical population: Activity intolerance Impaired adjustment Impaired physical mobility Pain Self-care deficit Alteration in elimination Potential for impaired gas exchanges in pulmonary system Increased risk for impaired skin integrity Increased risk for infection Ineffective Coping Enhance the patient experience by utilizing appropriate communication, providing patient centered care, and collaborating with the care team to ensure patient concerns are addressed. Educational/Experience Requirements: Graduate of an accredited school of nursing Bachelor of Science in Nursing (BSN) or higher nursing degree preferred. Adheres to the credentialing requirements of Luminis Health as stated in the nursing bylaws for Luminis Health Anne Arundel Medical Center (AAMC) and/or Luminis Health Doctor's Community Hospital (DCH). Five years current clinical nursing experience in specialty Required License/Certifications: Current licensure as a registered nurse by the Maryland Board of Nursing BLS - American Heart Association Healthcare Provider certification Working Conditions, Equipment, Physical Demands: Physical Demands - Light Work - Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. If the use of arm and/or leg controls requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated for light work. The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act. The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary. Luminis Health Benefits Overview: Medical, Dental, and Vision Insurance Retirement Plan (with employer match for employees who work more than 1000 hours in a calendar year) Paid Time Off Tuition Assistance Benefits Employee Referral Bonus Program Paid Holidays, Disability, and Life/AD&D for full-time employees Wellness Programs Eligible for shift differentials/OT Employee Assistance Programs and more *Benefit offerings based on employment status

10K sign-on bonus is available to well qualified applicants! Southern Tennessee Regional Health System has an opportunity for a Registered Nurse to join our Case Management Team. A Joint Commission accredited hospital, Sothern Tennessee Regional Health System serves the patients of south-central Tennessee with two locations (Winchester and Sewanee). Situated at the foot of Sewanee Mountain, in southern Middle Tennessee, the city of Winchester offers the best in small-town living while offering quick access to other major cities such as Chattanooga, Nashville, and Huntsville. Winchester has a host of top rated schools, both public and private. Its economy is strong and steadily growing thanks to major employers such as Nissan and Arnold Engineering. Noted as a great place for outdoor recreation, Winchester's beautiful Tims Ford Lake offers visitors an opportunity for year-round fishing, hiking, and camping. If golfing is more your style, you can enjoy The Bear Trace at Times Ford. This 6,790-yard golf course designed by The Golden Bear, Mr. Jack Nicklaus, has been named as one of the “Top Ten Places You Can Play” by Golf Magazine. And just down the road from Winchester, you'll find Lynchburg, TN. Home to another favorite tourist destination, the nation's oldest registered distillery, Jack Daniels. Monitors and manages patient care to promote continuity of care, optimal patient outcomes, patient satisfaction, cost efficiency, and compliance. Consults with nursing staff and multidisciplinary team regularly to evaluate patient's status and appropriateness of medical care, including admission, length of stay, transfer and discharge. Monitors patient and family satisfaction. Responds to questions and complaints from patients, family members, and payers regarding care. Participates in discharge planning including coordinating patient transfers to other facilities and coordinating community resources. Provides discharge education and resource referrals to patients. Performs chart review to identify actual or potential issues with service delivery, patient outcomes and satisfaction, compliance, cost, and reimbursement. Perform other duties as assigned. May be required to perform duties of the CNA, MA or LPN or other nursing staff on occasion. Attends and participates in staff meetings, in-service, projects and committees as assigned. Adheres to and supports policies and procedures of the STRHS. Works scheduled shifts including overtime, when necessary. Accepts all call schedule as directed. Compliance to the STRHS Standard of Behavior is required. Compliance to Dress Code Standards. Should this job description be filled by a PRN employee, they will be subject to the requirements of that position. Qualifications: Minimum Education Associate's degree is required. Required Skills Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action. Certifications AHA Basic Life Support (BLS) Licenses Registered Nurse licensed by the State of Tennessee, or licensed by a Compact state and proper request for Tennessee licensing have been submitted.

Hospice RN Educator Company: Empower Empower is seeking a full-time Hospice RN Educator to support clinical teams across our Lubbock, Amarillo, and Midland locations. This role is responsible for onboarding new hires, providing ongoing education, and ensuring clinical staff are equipped to deliver compassionate, compliant, and high-quality hospice care. The ideal candidate will be an experienced hospice nurse who is passionate about mentorship, enjoys working in the field, and has strong communication and leadership skills. This is a salaried position with regular regional travel and mileage reimbursement. Qualifications: Active RN license in Texas Minimum of 2 years of hospice nursing experience Strong knowledge of hospice clinical standards and regulations Prior training, preceptor, or educator experience preferred Ability to travel regularly within the assigned region

Trinity Health FirstChoice is seeking a travel nurse RN Virtual Care for a travel nursing job in Boise, Idaho. Job Description & Requirements Specialty: Virtual Care Discipline: RN Duration: 13 weeks 36 hours per week Shift: 12 hours, nights Employment Type: Travel This an On-site and Inpatient role, requiring a minimum of 8 years of Med Surg Tele or PCU and Cardiac Acute Care hospital experience. What you'll need to qualify: • 8 years of recent Med/Surg Tele or PCU experience in an acute care hospital • Current BLS and ACLS • Knowledge of Cerner • RN license in the state you wish to work. • Cannot hold a concurrent position at a Trinity Health facility. POSITION PURPOSE This unique model offers a new virtual role for the experienced nurse to care for patients, coordinate complex care and provide mentoring to early career nurses. Bedside nurses also benefit from having an RN mentor for support in patient care. You will be working virtually in the monitor room and view the patients on video. You will be doing things such as admissions, discharges, fall prevention documentation, stroke documentation, calling physicians, scheduling appointments, assisting new nurses (via video), skin assessments, etc. ESSENTIAL FUNCTIONS Experienced RNs are eligible for the onsite vRN role, allowing them to care for patients in a less physically demanding environment. Virtual RNs provide mentoring and support for bedside nurses. This is critical for early career nurses to feel engaged and have a fellow nurse help them navigate care questions or concerns. Allows experienced nurses to transition to a role that maximizes their expertise, while supporting desire for a change in physicality of work. Care Partners (LPN/LVN, CNA, NA) have access to two RNs for patient care. Care partners are an integral part of the Virtual Connected Care team addressing routine patient care needs appropriate to their license. Trinity Health FirstChoice Job ID #KTN-03252025-D. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: RN Virtual Care Onsite About Trinity Health FirstChoicePremium pay FirstChoice offers a rewarding career with significant premium pay and flexible scheduling to fit your life. FirstChoice healthcare travel professionals fill critical positions when unforeseen or unplanned circumstances occur; or, when there is a position open due to an extended leave-of-absence. You'll get to experience a variety of practice settings while traveling within your local region or traveling nationally - your choice! Healthcare travel professionals, join us in caring for our community, we can't do it without you. FirstChoice exclusively supports facilities within the Trinity Health system meaning you will have a consistent experience between job sites. Your training at one site will apply to other sites within the region and will minimize the time you are spending outside of patient care. We understand that there has been a fundamental shift in the nursing position in recent years and like any other employee, nurses want more options and flexibility in their careers. FirstChoice provides you with both along with the comfort and security of one employer. Benefits of Being a FirstChoice healthcare travel professional: Premium pay Choose your own travel adventure-work in a variety of practice settings Wide range of assignments available Housing and meal stipend Minimum Qualifications/Requirements of a FirstChoice Nurse: Registered nurse with a license in the state(s) you will work Minimum of 2 years, depending on specialty area Cannot hold a concurrent position at a Trinity Health facility Trinity Health is a leading not-for-profit Catholic health system with 92 hospitals and hundreds of primary, specialty and continuing care centers across the United States. Benefits Employee assistance programs 403b retirement plan Discount program

Northern Counties Health Care is seeking a compassionate and skilled Registered Nurse (RN) to join our team as a Triage Nurse for Danville Health Center. This position will begin on-site for training; after which it can transition to a hybrid schedule with up to three remote days per week. The ideal candidate will assess patients' conditions over the phone, respond to requests for medical treatment, determine illness severity, review and refill medications, and address other patient health concerns. This role requires excellent communication skills, clinical judgment, and the ability to remain calm under pressure. Key Responsibilities: * Conduct initial assessments of patients' symptoms and medical history. * Provide medical advice and guidance to patients via phone or virtual platforms. * Prioritize patient needs based on the severity of their condition. * Collaborate with healthcare providers to ensure appropriate patient care. * Document patient information accurately and efficiently in the Electronic Medical Record (EMR). * Adhere to all legal and ethical standards of nursing practice. Requirements: * Valid Registered Nurse (RN) license. * Minimum of three years of nursing experience in an ambulatory care setting. * Excellent assessment and communication skills. * Ability to make quick and accurate clinical judgments. * Proficiency in EMR systems and ability to work efficiently in a remote setting. Benefits: * Health, Vision, and Dental Insurance * Long-Term & Short-Term Disability * Life Insurance * Paid Parental Leave * 403b Retirement Plan * Generous Earned Time Accrual If you are an experienced Registered Nurse looking for a flexible hybrid or remote opportunity while providing essential patient care, we encourage you to apply! Northern Counties Health Care is an equal opportunity employer dedicated to diversity and inclusion.

This is a contract assignment that will start right away and end on April 30th 2024 Review Nurse SUMMARY DESCRIPTION: The review nurse is responsible for medical record abstractions and overreads during the annual Healthcare Effectiveness Data and Information Set (HEDIS) survey. The review nurse is responsible for reviewing and accurately performing comprehensive review of medical records to abstract relevant clinical data during HEDIS. HEDIS abstractions are completed in accordance with NCQA guidelines and technical specifications. Additional responsibilities include but not limited to folder and file management, annotating medical records and saving completed documents with correct naming conventions on a shared drive as well as data entry into QSHR. ESSENTIAL FUNCTIONS: Abstract medical records Apply product/plan specific abstraction criteria/requirements during medical record review process Maintain defined productivity volumes Sustain accuracy rate of 95% during abstraction and data entry throughout the HEDIS survey Perform quality reviews of abstracted medical records as assigned Ensure open and honest communication with management/designee regarding development or assistance needed throughout project Escalate work related challenges/issues to Senior Director or designee Attend scheduled daily and ad-hoc meetings with HEDIS Project Manager, and /or Quality Management Specialist/ designee to discuss project status, open issues and productivity Comply with HIPAA, PHI, patient confidentiality, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies Other duties as assigned JOB REQUIREMENTS: Registered Nurse (RN)/ Licensed Practical Nurse ( LPN ) with unrestricted license 2 years' HEDIS abstraction/over-reading experience Data entry proficiency Working knowledge PDF, Word and Excel Excellent written and communication skills Database management Preferred Skills: Experience in Pediatrics, Cardiology, Endocrinology and/or Obstetrics QSHR proficiency

Position: Part-Time, Non-Exempt, 5-20 hours per week Reports to: Forensic Nurse Expert II Supervisory responsibilities: None About the Company Godoy Medical Forensics Incorporated, originally founded in 2009 with one nurse, has evolved into a prominent consulting company boasting a diverse team of experts, including physicians, toxicologists, and Registered Nurses (RNs) from various backgrounds. With a wide-ranging scope, we offer expert opinions in numerous forensic areas, including but not limited to sexual assault, child abuse, gunshot wounds, assault, DUI, and homicide cases. We are retained by both the prosecution and the defense, with a significant portion of our cases coming from defense attorneys. Join us as we continue to expand our influence in the field of forensic nursing and expert consultation. Job Overview The Forensic Nurse Expert - SANE Specialty provides expert opinions and professional reports to attorneys in criminal and civil matters. The Forensic Nurse Expert - SANE Specialty is expected to represent the company in a manner that is professional and reputable. Essential functions Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions. Case review - The nurse will be required to review pertinent discovery in criminal and civil matters, provide verbal consultation with attorneys and offer opinions including, but not limited to, those that relate to medical conditions, traumatic injuries, and medication affects. Written reports - The nurse must be capable of writing professional reports, citing credible resources and produce a product that is free of grammatical mistakes and plagiarism. Testimony - The nurse must be willing to provide testimony in-person and remotely. The nurse must be willing to travel 1-2 times per month, with limited notice, including out of state, with full compensation for travel and travel time. Other Duties Sales/Marketing - The nurse may be asked to deliver presentations and exhibit at conferences for lead generation and company growth and development. Other tasks may include preparation of chronologies, locating and screening experts, and general assistance of other staff. Please note this job description is not designed to cover or contain a comprehensive listing of all activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Required Education, Experience and Skills Current IAFN SANE certification in either Adult/Adolescent or Pediatrics. Continually meet the continuing education/recertification requirements to maintain IAFN SANE certification in either Adult/Adolescent or Pediatrics. Ongoing and actively performing SANE exams in a clinical setting. Minimum of 5 years of clinical experience. Registered Nurse license that is current and free of any negative history. Bachelor's Degree in Nursing or related field. Spoken Communication - Fluent in English, with clear articulation and professional delivery. Written Communication- Written reports must be high quality, fluent and free of grammatical errors or plagiarism. Public Speaking - Must be comfortable with public speaking and able to deliver a presentation or testimony without outward signs of anxiety. Preferred Education and Experience Other specialized education, training and experience in forensic areas including, but not limited to child abuse, strangulation, gunshot wounds or homicide. It is desirable that the SANE FNE obtain a second specialty area as per the requirements set by Godoy Medical Forensics. It is highly recommended that the nurse obtain a Certification in Forensic Nursing, and start that program within six (6) months of employment. Emergency Room, Trauma, or ICU experience. Testimony experience. Public speaking experience. Additional Eligibility Requirements Professional attire during client interactions, both in and out of the courtroom, is required. This includes conservative jewelry and minimal fragrances. Tattoos must be able to be concealed when professional courtroom attire or speaking engagements are required. Clean background check, including criminal record. Access to high-speed internet connection in work environment Physical Demands: Sitting/Standing/Walking: Must be able to sit at computers for long periods of time. Standing and walking may be required. Speaking/Hearing: Ability to effectively communicate with co-workers and clients. Vision: Must be able to see details on computer screen and read printed materials. What We Offer • 401K w/Employer Match • 11 Paid Holidays, plus 1 Floating Holiday • Paid Sick Leave • Paid Vacation • Remote Work Environment • Opportunity for Growth and Leadership Development • Onboarding Includes on the Job Training and Mentorship. • Family-oriented Business Culture with Reasonable Flexibility • Tuition Reimbursement Godoy Medical Forensics, Inc. provides equal employment opportunities to all employees and applicants for employment.

We are seeking a dedicated and compassionate Wound Care Nurse, Telehealth Coordinator within the skilled nursing environment. The Wound Care Nurse, Telehealth Coordinator is the link between healthcare providers and patients while providing dressing changes to wounds, under direct supervision, utilizing real-time, imaging technologies. If you are passionate about excellent wound care and recognize the role telehealth has for consistent, convenient attention to patients in need, we encourage you to apply for the Telehealth Coordinator position and join our dedicated team. Responsibilities: Act as the in-person, hands on assistant to conduct weekly virtual wound rounds using technology under the guidance of wound care specialists, nurses, or healthcare providers. Photograph wounds using designated telehealth technology and ensure accurate documentation of images for clinical review. Aid patients in navigating telehealth platforms, troubleshoot technical issues, and ensure a seamless virtual connection for appointments. Facilitate patient telehealth scheduling, provide education on virtual visits to patients and staff as needed. Administer all aspects of wound care as per evidence based practice and facility policies, including dressing changes and rounds. Maintain strict adherence to patient confidentiality and privacy regulations, including HIPAA compliance, during all telehealth interactions and documentation processes. Submit orders for wound care products. Qualifications: Graduate of an accredited school of nursing required. Must possess current CPR certifications. Minimum of one (1) year of Wound Care experience required, (2) years preferred. Wound care certification is preferred. Must possess a current, unencumbered, active license to practice as a RN or LPN in state of practice. Excellent communication skills with the ability to convey medical information clearly to physicians, staff, patients and family Empathy, patience, and a genuine desire to provide quality healthcare services to patients at the bedside as well as through telehealth technology. Commitment to maintaining patient confidentiality, privacy, and data security in accordance with healthcare regulations (e.g., HIPAA). Ability to multitask, and adapt to changing telehealth workflows, job requirements, and patient populations. Prior experience in SNF, LTC, or Assisted Living preferred. Travel to assigned facilities using your personal car, valid driver's license, and mileage reimbursement offered. Role starts out Part-Time with the opportunity to be Full-Time.

Hi. We're Hummingbird. We're elevating patient access so patients can get healthcare how, when, and where they need it. We partner with healthcare systems to transform how patients access care, enabling their providers to focus on what matters most - caring for patients. By managing patient access as a technology-enabled service, we help health systems stabilize costs and improve patient experience while creating good jobs that attract and retain talent in the industry. Our team of experts is obsessed with the connection between the people, processes, and technology that make healthcare organizations hum. Join us and help build the healthcare experience we want for our communities, our families, and ourselves. Summary As an RN Agent at Hummingbird, you'll provide high-quality, efficient, and compassionate care to patients via telephone triage. This includes assessing patient needs, offering clinical advice, and ensuring appropriate follow-up care that follows client-specific clinical guidelines, policies, and processes. In this role, you will work under moderate supervision as you develop proficiency, conducting work of increasing complexity and contributing to team objectives and outcomes Responsibilities Compensation: The hiring range is $30.43 - 32.72 - 35.00 USD per hour, based on experience, less statutory deductions. Work Location: This is a work-from-home position. You must work from a private location within the United States with consistent, high-speed internet service. Travel: Work from home. There may be optional travel for company events. FLSA Status: Non-Exempt Benefits Eligible: Yes People Manager: No Telephone Triage Answer inbound telephone calls promptly and direct callers efficiently, adhering to defined service level agreements (SLAs) and quality metrics. Verify and document patient information, adhering to HIPAA regulations. Using Epic's Nurse Triage module, perform clinical assessments and provide appropriate medical advice following client-specific clinical guidelines, policies, and processes. Determine the urgency of patient symptoms and direct patients to the appropriate level of care. Identify patient needs, clarify information, and provide solutions or alternatives using appropriate tools and resources. Document patient interactions accurately in the electronic health record (EHR) system. Escalate complex inquiries to senior agents or supervisors as necessary. Clinical Decision-Making Use clinical knowledge and judgment to prioritize and manage patient care needs, following client-specific clinical guidelines, policies, and processes. Identify and address potential health risks and escalate cases to appropriate providers when necessary. Coordinate with team members and clinic teams to ensure accurate and efficient scheduling, patient communication, and comprehensive care. Customer Service Excellence Address and resolve customer service issues promptly and professionally, ensuring patient satisfaction while maintaining patient confidentiality and adhering to HIPAA regulations. Communicate effectively with supervisors and team leads, following established protocols and guidelines. Maintain high standards of service quality by following best practices, actively participating in training, and continuously seeking improvement. Team Engagement Actively support team initiatives, contributing to a culture of trust and transparency. Complete ongoing training to maintain competency in existing and changing workflows. Share insights and support team goals. Collaborate with non-clinical and clinical colleagues to enhance overall performance and understanding of appropriate situations for nurse triage. Suggest practical solutions to improve patient access services. Embrace continuous learning and professional development opportunities. Required & Desired Skills Required Skills and Experience 2+ years of clinical nursing experience, preferably in an emergency, telephonic triage, or critical care setting. Current, unrestricted RN license in the state of North Carolina. Strong clinical assessment and decision-making skills via telephone. Strong customer service skills including the ability to handle challenging situations with patience and professionalism. Basic computer literacy and troubleshooting skills. Ability to type 50 WPM with accuracy. Strong communication skills, both written and verbal. Ability to adhere to established clinical protocols and guidelines. Ability to multitask and prioritize tasks in a fast-paced environment. Ability to work collaboratively in a team setting. Comfortable working in a remote work environment. Desired Skills and Experience Current Compact State Nursing License or eligibility for licensure in a compact state. Previous telephone triage or contact center experience is highly desirable. Familiarity with contact center software and technology. Prior experience using Epic's electronic health records (EHR) software. The Hummingbird Approach We value a team that brings diverse perspectives and experiences to the work we do. While there are many ways to do this, people who are successful at Hummingbird: Lead with Respect by valuing kindness and working to actively foster an environment of inclusion and respect. Embrace Growth and seek out learning and growth for themselves and support those around them in their growth journey. They bring curiosity and an openness to innovation to all their interactions. Bring a Win Together mentality by approaching conflict directly, listening carefully, and seeking to understand. They problem-solve with the goal of finding successes, not trade-offs, for all involved. Equal Opportunity Statement Hummingbird Healthcare is an equal opportunity employer committed to diversity and inclusion. We do not discriminate based on race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other protected characteristic. We value the talents of individuals from all backgrounds and actively seek a diverse workforce. Our mission is to provide a fair and inclusive recruitment process for everyone, and reasonable accommodations are available to any applicant who may need them. Please reach out to talent@hummingbird.healthcare to request accommodations and we'd be happy to chat.

Job Title: Clinical Review Registered Nurse Why work at OpTech? OpTech is a woman-owned company that values your ideas, encourages your growth, and always has your back. When you work at OpTech, not only do you get health and dental benefits on the first day of employment, but you also have training opportunities, flexible/remote work options, growth opportunities, 401K and competitive pay. Apply today! To view our complete list of openings, please visit our website at ***************** SUMMARY: * Our Client is looking for a Clinical Review Registered Nurse to support operations within its Utilization Management team. * This is a full-time (40 hours, M-F) remote opportunity for a 1-3 month duration with potential to extend as needed. * This position executes utilization management processes to ensure the delivery of medically necessary and appropriate, cost-effective and high-quality care through the performance of clinical reviews. * Reviews requests against standardized medical necessity and appropriateness criteria for an initial and a continued service authorization. * Identifies questionable cases and refers to superior or a medical director for review. * There is no travel required for this role. RESPONSIBILITIES: * This position executes utilization management processes to ensure the delivery of medically necessary and appropriate, cost-effective and high-quality care through the performance of clinical reviews. * Reviews requests against standardized medical necessity and appropriateness criteria for an initial and a continued service authorization * Identifies questionable cases and refers to superior or a medical director for review * Perform related duties as required or directed PRIMARY RESPONSIBILITIES: * Conduct clinical reviews of all prior approval, post service reviews, customer service and claim requests * Determine adequacy of clinical elements of clinical information submitted * Determine essential elements of clinical information for decision-making and request same as appropriate * Make determinations based on medical policy, evidence-based guidelines, and medical necessity * Communicate directly with requesting providers to obtain additional clinical information as needed in order to make utilization management decisions. * Review late and out of network prior approval / referral authorizations for appropriateness and make determination on benefit level based on medical necessity * Provide timely and accurate review for procedure/service appropriateness, reconsideration, and appeals based on Rule 9-03, DRF, and NCQA Standards * Perform monthly audits related to prior approval processes as well as weekly guidelines to confirm medical necessity and appropriateness of reviewed services * Use sound clinical judgment along with appropriate review criteria and practice guidelines to confirm medical necessity and appropriateness of reviewed services * Provide support to Provider Relations and Provider Reimbursement in regard to clinical issues relating to new procedure, coding, pricing and provider communications * Provide appropriate and timely referrals to the medical director. Identify and report any potential quality of care of services issue to the medical director. * Perform timely case review information, case entry and updates to case file in the appropriate systems * Participate in medical policy committee including research and development of policies and collaboration with participating provider * Assist in review of health service delivery and utilization and cost data * Determine through clinical review members that would potentially benefit from case management. Initiate referrals to triage to assess these members for effective case management intervention * Determine and interpret member eligibility, coverage and available benefits. Contribute to member and provider satisfaction within program and organization * Assist the claims payer in accurate adjudication of care management approved services as needed QUALIFICATIONS: * RN with Vermont License required * Also open to candidates who have a compact license * BSN desired * 5-7 years of clinical practice required * 1-3 years of insurance related experience desired * Must be willing to participate in on-going CEU training Top 3 Required Skills/Experience: * Subject Matter Expertise: * Strong knowledge base in health care delivery systems, health insurance, medical care practices and trends, regulatory and accreditation agencies/standards, and provider network management * Strong knowledge of all Plan products and services benefits that effect clinical decision making * Strong knowledge of clinical nursing practice * Computer Skills: * Proficient in all Microsoft Office applications * Proficient in CPT, HCPCS coding and ICD-10 diagnosis codes * Proficient in specialized computer applications preferred including SalesForce Health Cloud, Acuity, Microsoft CRM, Onbase (or similar document mgt system), Jira * Analytical Skills: * Strong analytical skills, including statistical data analysis Required Skills/Experience - The rest of the required skills/experience. Include: * Communication Skills - Strong written and oral communication skills * Interpersonal Skills - Strong interpersonal skills * Organizational Abilities - Strong organizational skills * 5 - 7 years of clinical practice required Preferred Skills/Experience - Optional but preferred skills/experience. Include: * 1- 3 years of insurance related experience desired * Willing to participate in required on-going CEU training Education/Certifications - Include: * Licensed RN ; BSN desired; Licensed in compact state desired Supervision Received - Discretion and Judgment: * Is expected to regularly use discretion and judgment to make decisions without approval such as planning projects, analyzing accounts, solving problems, or improving processes. Nature of Duties: * Primary duties are non-manual in nature (i.e., call handling, accounting) Focus of Work: * Primary duties are directly related to general business operations (nearly all of Our Clients) Knowledge Requirements: * Ability to perform the job duties requires sue of advance knowledge acquired by a lengthy course of study and/or instruction. Physical Demands in Performing Essential Job Functions (amount of time): This section is to comply with the Americans with Disabilities Act (ADA): * Stand - 1/3 * Walk - 1/3 * Talk to hear - 2/3 * Sit - 2/3 * Reach with hands and arms - 1/3 * Push/pull - 1/3 * Stoop, kneel, crouch or crawl - 1/3 * Fine dexterity - 1/3 to 2/3 * Repetitive use of hands - 2/3 * Visual activity - 2/3 * Aural acuity - 2/3 The above is intended to describe the general contents and requirements of work being performed by people assigned to this position. Nothing in this position description of Our Client's right to assign or reassign duties and responsibilities to this position at any time. OpTech is an equal opportunity employer and is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, status as a parent, disability, age, veteran status, or other characteristics as defined by federal, state or local laws. *************************************************

Available! Inspire Hospice is seeking a dedicated part-time Remote Triage Nurse to join our team. This role is perfect for individuals passionate about providing exceptional end-of-life care from the comfort of their own home. Position: Remote Triage Nurse Schedule: Part-time; Saturdays and Sundays, 8 AM to 8 PM Compensation: $25 per hour Key Responsibilities: Provide phone-based triage, assessing patient needs and offering appropriate guidance. Utilize our electronic medical records system to review patient histories and ensure accurate documentation. Work collaboratively with our care team to ensure a comprehensive support system for our patients. Manage patient calls with a focus on responsiveness and compassion. Requirements: Must possess a current Georgia RN license. Residency in Georgia is required. Prior experience in hospice, palliative, or end-of-life care. Access to high-speed internet and a private, HIPAA-compliant workspace. Proficiency in technology with strong keyboard skills and the ability to navigate multiple software applications. Ability to work efficiently in a fast-paced environment. Ideal Candidate Will: Demonstrate excellent communication skills and empathetic patient interactions. Have a strong background in critical care or similar fast-paced medical settings. Be highly organized and capable of multitasking effectively. Benefits: Remote work arrangement to eliminate commuting and maximize work-life balance. Competitive hourly wage. Be part of a mission-driven organization that values compassion and quality care. Apply Now: If you are committed to making a difference in the lives of patients and looking for a fulfilling role that offers flexibility, please apply to join our dynamic team at Inspire Hospice.

Key Responsiblities: · Provide phone-based triage, assessing patient needs and offering appropriate guidance. · Utilize our electronic medical records system to review patient histories and ensure accurate documentation. · Work collaboratively with the care team to ensure a comprehensive support system for our patients. · Manage patient calls with a focus responsiveness and compassion. Requirements: · Must possess an active RN License for the state of Georgia. · Residency in Georgia is required. · Prior experience in hospice, palliative, or end-of-life care. · Access to high-speed internet and a private. HIPAA-compliant workspace. · Proficiency in technology with strong computer skills. Ability to navigate multiple software applications. · Ability to work efficiently in a fast-paced environment. · Must have a strong background in critical care or similar medical setting. Schedule: Part-time; Saturdays and Sundays 8:00 AM - 8:00 PM Pay Rate: $25.00 / HR

Available! Inspire Hospice is seeking a dedicated part-time Remote Triage Nurse to join our team. This role is perfect for individuals passionate about providing exceptional end-of-life care from the comfort of their own home. Position: Remote Triage Nurse Schedule: Part-time; Saturdays and Sundays, 8 AM to 8 PM Compensation: $25 per hour Key Responsibilities: Provide phone-based triage, assessing patient needs and offering appropriate guidance. Utilize our electronic medical records system to review patient histories and ensure accurate documentation. Work collaboratively with our care team to ensure a comprehensive support system for our patients. Manage patient calls with a focus on responsiveness and compassion. Requirements: Must possess a current Georgia RN license. Residency in Georgia is required. Prior experience in hospice, palliative, or end-of-life care. Access to high-speed internet and a private, HIPAA-compliant workspace. Proficiency in technology with strong keyboard skills and the ability to navigate multiple software applications. Ability to work efficiently in a fast-paced environment. Ideal Candidate Will: Demonstrate excellent communication skills and empathetic patient interactions. Have a strong background in critical care or similar fast-paced medical settings. Be highly organized and capable of multitasking effectively. Benefits: Remote work arrangement to eliminate commuting and maximize work-life balance. Competitive hourly wage. Be part of a mission-driven organization that values compassion and quality care. Apply Now: If you are committed to making a difference in the lives of patients and looking for a fulfilling role that offers flexibility, please apply to join our dynamic team at Inspire Hospice.

Staffing Solutions Organization LLC (SSO), an affiliate of Public Consulting Group LLC (PCG), is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed to a diverse workforce, which is a reflection of our clients and the people they serve. **Care Coordination Nurse in Augusta, ME (Remote)** **This position can be Remote, but this person must have an active nursing license in the State of Maine.** **Required** : Licensed as a Registered Professional Nurse (RN) or Licensed Practical Nurse (LPN) in the **State of Maine** as issued by the State Board of Nursing. RN is preferred; however, an LPN is acceptable if a RN is not available. **DESCRIPTION:** As a Registered Nurse, you will work closely with existing care coordination capacity in the community to maximize the efficient use of state resources to identify and fill in gaps where no care coordination capacity exists for high need MaineCare members. You will partner with hospitals and providers to conduct clinical reviews of members using the Emergency Department (ED) for avoidable reasons identified through claims data and ED daily census. You will educate providers and members on resources available to assist with referrals as needed and will coordinate and participate in community team meetings with providers for MaineCare members that are more difficult to manage. You will collaborate with staff regarding other initiatives within MaineCare. In performing this work your duties will include but are not limited to, the following: + Develop and implement a targeted plan of care to decrease avoidable emergency department usage for MaineCare members. + Partner with hospitals to provide ongoing education to MaineCare members and the MaineCare Provider community. + Work with other members of the Care Coordination Unit to monitor work queues and complete assigned tasks. + Collect data and prepare records, reports and statistical information to assist in the evaluation and measurement of wellness programs and the ED Collaborative + Develop plans of care for clinically complex MaineCare members. + Attend conferences regularly for wellness initiatives available within the community. + Provide outreach to MaineCare members in the community via phone, mail, and fax. + Perform other duties and responsibilities as assigned. **KNOWDEDGE AND CERTIFICATION REQUIRMENTS:** + Knowledge of the principles and methods of professional nursing practice. + Knowledge of current standards of care and practices relating to services provided by health care facilities, agencies, and practitioners. + Ability to plan, organize, and direct the work of others. + Ability to maintain objectivity and professionalism during unusual and stressful circumstances. + Ability to communicate effectively. + regulations relative to the qualifications of health care professionals and paraprofessionals. + Knowledge of community organizations Ability to write clearly and effectively. + Ability to draw valid conclusions, use critical thinking skills, and make independent decisions. + Ability to establish and maintain effective working relationships. **SKILLS AND ABILITIES REQUIRED:** + Knowledge of state and federal and resources. + Knowledge of state licensing and federal certification regulations for health care providers. + Knowledge of federal and state accreditation commissions and standards. + Knowledge of Department policies and procedures. + Knowledge of the Maine Medical Assistance Manual. + Ability to interpret and apply federal and state rules and regulations. + Ability to provide technical assistance. + Ability to develop and implement corrective actions. **MINIMUM QUALIFICATIONS:** + Licensed Nurse and three (3) years of progressively responsible experience in the field of nursing and/or in the delivery of health care services. + LICENSING/REGISTRATION/CERTIFICATION REQUIREMENTS: + Licensed as a Registered Professional Nurse (RN) or Licensed Practical Nurse (LPN) in the State of Maine as issued by the State Board of Nursing. RN is preferred; however, an LPN is acceptable if a RN is not available. This position is not eligible for work authorization sponsorship (including H-1B sponsorship) by SSO and under the federal laws relating to the F-1 STEM EAD program, this position is not eligible to support a STEM EAD extension application. Compensation for roles at Staffing Solutions Organization LLC (SSO) varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience. As required by applicable law, SSO provides a reasonable range of compensation for this role. In addition, SSO provides a range of benefits for this role. Applicants must be authorized to work for ANY employer in the U.S. We are unable to sponsor or take over sponsorship of an Employment Visa at this time. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, marital status, age, national origin, protected veteran status, or disability. Staffing Solutions Organization LLC is an e-Verify participant. **Job Details** **Pay Type** **Hourly** **Education Level** **Certification** **Travel Required** **No** **Telecommute Percentage** **100** **Hiring Max Rate** **35.18 USD**

**Become a part of our caring community and help us put health first** The Nurse Practitioner, Virtual Care applies advanced education and clinical competencies to achieve optimal patient outcomes. The Nurse Practitioner works on problems of diverse scope and complexity ranging from moderate to substantial. This remote role will be supporting the Broward (FL) geographical area. The Nurse Practitioner, Virtual Care provides health promotion and maintenance through the diagnosis and treatment of acute illness and chronic conditions. Prescribes medication, treats patients, diagnoses illnesses, and provides treatment. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action. **Use your skills to make an impact** Required Qualifications · Minimum of two to five years of relevant experience · Successful completion of a Nurse Practitioner program with Board Certification · Current and unrestricted state license Nurse Practitioners Licensure in the state of employment prior to the start of employment. · Excellent communication skills written and verbal, demonstrate a high level of skill with interpersonal relationships and communications with all colleagues · Superior patient/customer service. · Basic computer skills, including email and EMR (Athena/E-Clinical). · Appropriate certification to write prescriptions under the authority of a collaborating physician/medical director · Expertise with web-side manner and willing to take a sponsored CME course on web-side manner, as needed Preferred Qualifications: · Active and unrestricted DEA license · Medicare Provider Number/ Medicaid Provider Number · Bilingual in English and Spanish · Knowledge of Medicare guidelines and coverage. · Knowledge of HEDIS quality indicators. · Experience working in value-based care settings · Telehealth experience · IHWA experience Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $104,000 - $143,000 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About us** About Conviva Senior Primary Care: Conviva Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. As part of CenterWell Senior Primary Care, Conviva's innovative, value-based approach means each patient gets the best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can impact our patients' well-being. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options *************************************************************

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross. Residency in or relocation to Louisiana is preferred for all positions. Onsite training is required for the first 2-3 weeks at our Baton Rouge Corporate campus. POSITION PURPOSE Staff in the Population Health and Health Services area: Utilize a collaborative process to assess, plan, implement, monitor and evaluate options and services required to meet the member's, providers' and communities' healthcare needs. Utilizing the disease management referral and assessment process, the disease management nurse will identify the most appropriate resources to promote quality, cost effective outcomes. Utilization Review staff are responsible for providing clinical service and/or member management. Accountable for complying with all laws, regulations and accreditation standards that are associated with duties and responsibilities. NATURE AND SCOPE This role does not manage people Necessary Contacts: In order to effectively fulfill this position the incumbent must be in contact with: All internal departments, providers, subscribers, group representatives, reinsurance carriers, Department of insurance, other insurance carriers, and healthcare vendors. QUALIFICATIONS Education High School Diploma or equivalent required Work Experience 4 years of direct patient care experience required Managed Care or claims processing experience and knowledge of medical terminology and ICD 10 codes required 1 year of medical review and/or authorization experience preferred Skills and Abilities Prefer knowledge of insurance, reinsurance, and/or customer service operations. Ability to research and analyze cases and make appropriate quality and cost effective decisions. Must be able to communicate effectively with members, providers, pharmacy staff and fellow employees at all levels of the organization. Must be detail oriented, organized, and self motivated. Must use appropriate professional judgment and be able to make decisions and delegate work appropriately while working on multiple tasks. Working knowledge of related software and office equipment. Ability to comprehend Medicare guidelines and assume responsibility for decisions based on these Guidelines is required. Knowledge of coding guidelines for ICD, HCPCS and CPT preferred. Licenses and Certifications Current, unrestricted LPN license in the state of Louisiana and/or in the required jurisdictions, or where services are provided with graduation from an accredited vocational or technical school for Practical Nursing 180 days required Current, unrestricted Certified Professional in Disease Management or Health Care Management license in the state of Louisiana and/or in the required jurisdictions, or where services are provided 2 years required Current, unrestricted Certification in Utilization Review or Managed Care in the state of Louisiana and/or in the required jurisdictions, or where services are provided 2 years required ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS Assess member's status by collecting in-depth information about the patient's situation and functioning to identify needs in order to develop and implement a comprehensive disease management plan that will address needs. Develop and implement a plan by determining specific objectives, goals, and actions as identified through the assessment in action oriented and time specific indicators. Implement specific interventions that will lead to accomplishing the goals established in the plan. Coordinate by organizing, integrating, and modifying the resources necessary to accomplish the goals. Monitor by gathering sufficient information from relevant sources in order to determine the effectiveness of the plan. Responsible for meeting targets for staff and unit performance to maximize program value and ensure achievement of department productivity goals. Care coordination or Utilization Management as designated by RN and/or clinical leadership. Researches and interprets contract benefits to facilitate accurate benefit administration and fulfill product-specific authorization requirements. Conducts medical necessity reviews based upon the patient's condition and/or symptoms utilizing medically-accepted review criteria/guidelines, medical delegations and/or policies to provide quality healthcare and meet regulatory requirements. Responsible for reviewing, resolving, and responding to issues regarding utilization of benefits. Works closely with internal and external customers to coordinate appropriate care for authorized services. Negotiates rate of payment when provider network deficiency exists and accurately calculates and documents care management savings to initiate care management programs, identify product enhancement opportunities, and capture returns on investments (ROI). Communicates directly with members and/or providers regarding contract requirements and collects relevant planned care information via telephone to facilitate member management. Responsible for timely management for appropriate verbal notifications and/or written materials to ensure compliance with regulatory and/or operational guidelines. Responsible for meeting targets for staff and unit performance to maximize program value and ensure achievement of department productivity goals. Serves as a technical resource to the non-clinical staff by responding to inquiries regarding the interpretation of clinical information to provide clinical support for non-clinical staff involved in the review process. Additional Accountabilities and Essential Functions The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions Perform other job-related duties as assigned, within your scope of responsibilities. Job duties are performed in a normal and clean office environment with normal noise levels. Work is predominately done while standing or sitting. The ability to comprehend, document, calculate, visualize, and analyze are required. #LI_MS1 An Equal Opportunity Employer All BCBSLA EMPLOYEES please apply through Workday Careers. PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI) Additional Information Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account. If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact ********************* for assistance. In support of our mission to improve the health and lives of Louisianians, Blue Cross encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free. Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner. Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.

When you come to the University of Maryland St. Joseph Medical Center, you're coming to more than simply a beautiful 37-acre, 218-bed suburban Baltimore, Maryland campus. You're embarking on a professional journey that encourages opportunities, values a team atmosphere, and makes convenience and flexibility a priority. Joining our team of healthcare professionals means you'll be contributing to a locally and nationally recognized institution. UM St. Joseph has been recognized by The Leapfrog Group as a grade ‘A' hospital and by U.S. News & World Report as #3 in both the state and Baltimore Metro area, making UM St. Joseph the highest-ranking community hospital in Maryland. In addition, we've been consistently recognized as a top employer by Baltimore magazine. Job Description Hybrid Role includes both bedside shifts and virtual nursing shifts. Work Schedule: 1 week onsite/bedside In Med Surg Tele Unit (7am - 7:30pm) 1 week onsite in virtual nursing office in SJMC (9a-9:30pm) Each week consist of 3 x 12hrs shifts Every 3rd weekend requirement. This is not a remote role. A minimum of 3 years' experience as a Medical Surgical, Telemetry, or Oncology Nurse. Under the supervision of the Nursing Director of Medical/Surgical Services and Nurse Manager, the Virtual Nurse will provide hybrid support to the front-line nursing care team, combining bedside care and virtual assistance to enhance patient outcomes. This role is essential for facilitating specific aspects of the admission, discharge, and education process for inpatients at UM SJMC, ensuring an efficient and safe transition of care throughout their hospital encounter. The position description reflects general responsibilities but may include other duties as required by operational needs. PRIMARY RESPONSIBILITIES Documentation Support: Provide virtual assistance with documentation for admissions and discharges. Education and Training: Help bridge the gap between novice and experienced nurses by offering educational support and guidance. Patient Experience: Enhance patient care and satisfaction through leadership rounding, collaborative communication with patients and families, and ensuring quality of care. Interdisciplinary Collaboration: Foster relationships across different disciplines to support cohesive care delivery. Patient Education: Complete and document patient education, including care plans related to hospitalization. Virtual Care Assistance: Support front-line nurses by offering virtual expertise and guidance on patient care. Compliance and Standards: Review clinical metrics and identify incomplete entries in the Electronic Medical Record (EMR) to ensure compliance with care standards. Policy and Procedure Compliance: Support nurses in adhering to procedural and policy guidelines through secondary validation and educational support. Customer Service: Improve service timeliness by interacting virtually with patients and families, allowing nurses to prioritize hands-on patient care. Flexible Scheduling: Provide virtual and bedside support as required, adapting to the needs of the clinical environment. This hybrid Virtual Nurse position requires flexibility, adaptability, and strong communication skills to effectively support patient care from both bedside and virtual platforms. By enhancing nursing support and promoting a seamless transition of care, the Virtual Nurse contributes significantly to the overall quality of patient care at UM SJMC. Clinical Nurse II: Competency in care of unit specific patient population; independently practices with solid knowledge and clinical skills; engaged in advancing own practice. Serves as a clinical resource for others. Applies and integrates evidence into practice Functions effectively in roles specific to unit, such as arrest team for ICU, triage for ED, etc. Collaborates with interdisciplinary team to plan and coordinate care; independently advocating for patient/family needs Models practice consistent with unit operations to ensure safe, timely effective, efficient, equitable, patient centered care. Qualifications Licensure as a Registered Nurse in the state of Maryland, or eligible to practice due to Compact state agreements outlined through the MD Board of Nursing, is required. More than 12 months nursing experience. Solid knowledge and clinical skills. Current AHA BLS certification required. Must meet all unit specific certification requirements: (PALS, ACLS, NRP) Additional Information All your information will be kept confidential according to EEO guidelines. Compensation Pay Range: $35.19 - $47.39 Other Compensation (if applicable): Review the 2024-2025 UMMS Benefits Guide

Full-time Description The MDS Nurse supports Engage Consulting clients by providing a variety of tasks, such as MDS completion, case mix review, and auditing services that are related to CMS initiatives, regulatory compliance, MDS coding, billing, and reimbursement accuracy. The successful candidate will excel in critical thinking, accuracy, and MDS completion skills while thriving in an environment that supports the work being a hybrid of remote and in-person. This position reports to the Director of Clinical Consulting. Essential Functions of the Job: Responsible for the coordination, completion, and submission (including timing and scheduling) of mandated OBRA and Medicare MDS assessments, as assigned. Responsible for the development, review, and/or revision of resident specific care plans as a member of the interdisciplinary team, in coordination with the completion of MDS assessments following RAI Guidelines. Responsible for contributing to and attending key meetings in the facility in-person and remotely including but not limited to morning meeting, Case Mix, Quality Measure, and Medicare/Utilization Review Provide interim MDS completion services, as assigned focusing on accurate scheduling, completion, and submission of MDS following RAI Guidelines. Provide technical review of audits with ability to focus on reimbursement accuracy/optimization, Case Mix Management, Quality Measure Management, and MDS accuracy reviews. Maintain clinical and regulatory knowledge in accordance with current geriatric care standards of practice, including but not limited to Federal Survey Requirements, MDS 3.0 RAI Manual, federal and state health regulations, CMS Requirements of Participation, and payor guidelines. Consistently demonstrate sound judgement and provides ethical guidance to customers for SNF practices. Provide direct assistance to the Senior Practice Manager and Director of Clinical Consulting as requested. Must be familiar with Electronic Medical Record (EMR) programs including Point Click Care, Matrix Care, and therapy software systems. Ability to work a hybrid schedule of remote as well as in-person facility representation. Consistently portray the mission, vision, core values, cornerstones and professional image of Engage Consulting, exercise good judgement in the performance of the job. Special projects and other duties as assigned. Requirements Required Qualifications: Registered Nurse (RN) or Licensed Practical Nurse (LPN) with active Nursing licensure. Minimum two years of experience performing MDS completion in a SNF. AAPACN Resident Assessment Coordinator Certification (RAC-CT) preferred. Intermediate knowledge of SNF Reimbursement and Billing Regulations, including but not limited to RAI guidelines, PDPM Reimbursement, Case Mix Management, and specific state nursing documentation guidelines. Intermediate knowledge of Microsoft Office (Word, Excel, PowerPoint, and Outlook). Core Competencies Healthcare Billing Expertise, Relationship Management, Project Management, Excellent Interpersonal Skills, Care Plan Development, Technological Skills, Problem-Solving and Analytical Skills, Critical Evaluation, Cultural Awareness, Ethical Practice, Ability to Exercise Independent Judgement and Discretion, Maintain Confidentiality.

Chronic Care Management Nurse/RN Reports to Chief Quality Officer Cahaba Medical Care Foundation Chronic Care Management Nurse/RN Supervised by: Chief Quality Officer The Chronic Care Management Nurse plays a pivotal role in providing personalized care for patients with chronic conditions, including but not limited to diabetes, hypertension, asthma, COPD, heart disease, and other long-term illnesses. This role involves monitoring patients' health status, educating them on their conditions, ensuring adherence to treatment plans, and promoting proactive measures to prevent complications. The Chronic Care Management Nurse collaborates closely with physicians, care teams, and patients to deliver high-quality care in a clinic setting. Working Environment: Clinic Hours: Monday to Friday, 8:00 AM - 5:00 PM (with occasional extended hours depending on patient needs). Environment: Fast-paced, team-oriented, and patient-focused clinic setting. Physical Demands: Standing, walking, and sitting for extended periods. Occasional lifting of patients or equipment may be required. Key Responsibilities:Patient Care & Management: Chronic Disease Management: Monitor and assess the health status of patients with chronic conditions, including vital signs, lab results, medications, and treatment adherence. Provide ongoing education and support to patients on managing their chronic conditions and improving health outcomes. Collaborate with physicians and other healthcare providers to develop and implement personalized care plans based on patient needs. Offer routine assessments for patients in both in-person and remote settings, such as phone calls or telehealth visits. Medication Management: Educate patients on the proper use of prescribed medications and monitor for adherence, side effects, and potential drug interactions. Coordinate medication refills and communicate with pharmacies/providers as necessary. Assist in adjusting medication regimens as ordered by the physician, in accordance with established protocols. Care Coordination: Act as a point of contact for patients with chronic conditions, ensuring that all aspects of care are coordinated, including referrals, tests, and specialist visits. Communicate and follow up with patients to ensure continuity of care and address any issues or concerns promptly. Monitor patients' progress and identify early signs of complications or deterioration in their condition. Education & Support: Patient Education: Provide education on managing chronic diseases, including self-management skills, lifestyle changes, diet, exercise, and coping strategies. Educate patients and their families on the importance of preventative care, such as routine screenings, immunizations, and other health-related behaviors. Use self management methods to ensure patients understand their treatment plans and health goals. Health Promotion: Help patients set realistic, measurable goals to improve their health and quality of life. Guide patients through disease-specific management strategies, including symptom monitoring, tracking triggers, and recognizing warning signs. Empower patients to take ownership of their health and become active participants in their care plans. Documentation & Reporting: Patient Records: Maintain accurate and up-to-date patient records in compliance with clinic policies and relevant regulations (e.g., HIPAA). Document patient assessments, care plans, interventions, progress notes, and any changes in condition or treatment in the electronic health record (EHR). Complete required reports related to chronic care management programs, including billing and outcome documentation. Quality Improvement: Outcomes Monitoring: Track and report on the effectiveness of chronic care management services, identifying areas for improvement in care delivery. Participate in quality improvement initiatives aimed at improving patient outcomes and enhancing the overall care process. Support the clinic's efforts to meet accreditation standards, quality measures, and performance benchmarks for chronic care management. Skills and Qualifications: Education and Certification: Registered Nurse (RN) or Licensed Practical Nurse (LPN)with an active state license. BLS (Basic Life Support) certification Experience: Minimum of 2-3 years of nursing experience, with a focus on chronic disease management, geriatrics, or related areas. Experience working in a clinic or outpatient setting preferred. Knowledge and experience in patient education, health promotion, and care coordination. Technical Skills: Proficiency with Electronic Health Records (EHR) systems. Basic knowledge of chronic care management programs and healthcare regulations. Familiarity with telemedicine platforms and remote patient monitoring is a plus. Interpersonal Skills: Excellent communication skills, both verbal and written, to effectively interact with patients, families, and healthcare professionals. Ability to work collaboratively within a multidisciplinary team. Strong critical thinking and problem-solving skills, with the ability to assess complex situations and make sound clinical decisions. Personal Attributes: Empathy and compassion for patients with chronic conditions. Strong organizational skills and attention to detail. Ability to manage a high volume of patients and prioritize care effectively. Additional Information: The Chronic Care Management Nurse is a critical member of our care team, dedicated to improving the health and quality of life of patients with chronic conditions. This role provides an opportunity to make a meaningful difference in the lives of patients, empowering them to manage their health and prevent complications associated with chronic diseases.