TEXASCONNECT INC

Emergency Prospective Review RN

Posted on:

March 21, 2026

Job Type:

Full-Time

Role Type:

Case Management

License:

RN

State License:

California

Texas Connect, Inc. (TCI) is a Management Services Organization (MSO). ‍ As an MSO, we are dedicated to providing business and administrative services for healthcare providers, such as medical practices and hospital systems, allowing them to focus on patient care. TCI handles crucial backend functions, such as Information Technology, Billing, and Medical Coding. This allows our client healthcare organizations to delegate these and other essential, but non-medical tasks to TCI to improve operational efficiency. https://www.texasconnectinc.com

This position is open to Texas residents ONLY. We're hiring for 3 shifts, 7am, 7md, 7pm.

SPECIFIC SKILLS NEEDED: Excellent verbal and written communication skills Ability to follow chain of command Knowledge of hospital operations especially from an ER, ICU, nursing unit, environmental services and financial perspective. Knowledge of EMTALA regulations Advanced ability to multi-task and maintain focus Proactive, can-do approach and desire to build positive working relationships through collaborative problem-solving Self-motivated and results oriented. Must be able to demonstrate sound decision making, flexibility and prioritization skills. Strong organizational skills Basic computer skills; Outlook, Word, and Excel EDUCATION/EXPERIENCE/TRAINING Required: Maintain an active California RN Minimum of two (2) years of acute hospital nursing experience or similar field Preferred: CCM or ACM (Certified Case Manager, Accredited Case Manager) Minimum of one (1) year acute hospital nursing experience in Critical Care or Emergency Department Previous experience in case management, access management or utilization management Knowledge of payer requirements

The Emergency Prospective Review (EPR) RN has the responsibility to conduct a review of all patients requiring hospital admission from the emergency room at all facilities after stabilizing care has been initiated for medical necessity and appropriateness. Also, the EPR-RN is responsible for reviewing all interfacility transfer request from non-PIH facility in accordance to transfer policies, Health and Safety Codes, and applicable laws (COBRA/EMTALA). The EPR-RN performs, and supervises the EPRN-LVN, in utilization review with a prominent level of expertise by using approved criteria that demonstrates medical necessity to achieve appropriate authorization and reimbursement for services for the appropriate level of care and status (Inpatient, Observation, or Outpatient). EPR-RN Communicates medical necessity criteria effectively to outside insurance providers to obtain appropriate authorization for services up front or engages in disagreement of care in accordance with Health and Safety Codes. Additionally, EPR-RN collaborates closely with patient’s insurance and various payors to coordinate and assist with reparation/transfer of out-of-network patients from PIH facility to the patient’s contracted facility including coordination of post-emergency discharge needs, as necessary. EPR-RN is also responsible for the repatriation of all PHP risk patients from non-PIH facilities to any one of the PIH facilities in an expeditious manner. EPR-RN conducts emergency physician-to-emergency physician discussions of members and provides authorization for post-stabilization care of PHP members presenting at a non-PIH facility and is required to assist in making other appropriate arrangements to promote/enhance continuity of care. Similarly, EPR -RN is responsible for the issuance of post stabilization care (PSC) denial to facilities and providers who fail to meet requirements in accordance with Health and Safety Codes. Lastly, the EPR-RN Works collaboratively with House Supervisor or designee in ensuring timely bed assignment and placement of patient admissions or transfers from PIH ED or outside facility. The position serves as a liaison between patients, families, providers, payors, and PIH Health leadership to optimize resource utilization and patient outcomes. This position is considered hybrid with remote and in-office assignment.

TEXASCONNECT INC

Utilization Management LVN

Posted on:

March 21, 2026

Job Type:

Full-Time

Role Type:

Utilization Review

License:

LPN/LVN

State License:

California

Texas Connect, Inc. (TCI) is a Management Services Organization (MSO). ‍ As an MSO, we are dedicated to providing business and administrative services for healthcare providers, such as medical practices and hospital systems, allowing them to focus on patient care. TCI handles crucial backend functions, such as Information Technology, Billing, and Medical Coding. This allows our client healthcare organizations to delegate these and other essential, but non-medical tasks to TCI to improve operational efficiency. https://www.texasconnectinc.com

There are 3 open positions for this role.

SPECIFIC SKILLS NEEDED: Excellent verbal and written communication skills Ability to follow chain of command Highly developed ability to multi-task and maintain focus Proactive, can-do approach and desire to build positive working relationships through collaborativeproblem-solving Self-motivated and results oriented. Must be able to demonstrate sound decision making, flexibility and prioritization skills with minimal supervision. Strong organizational skills Basic computer skills: Word, Excel, PowerPoint, Outlook. Able to utilize multiple electronic systems. Type 50 WPM Ability to apply appropriate UM criteria EDUCATION/EXPERIENCE/TRAINING Required: Current licensure as a LVN in the state of California. A minimum of 2 years of case management experience. Knowledge of payer requirements. Preferred: Certified Case Manager or Accredited Case Manager Experience with Milliman Care Guidelines (MCG) A minimum of 2 years of bedside nursing experience in an acute care setting

The Utilization Management (UM) LVN performs utilization review activities, including, but not limited to, precertification, ensures appropriate level of care and status (Inpatient, Outpatient, and Observation) throughout admission and performs concurrent reviews/retrospective reviews according to guidelines. In addition, the UM LVN delegates to UM RN initial reviews and determines the medical necessity of requests by performing first level reviews. The UM LVN ensures a process that is efficient for providing care, ensuring timely and appropriate levels of care for the incoming patients. UM LVN is responsible for preparing cases for Physician Advisor for 2nd level review. This position will be hybrid with remote and in-office assignment.

TEXASCONNECT INC

Utilization Management RN

Posted on:

March 21, 2026

Job Type:

Full-Time

Role Type:

Utilization Review

License:

RN

State License:

California

Texas Connect, Inc. (TCI) is a Management Services Organization (MSO). ‍ As an MSO, we are dedicated to providing business and administrative services for healthcare providers, such as medical practices and hospital systems, allowing them to focus on patient care. TCI handles crucial backend functions, such as Information Technology, Billing, and Medical Coding. This allows our client healthcare organizations to delegate these and other essential, but non-medical tasks to TCI to improve operational efficiency. https://www.texasconnectinc.com

There are 6 open positions for this role. The Utilization Management (UM) RN performs utilization review activities, including, but not limited to, precertification, ensures appropriate level of care and status (Inpatient, Outpatient, and Observation) throughout admission and performs initial reviews, concurrent reviews, and retrospective reviews according to guidelines. Determines the medical necessity of requests by performing first level reviews. The UM nurse ensures a process that is efficient for providing care, ensuring timely and appropriate levels of care for the incoming patients. UM RN is responsible for preparing cases for Physician Advisor for 2nd level review. UM RN delegates accordingly to LVN and works in conjunction with a multi-disciplinary team to manage the care of patients in an ethical and fiduciary responsible manner. This position is hybrid with remote and in-office assignment.

SPECIFIC SKILLS NEEDED: Knowledge of payer requirements Excellent verbal and written communication skills Ability to follow chain of command Highly developed ability to multi-task and maintain focus Proactive, can-do approach and desire to build positive working relationships through collaborative problem-solving Self-motivated and results oriented. Must be able to demonstrate sound decision making, flexibility and prioritization skills with minimal supervision. Strong organizational skills Basic computer skills: Word, Excel, PowerPoint, Outlook. Able to utilize multiple electronic systems. Type 50 WPM Ability to apply appropriate UM criteria EDUCATION/EXPERIENCE/TRAINING Required: Current licensure as an RN in the state of California. A minimum of 2 years of bedside nursing experience in an acute care setting. A minimum of 2 years of case management experience. Preferred: Certified Case Manager or Accredited Case Manager BSN Experience with Milliman Care Guidelines (MCG)

TEXASCONNECT INC

Case Manager-Denials/Appeals

Posted on:

March 21, 2026

Job Type:

Full-Time

Role Type:

Case Management

License:

RN

State License:

California

Texas Connect, Inc. (TCI) is a Management Services Organization (MSO). ‍ As an MSO, we are dedicated to providing business and administrative services for healthcare providers, such as medical practices and hospital systems, allowing them to focus on patient care. TCI handles crucial backend functions, such as Information Technology, Billing, and Medical Coding. This allows our client healthcare organizations to delegate these and other essential, but non-medical tasks to TCI to improve operational efficiency. https://www.texasconnectinc.com

We have 8 openings. This position supports denials, appeals and compliance activities within the Care Management Department, including patient chart review, writing appeal letters and various audits supporting the Department and hospital in meeting regulatory requirements associated with Care Management.

SPECIFIC SKILLS NEEDED: Excellent verbal, written, and organizational skills required Ability to follow chain of command Knowledge of medical terminology and current third party payor reimbursement methodologies Selfmotivated and results oriented. Must be able to demonstrate sound decision making and prioritization skills, utilizes the approved process to resolve biophysical, psychological, educational and environmental needs of patient/significant others when administering or explaining care. EDUCATION/EXPERIENCE/TRAINING Required: Maintain an active California LVN license Minimum of 2 years acute hospital experience Proficiency with mainframe and personal computers Preferred: Maintain an active California RN license. Managed care and case management experience

CorVel Corporation

Telephonic Case MGR II

Posted on:

March 21, 2026

Job Type:

Full-Time

Role Type:

Telehealth

License:

RN

State License:

Illinois

CorVel is a national provider of industry leading risk management solutions to employers, third party administrators, insurance companies and government agencies. We have over 30 years of experience and are publicly traded (NASDAQ: CRVL). Annual revenues exceeded $429 million in 2013. We specialize in applying advanced communication and information technology to improve healthcare management. Nationwide, our associates work side by side with our customers to deliver innovative, tailored solutions to manage risk and keep our customers ahead of their costs.

The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals. The goal is to support quality treatment and, when appropriate, a timely return to work. This role uses clinical expertise to assess the appropriateness of current treatment plans based on the patient’s medical and physical condition. The Case Manager communicates directly with treating physicians to evaluate and recommend alternative care options when needed. They also explain medical conditions and treatment plans to patients, family members, and adjusters, while supporting the objectives of the Case Management department and of CorVel. This is a remote role.

KNOWLEDGE & SKILLS: Ability to make independent medical decisions and recommendations to all parties Effective multi-tasking skills in a high-volume, fast-paced, team-oriented environment Ability to interface with claims staff, attorneys, physicians and their representatives, and advisors/clients and coworkers Excellent written and verbal communication skills Ability to meet designated deadlines Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets Strong interpersonal, time management, and organizational skills Ability to work both independently and within a team environment EDUCATION & EXPERIENCE: Bachelor’s degree required, BSN preferred Graduate of accredited school of nursing Current RN Licensure in state of operation 3 or more years of recent clinical experience, preferably in rehabilitation URAC recognized Case Management certification (ACM, CCM, CDMS, CMAC, CMC, CRC, CRRN, COHN, COHN-S, RN-BC) required to be obtained within 3 years of hire if no nationally recognized certification is present at time of hire Strong clinical background in orthopedics, neurology, or rehabilitation preferred Strong cost containment background, such as utilization review or managed care helpful Certification as a CIRS or CCM preferred

Provide medical case management to individuals through coordination with the patient, the physician, other health care providers, the employer, and the referral source Provide assessment, planning, implementation, and evaluation of patient's progress Evaluate patient's treatment plan for appropriateness, medical necessity, and cost effectiveness Utilize medical and nursing knowledge to discuss the current treatment plan/alternate treatment plans with the physician Make medical recommendations of available treatment plans to the payer Implement care such as negotiating and coordinating the delivery of durable medical equipment and nursing services Devise cost-effective strategies for medical care Required to prepare organized reports within a specified timeframe Minimum Productivity Standard is 95% per month Additional duties as assigned

Light the Way Home Care

Part-Time / Contract Registered Nurse (RN) – Home Care Startup (Flexible, Minimal Hours)

Posted on:

March 21, 2026

Job Type:

Contract

Role Type:

Leadership / Management

License:

RN

State License:

Compact / Multi-State

Light the Way Home Care is a faith-based, family-centered startup in Florida providing compassionate non-medical homemaker and companion services to seniors and families in need. At Light the Way, we are committed to serving with compassion, dignity, and integrity while building a supportive environment for both our clients and team.

We are seeking a Registered Nurse (RN) for a flexible per diem/PRN supervisory role to support agency compliance as we grow. This position is ideal for an RN seeking supplemental income with minimal time commitment.

Responsibilities are primarily administrative and compliance-based, with a largely remote and flexible schedule. This is a per diem/PRN-style role with a flat monthly stipend, reflecting the limited scope and minimal hours required.

Professional Fire Fighters Association of Arizona Trust

Nurse Advocate

Posted on:

March 21, 2026

Job Type:

Part-Time

Role Type:

Case Management

License:

RN

State License:

Compact / Multi-State

The Nurse Advocate serves as the Trust’s clinical liaison to members, dependents, providers, and vendors. The role ensures members receive timely, appropriate, and high‑quality care while supporting the Trust’s cost‑management strategies, plan design, and fiduciary obligations. This position blends clinical judgment, care navigation, education, and data‑driven outreach to improve outcomes and reduce avoidable spend in a self‑funded environment.

Registered Nurse (RN) with an active, unrestricted license. Minimum 3–5 years of clinical experience in acute care, case management, care coordination, or a related field. Experience working with self‑funded plans, TPAs, or employer‑sponsored benefits. Strong understanding of medical terminology, evidence‑based care, and care management principles. Excellent communication, empathy, and problem‑solving skills. Ability to work independently while collaborating with multiple stakeholders. Preferred Qualifications: Experience with firefighter, public safety, or high‑risk occupational populations. Background in utilization management, population health, or chronic disease programs. Familiarity with PBM programs, specialty drug management, and high‑cost claim mitigation. Certification in Case Management (CCM), Care Coordination (CCCTM), or similar credential. Core Competencies: Clinical judgment grounded in evidence‑based practice. Member‑first mindset with strong advocacy skills. Data‑informed decision‑making to identify risk and drive interventions. Cross‑functional collaboration with TPAs, providers, and vendors. Clear communication with members, trustees, and operational partners. Confidentiality and compliance with HIPAA and fiduciary standards.

Member Advocacy & Care Navigation: Provide one‑on‑one clinical guidance to members and families regarding diagnoses, treatment options, specialist referrals, and care pathways. Assist members in navigating complex medical situations, including chronic conditions, cancer care, high‑cost procedures, and post‑hospital transitions. Coordinate with providers to ensure continuity of care, timely follow‑up, and adherence to evidence‑based guidelines. Support members in understanding plan benefits, coverage rules, and available Trust‑sponsored programs. Clinical Case Management & Cost Stewardship: Identify high‑risk, high‑cost, or rising‑risk members through data reports, and vendor analytics. Conduct proactive outreach to support early intervention, reduce avoidable ER visits, and improve chronic disease management. Collaborate with the TPA’s medical management team to review complex cases, prior authorizations, and utilization trends. Recommend care pathways, centers of excellence, or alternative treatment options aligned with quality and cost‑effectiveness. Provider & Vendor Coordination: Serve as the Trust’s clinical point of contact with TPAs, PBMs, wellness vendors, behavioral health partners, and specialty networks. Participate in case rounds, utilization review discussions, and appeals/denials processes. Support integration of clinical programs such as telehealth, mental health services, wellness initiatives, and disease‑specific programs. Member Education & Outreach: Develop and deliver educational materials, workshops, and communications on preventive care, chronic disease management, and health literacy. Provide targeted outreach to improve compliance with screenings, vaccinations, and Trust‑sponsored wellness programs. Support member engagement strategies that improve outcomes and reduce long‑term plan costs. Compliance, Reporting & Quality Improvement: Maintain accurate, confidential case notes and documentation consistent with HIPAA and Trust policies. Track and report key metrics such as case outcomes, member engagement, cost avoidance, and program utilization. Identify trends and recommend improvements to plan design, vendor programs, or clinical processes. Participate in annual plan evaluation, renewal discussions, and strategic planning with Trust leadership.

The Travelers Companies, Inc.

Clinic Nurse Medical Case Manager - Workers Compensation - Irwindale

Posted on:

March 21, 2026

Job Type:

Full-Time

Role Type:

Case Management

License:

RN

State License:

California

Taking care of our customers, our communities and each other. That’s the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.

Under moderate supervision, provide office based telephonic and/or in-person medical case management supporting Concierge locations with emphasis on early intervention, return to work planning, coordination of quality medical care on claims involving disability and medical treatment as well as in-house medical reviews as applicable to claim handling laws and regulations. Responsible for helping to ensure injured parties receive appropriate treatment directly related to the compensable injury or assist claim handlers in managing medical treatment to an appropriate resolution.

RN or LVN Disability case management experience. Prior clinical experience. Familiarity with URAC standards. Analytical Thinking: Identifies current or future problems or opportunities; analyzes, synthesizes and compares information to understand issues; identifies cause/effect relationships; and explores alternative solutions that support sound decision-making. Communication: Expresses, summarizes and records thoughts clearly and concisely orally and in writing by applying proper content, format, sentence structure, grammar, language and terminology. Ability to effectively present file resolution to internal and/or external stakeholders. Negotiation: Intermediate ability to understand alternatives, influence stakeholders and reach a fair agreement through discussion and compromise. General Insurance Contract Knowledge: Ability to understand policies and contracts, as they apply to policy conditions. Principles of Investigation: Intermediate investigative skills. Follows a logical sequence of inquiry with a goal of securing information about the work accident, resulting injury, anticipated treatment, job duties and any material factors that may impact recovery and return to work. Value Determination: Basic ability to determine liability and assigns a dollar value based on damages claimed and estimates, sets and readjusts reserves. Legal Knowledge: Basic knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry. Medical knowledge: Thorough knowledge of the nature and extent of injuries, periods of disability, and treatment needed. WC Technical: intermediate ability to demonstrate understanding of WC Products and ability to apply available resources and technology to manage treatment plans and assist with claim resolution. Demonstrate a clear understanding and ability to work within jurisdictional parameters within their assigned state. Customer Service: Advanced ability to build and maintain productive relationships with our insureds and deliver results with optimal outcomes. Teamwork: Advanced ability to work together in situations when actions are interdependent and a team is mutually responsible to produce a result. Planning & Organizing: Advanced ability to establish a plan/course of action and contingencies for self or others to meet current or future goals. Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), Clinical Research Counselor (CRC), or Certified Rehab Registered Nurse (CRRN). What is a Must Have? Registered Nurse; Licensed Practical Nurse or Licensed Vocational Nurse.

Meet with injured employees face to face following office visits at a provider's medical facility to assist with the claim process and ensure compliance with their medical treatment plan. Contact customer, medical provider and injured parties on claims involving medical treatment and /or disability to coordinate appropriate medical care and return to work. Develop strategies to facilitate an injured employee's return to work and achieve maximum medical improvement. Evaluate and update treatment and return to work plans within established protocols throughout the life of the claim. Coordinate with medical providers to ensure the injured employee is actively participating in a viable treatment plan. Evaluate medical treatment requests to ensure that they are reasonable and necessary based upon jurisdictional guidelines. Engage specialty resources as needed to achieve optimal resolution (Dial-a-doc, physician advisor, peer reviews, MCU). Partner with Claim Professional to provide medical information and disability status necessary to create an overall strategy to achieve an optimal outcome. Utilize internal Claim Platform Systems to manage all claim activities on a timely basis. Utilize Preferred Provider Network per jurisdictional guidelines. Partner with Claim Professional to provide input on medical treatment and recovery time to assist in evaluating appropriate claim reserves. Submit accurate billing documentation on all activities as outlined in established guidelines. Customer Engagement. Participate in Telephonic and/or onsite File Reviews. Respond to inquiries - oral and written. Keep injured worker apprised of claim status. In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) and/or certifications may be required to comply with state and Travelers requirements. Generally, License(s) are required to be obtained within three months. Perform other duties as assigned.

HealthArc

Care Manager (Registered Nurse)

Posted on:

March 21, 2026

Job Type:

Full-Time

Role Type:

Care Management

License:

RN

State License:

Compact / Multi-State

We are seeking a compassionate, organized, and experienced Registered Nurse (RN) to join our care team as a Clinical Care Manager. This role combines patient-centered care with remote monitoring and chronic care management (RPM/CCM) and includes supervisory responsibility over a team of CMAs (Certified Medical Assistants / Medication Aides) and LPNs and RNs. The ideal candidate will ensure high-quality patient care, streamline care coordination, and lead a clinical support team to deliver efficient and safe patient services. Location: Remote (FL, GA, NJ, NY, OH, TX)

Active, unrestricted Registered Nurse (RN) license. Knowoledge or remote care space and virtual care Preferred: BSN degree from an accredited institution Minimum of 2–5 years of clinical nursing experience; prior exposure to case management, chronic care, telehealth, home-health.

Lead a team of clinical personnel to provide the highest quality patient care Monitor and review biometric and physiologic data (e.g. blood pressure, glucose, weight, heart rate, oxygen saturation, etc.) transmitted via RPM devices from patients’ homes. Perform clinical assessments (telephonic or virtual) based on RPM data, identify alarming signals or concerning trends, and escalate care or intervene as appropriate and coach others on how to do this. Provide patient education and coaching — explain device usage, help patients understand their health data, reinforce treatment plans, and encourage adherence. Document all data, assessments, interventions, and communications accurately in electronic health records (EHR) or care-management software; ensure compliance with clinical and billing documentation requirements. Team Supervision & Leadership (CMAs & LPNs): Supervise and oversee the daily work of CMAs and LPNs assigned under your direction — assign shifts and duties to ensure adequate coverage and balanced workload. Provide orientation, training, and ongoing education for CMAs/LPNs regarding care protocols, safety standards, documentation procedures, and scope-of-practice guidelines Mentor and coach the team — offer clinical guidance, support decision-making, answer questions, and promote professional development of support staff. Evaluate performance of team members, provide feedback, conduct performance reviews, and implement corrective actions or improvement plans when necessary. Ensure that tasks assigned to CMAs/LPNs are within their legal scope of practice and follow appropriate delegation rules under RN supervision. Monitor quality and consistency of care delivered — perform periodic audits, review documentation, and conduct rounds (in-person or virtual) to ensure safety and adherence to standards. Manage staffing and scheduling — maintain adequate staffing levels per shift, adjust assignments based on patient acuity, leave or peak times, and ensure coverage for all necessary care services. Serve as a liaison between the nursing/support staff and other healthcare professionals (physicians, specialists, therapists, social workers), ensuring proper communication, smooth handoffs, and coordination of care across disciplines. Care Coordination, Quality Assurance & Program Management: Oversee the overall care delivery process for patients under RPM/CCM and the clinical support team — ensuring care quality, patient safety, and regulatory compliance. Participate in developing, implementing, and maintaining protocols, policies, and standard operating procedures (SOPs) for care delivery, remote monitoring, documentation, and care coordination. Track clinical outcomes, readmissions, hospitalizations, patient satisfaction, and other relevant metrics; analyze trends and recommend quality improvement initiatives. Facilitate patient and family education — teach about chronic disease management, self-care, medication adherence, use of RPM devices, lifestyle modifications, and health literacy. All other assigned duties.

Cadence Health

Registered Nurse - Nights

Posted on:

March 21, 2026

Job Type:

Full-Time

Role Type:

Triage

License:

RN

State License:

Compact / Multi-State

Cadence Health was built around a simple promise: patients always come first. Our technology-enabled remote care model pairs continuous health insights with a highly skilled clinical Care Team, empowering seniors to stay healthier, avoid complications, and live more independent, fulfilling lives, all without the limits of a traditional office visit.

In the U.S., 60% of adults – more than 133 million people – live with at least one chronic condition. These patients need frequent, proactive support to stay healthy, yet our care system isn't built for that level of attention. With rising clinician shortages, strained infrastructure, and reactive care models, patients too often end up in the ER or the hospital when those outcomes could have been prevented. At Cadence, we're building a better system. Our mission is to deliver proactive care to one million seniors by 2030. Our technology and clinical care team extend the reach of primary care providers and support patients every day at home. In partnership with leading health systems, Cadence consistently monitors tens of thousands of patients to improve outcomes, reduce costs, and help patients live longer, healthier lives. The Cadence Health team seeks a Registered Nurse that will be responsible for appropriately monitoring and triaging patients based on vitals and alerts; supporting the management of patient treatment plans and medications in collaboration with Cadence NPs and the patient's Physician. A core part of this role includes fielding inbound patient calls and managing patient alerts after normal core business hours. Available Schedules: Sunday, Monday, Tuesday, and every other Wednesday, 7:00 PM to 7:00 AM ET

4+ years experience treating CHF, hypertension, and Diabetes patients either in an outpatient or inpatient setting. Compact multi-state licensure (RN compact). Experience working in a CHF bridge clinic environment. Experience working with remote patient monitoring technology. Passion for the patient/ customer experience and systematically improving healthcare with digital innovation. Independent thinker/ operator. Ability to monitor patient vitals, symptoms and labs to identify patients in need of clinical interventions. Ability to follow up with patients with abnormal readings to gather more information on their clinical status and triage appropriately. Ability to lead virtual follow-ups with patients to support program enrollment, treatment plan changes, medication adherence and achievement of lifestyle goals.

Follow standardized triage protocols for incoming calls and escalate appropriately (e.g. Schmitt - Thompson clinical telephonic triage guidelines). This can range from directing the patient to their clinic after-hours call line for non-urgent needs to sending the patient to the ER and/or dialing 911 for emergencies. Follow up with patients with abnormal readings to gather more information on their clinical status and triage appropriately. Monitor patient vitals, symptoms, and labs to identify patients in need of clinical interventions and appropriate escalation. Additional administrative support as needed: Follow up with patients who need rescheduling, reach out to patients who have had lapses in taking their vitals and other administrative work. Respond to inbound patient clinical questions and escalations by phone (and/or text message). Support clinical documentation for the patients' Cadence care team (NP, RN, and Patient Success); including documenting patient case notes in the Cadence platform and logging tickets/follow-up tasks in ZenDesk. Ensure every healthcare interaction with Cadence is an exceptional experience that prioritizes the well-being of the patient and aligns with the goals of our health system partners.

WEP Clinical

Clinical Research Nurse - Home Visits (PRN); Scranton, Pennsylvania

Posted on:

March 21, 2026

Job Type:

Contract

Role Type:

Clinical Operations

License:

RN

State License:

Pennsylvania

Are you a skilled, compassionate nurse looking for flexible work in clinical research? As a Clinical Research Nurse – Home Visits (PRN), you’ll provide high-quality nursing care directly in patients’ homes while supporting important research studies. This role is ideal for nurses who value flexibility, independence, enjoy local travel, and want to supplement their income with meaningful work. Key Points to Know: • You’ll use your own vehicle to visit patients in their homes, typically within 1–2 hours of your location. • Shifts are PRN / per diem, meaning you’ll work only when projects are available in your area; project frequency may vary. • Orientation, training, and project-specific instructions are provided before each assignment. • You will be compensated for all time spent on training, travel, and patient visits, including documentation. Position: Clinical Research Nurse – Home Visits (PRN) Job Type: Contract, PRN, Per Diem Hourly Rate: $60/hr onsite and $50/hr travel time Work Location: Scranton, Pennsylvania; Drive up to 1–2 hours to patient homes in your area (travel time compensated!) Job Description: As a Clinical Research Nurse – Home Visits (PRN), you will play a crucial role in ensuring the successful execution of research studies in patient homes. You will be responsible for administering investigational medications/products, conducting patient assessments, collecting vital information, and adhering to study protocols with utmost accuracy and ethics. Your expertise and caring nature will help us maintain compliance with each study's protocol and safeguard the well-being of study patients.

Relevant Nurse Licensure CH-GCP Certificate Graduate from an accredited BSN or Associate Degree in Nursing or Nursing Diploma program Minimum 2 years’ post qualification acute care experience Clinical Research experience preferred BLS certification required Experience and knowledge of working in clinical research trials with ICH-GCP (Good Clinical Practice) Certification - (training can be provided) Good basic IT skills, utilizing mobile devices and Microsoft systems Trained in Handling and Transport of Hazardous Substances (training can be provided) A flexible schedule is essential Unencumbered driver’s license, reliable car

Deliver competent, high-quality nursing care to study patients in their homes. Accountable for the competent and confident delivery of high-quality clinical care to patients/participants. Ensure compliance with each study’s protocol by providing thorough review and documentation at each subject study visit. Administer investigational medications/products as needed; Perform patient assessments to determine presence of side effects; notify Principal Investigator of findings/issues. Perform medical tests as outlined in protocol, including, but not limited to: vital signs, specimen collection, electrocardiograms; Process specimens and ship specimens per protocol. Provide patient education and medical information to study patients to ensure understanding of proper medication dosage, administration, and disease treatment. Responsible for adherence to clinical research policies to ensure ethical conduct and protect vulnerable populations. Communicate effectively, promoting open and trusting relationships.

WEP Clinical

Clinical Research Nurse - Home Visits (PRN); Richmond, Virginia

Posted on:

March 20, 2026

Job Type:

Contract

Role Type:

Clinical Operations

License:

RN

State License:

Compact / Multi-State

Are you a skilled, compassionate nurse looking for flexible work in clinical research? As a Clinical Research Nurse – Home Visits (PRN), you’ll provide high-quality nursing care directly in patients’ homes while supporting important research studies. This role is ideal for nurses who value flexibility, independence, enjoy local travel, and want to supplement their income with meaningful work. Key Points to Know: • You’ll use your own vehicle to visit patients in their homes, typically within 1–2 hours of your location. • Shifts are PRN / per diem, meaning you’ll work only when projects are available in your area; project frequency may vary. • Orientation, training, and project-specific instructions are provided before each assignment. • You will be compensated for all time spent on training, travel, and patient visits, including documentation. Position: Clinical Research Nurse – Home Visits (PRN) Job Type: Contract, PRN, Per Diem Hourly Rate: $55/hr onsite and $50/hr travel time Work Location: Richmond, Virginia; Drive up to 1–2 hours to patient homes in your area (travel time compensated!) Job Description: As a Clinical Research Nurse – Home Visits (PRN), you will play a crucial role in ensuring the successful execution of research studies in patient homes. You will be responsible for administering investigational medications/products, conducting patient assessments, collecting vital information, and adhering to study protocols with utmost accuracy and ethics. Your expertise and caring nature will help us maintain compliance with each study's protocol and safeguard the well-being of study patients.

Relevant Nurse Licensure CH-GCP Certificate Graduate from an accredited BSN or Associate Degree in Nursing or Nursing Diploma program Minimum 2 years’ post qualification acute care experience Clinical Research experience preferred BLS certification required Experience and knowledge of working in clinical research trials with ICH-GCP (Good Clinical Practice) Certification - (training can be provided) Good basic IT skills, utilizing mobile devices and Microsoft systems Trained in Handling and Transport of Hazardous Substances (training can be provided) A flexible schedule is essential Unencumbered driver’s license, reliable car

Deliver competent, high-quality nursing care to study patients in their homes. Accountable for the competent and confident delivery of high-quality clinical care to patients/participants. Ensure compliance with each study’s protocol by providing thorough review and documentation at each subject study visit. Administer investigational medications/products as needed; Perform patient assessments to determine presence of side effects; notify Principal Investigator of findings/issues. Perform medical tests as outlined in protocol, including, but not limited to: vital signs, specimen collection, electrocardiograms; Process specimens and ship specimens per protocol. Provide patient education and medical information to study patients to ensure understanding of proper medication dosage, administration, and disease treatment. Responsible for adherence to clinical research policies to ensure ethical conduct and protect vulnerable populations. Communicate effectively, promoting open and trusting relationships.

Atrium Health

Care Manager Registered Nurse - Atrium Health Remote PT Weekends

Posted on:

March 20, 2026

Job Type:

Part-Time

Role Type:

Triage

License:

RN

State License:

North Carolina

Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits. The Registered Nurse (RN), a member of Advocate Health Nursing Professional Governance community, provides high- quality, patient-centered care through evidence-based practice, clinical expertise, and compassionate care delivery in an acute care setting. The RN collaborates with interdisciplinary teams, advocates for patient needs, and upholds professional practice standards to promote optimal health outcomes.

Department: 39733 Enterprise Corporate - Care Transitions Status: Part time Benefits Eligible: Yes Hours Per Week: 20 Schedule Details/Additional Information: Preferred qualifications: 3+ years RN: experience in case management, triage, with prior telephonic/remote experience. This is a weekend position, hours of operation 8am to 8:30pm with a potential to include holidays. This is a remote work from home position. Must have high speed internet. Must live within 1 hour of Mint Hill, NC Primary Care office. Pay Range $38.20 - $57.30 Job Description: Must live within 1 hour of Mint Hill, NC Primary Care Office to be considered for this remote opportunity.

Licensure, Registration, and/or Certification Required: Registered Nurse license issued by the state in which the team member practices. Education Required: Bachelor's Degree in Nursing or related field. Experience Required: Typically requires 5 years of experience in clinical nursing or 1-2 years of care management experience. Knowledge, Skills & Abilities Required: Applicable certification is encouraged. Must be self-directed with the ability to work well independently and within a team environment while recognizing and meeting the individual needs of external and internal partners/customers. Ability to demonstrate excellent oral, written and interpersonal skills. Ability to demonstrate critical thinking, problem solving and excellent organizational skills. Ability to work productively and effectively in a complex environment that includes multiple changing priorities. Demonstrated ability to work well with physicians and other healthcare professionals in a direct and positive manner. Proficient computer/Microsoft-suite skills and previous Epic EMR experience. Ability to handle multiple responsibilities. Physical Requirements and Working Conditions: Position may require travel between clinic sites so there may be exposure to road and weather conditions. Manual dexterity required for operation computer and calculator. Visual acuity required to facilitate review of written documents/computer screens, medical records, and to record information accurately. Clear oral communications and hearing acuity required for receiving instructions and converse on standard telephone. Functional speech and hearing to allow for effective communication of instructions and conversation over the telephone. Exposed to normal office environment; including usual hazards related to operating electrical equipment. Operates all equipment necessary to perform the job.

Facilitates communications among patient/family, multidisciplinary team, medical management team, community resources and other disciplines to anticipate, identify, evaluate, and act to resolve any potential barriers and constraints to delivery of care in a timely manner. Understands and interprets multiple contracts and contractual obligations in order to enable the care management team to achieve maximum clinical and financial outcomes. Collaborates with the patient/family and inter-professional team including the primary care team, hospital care team, post acute care managers, and other care partners to provide a model of care that ensures the delivery of quality, efficient, and cost-effective healthcare services. May work embedded within a provider office or telephonically working with a care team. Uses evidenced-based approaches to increase patient and family activation and engagement in their own care. As appropriate to the population, partners with patient and family to develop SMART (specific, measurable, attainable, relevant, time-bound) goals. Assists in the development, procurement, and adoption of patient self-management educational resources. Identifies potential barriers to learning and/or to the optimal delivery of care. Reports abnormal findings to the responsible provider/care team, and collaborates to develop a plan. Independently manages CM caseload according to department expectations. Ensures timely completion of tasks and documentation related to MCO, regulatory and contractual requirements. Partners with identified at-risk patients throughout the diagnosis, treatment and follow-up in order to deliver continuity of care. Anticipates the needs of the patient, recognizes and responds to changes in a patient’s status and determines priorities of patient care based on essential patient needs. Coordinates patient information and communication between and among the patient/family, the referring/accepting facilities and physicians, community caregivers (as applicable) and other members of ACM to ensure smooth transitions of care. Coordinates referrals to other internal AAH departments and/or external community resources as necessary. Must be able to demonstrate knowledge and skills necessary to provide care appropriate to the age of the patients served. Must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirements relative to his/her age-specific needs, and to provide the care needed as described in the department's policies and procedures. Age-specific information is developed further in the departmental job standards.

Atrium Health

Registered Nurse - Atrium Health Call Center Weekender 7a-7p PT (Remote)

Posted on:

March 20, 2026

Job Type:

Part-Time

Role Type:

Telehealth

License:

RN

State License:

Compact / Multi-State

Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits. The Registered Nurse (RN), a member of Advocate Health Nursing Professional Governance community, provides high- quality, patient-centered care through evidence-based practice, clinical expertise, and compassionate care delivery in an acute care setting. The RN collaborates with interdisciplinary teams, advocates for patient needs, and upholds professional practice standards to promote optimal health outcomes.

Department: 12707 Enterprise Corporate - Patient Access & Care Team: NC/GA Nursing Status: Part time Benefits Eligible: Yes Hours Per Week: 24 Schedule Details/Additional Information: Weekender, every Saturday and Sunday 8a-8p, at least 5 years RN experience required, BSN required Pay Range $38.20 - $57.30

Minimum Job Requirements Education: Graduate of a Board of Nursing approved nursing education program. Certification / Registration / License: Basic Life Support (BLS). Additional education, training, certifications, or experience may be required based on specialty. Active, unrestricted registered nurse (RN) multi-state compact and/or single-state license with privileges to practice in the state(s) where the RN is providing client nursing services Note: Licensed nurses practicing via telehealth/telenursing/virtual modalities are required to be licensed or hold the privilege to practice in the state(s) where the client(s) is/are located. Licensed nurses are responsible and accountable for knowing, understanding, and practicing in compliance with the laws, rules, regulations, and standards of practice of the state(s) where the client(s) is/are located. Experience: Typically requires 1 year of experience in clinical nursing. Knowledge / Skills / Abilities: Strong clinical judgment and critical thinking. Time management, prioritization and problem-solving skills. Excellent communication and interpersonal skills. Ability to work in a fast-paced, dynamic environment. Proficiency in operating computer functions (e.g., E-mail, electronic records, digital platforms etc.) clinical, aviation, maintenance, communications, and administrative departments. Physical Requirements and Working Conditions: Must be able to sit, stand, walk, lift, squat, bend, reach above shoulders, and twist frequently throughout the workday. Must be able to lift and support the weight of 35 pounds in handling patients, medical equipment, and supplies. Must be able to: push/pull with 30 lbs. of force and perform a sliding transfer of 150 lbs. with a second person present. Must have functional speech, vision, hearing, and touch with ability to use fine hand manipulation skills for IV insertion and other procedures/functions. Maneuver foot pedals on carts or machines. Perform physical safety interventions such as patient restraint and verbal de-escalation, if needed. May be exposed to chemical and hazardous waste as well as blood and body fluids and communicable disease. Therefore, protective clothing and equipment must be worn as necessary. Must be able to respond quickly to changes in patient and/or unit conditions. Physical Abilities Testing may be required. Additional department specific physical requirements may be identified for unique responsibilities within the department by the nurse leader. Preferred Job Requirements Education: Bachelor of Science degree in Nursing (BSN)

Engages in unit councils, professional governance, and quality initiatives to improve care processes and apply evidence-based practices. Utilizes the nursing process to assess, plan, diagnose, implement, and evaluate nursing care, engaging patients and families through the continuum of care. Monitors patient conditions, adjusts care plans, mobilizes resources, and collaborates with the care team to influence care outcomes. Upholds and promotes a culture of safety. Continuously evaluates patient, team, and unit outcomes, taking action as needed. May administer medications, treatments, and therapies safely and according to clinical protocols and procedures. Demonstrates effective communication, feedback, and conflict resolution, fostering team collaboration and appropriate delegation. Pursues professional development, completes required education, and maintains certifications. Adhere to the ANA Code of Ethics and practices ethical decision-making, respects interdisciplinary roles, and contributes to integrated, unbiased patient care. Appropriate delegation to other Registered Nurses, Licensed Practical Nurses, and unlicensed assistive personnel (i.e., nurse aides, credentialed medical assistants, etc.). Maintains accurate, timely EHR documentation. May be required to float to other units, departments, care areas, or facilities within the designated service area to meet patient care needs. Must be able to demonstrate knowledge and skills necessary to provide care appropriate to the age of the patients served. Must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirements relative to his/her age-specific needs, and to provide the care needed as described in the department's policies and procedures. Age-specific information is developed further in the departmental job standards

Evergreen Nephrology

Remote Licensed Practical Nurse - Eastern Time

Posted on:

March 20, 2026

Job Type:

Full-Time

Role Type:

Telehealth

License:

LPN/LVN

State License:

Maryland

Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic, and comprehensive approach to kidney care. We believe patients living with kidney disease deserve the best care. We are committed to improving patient outcomes and improving quality of life by delaying disease progression, shifting care to the home, and accelerating kidney transplants. We help nephrologists focus on the right patients at the right time across the full care spectrum. We do this by providing them with the best-in-class interdisciplinary clinical resources, analytical insight and tools, and services to patients. We listen to the needs of our patients, our employees, and our client partners, continually working to push beyond the status quo in which the care system manages patients today.

You are devoted, compassionate, and enjoy being on the front lines of healthcare, changing the lives of patients by supporting them and the team by focusing on customers. You’re excited about being part of a team that is building a healthcare delivery model that ensures the highest possible quality of life and best outcomes for those in our care. You believe people living with kidney disease deserve the best person-centered, holistic, comprehensive care and want to influence the healthcare system to drive towards that. You thrive in innovative and evolving environments with high rates of change. Your Role: As a Licensed Practical Nurse (LPN) with Evergreen Nephrology, you are responsible for conducting monthly clinical check-ins, identifying and addressing clinical concerns, reinforcing care plans, escalating issues appropriately, and ensuring clinical documentation accuracy across both the EHR and partner technology platform. This position requires clinical judgment, licensed expertise, and the ability to support patients between office visits while collaborating closely with Evergreen’s providers, care teams, and leadership. LPNs are essential to delivering a safe, compliant, clinically credible Connected Care Program. The program uses SMS as the first-line channel for patient engagement, with phone outreach used when appropriate. While this position is fully remote, you must be able to work from 8:30am – 5pm in the Eastern time zone.

Required Qualifications: Active LPN or Licensed Vocational Nurse (LVN) license Minimum 1–2 years of clinical experience in: Ambulatory care Population health Care coordination Case management Strong clinical assessment, communication, and documentation skills. Comfortable working in two systems (EHR + CCM platform) simultaneously. Ability to manage a structured, metric-driven workflow with reliability. Intermediate skills with MS Office Suite of products including Outlook and Teams Able to work effectively in a primarily remote environment: Home internet must support a minimum download speed of 25 Mbps and upload speed of 10 Mbps. Cable, Fiber, or DSL connections hardwired to the internet device are recommended Evergreen will provide remote employees with telephony applications and equipment to meet the business requirements for their role Employees must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Preferred Qualifications: Experience in chronic disease management Prior work in virtual care, remote nursing, or telehealth programs. Familiarity with CCM regulatory requirements. Strong patient education and motivational interviewing skills.

Some responsibilities may vary based on specific patient programs, but this role's primary duties include the following: Patient Engagement & Outreach Perform monthly CCM touchpoints for assigned patient panels. Build strong, ongoing relationships with patients and caregivers through regular outreach. Review patient chart data (diagnoses, kidney disease history, medications, labs, imaging, treatment cycles) before calls. Explain CCM participation and reinforce program benefits. Clinical Assessments & Judgment Conduct structured symptom assessments (pain, fatigue, neuropathy, SOB, nausea, etc.). Evaluate changes in condition using licensed clinical judgment. Assess medication adherence issues, side effects, or confusion about regimen. Identify clinical red flags requiring escalation (e.g., worsening symptoms, new SOB, uncontrolled pain, concerning vitals). Escalation, Coordination & Provider Communication Escalate urgent issues based on defined triage pathways (same-business-day or immediate). Collaborate with the provider team on symptom changes, new concerns, or medication-related issues. Route EHR messages with clinically relevant documentation. Assist in coordinating care: scheduling follow-up, arranging labs, ensuring nephrology appointments are kept, and reducing missed care. Care Plan Reinforcement & Patient Education Reinforce provider-developed CKD and chronic disease care plans. Provide clinical explanation of symptom management instructions (within LPN scope). Support adherence to medications, lifestyle changes, and follow-up instructions. Identify social, behavioral, or access barriers and determine appropriate interventions or referrals. Documentation, EHR Updates & Compliance Document all patient interactions clearly in both the EHR and CCM patient management platform. Track and log qualifying CCM time accurately for billing compliance. Ensure documentation meets regulatory, internal QA, and partner expectations. Maintain high call quality and adherence to scripting and workflow pathways. Quality, Performance & Continuous Improvement Maintain or exceed: ≥80% monthly engagement ≥90% billable conversion High QA/documentation accuracy scores Participate in peer reviews, QA audits, coaching sessions, and continuous education. Identify recurring patient needs and communicate trends to the Program Manager. Other duties consistent with this role, as assigned.

Evergreen Nephrology

Program Manager - Chronic and Complex Care Management & Transitions of Care

Posted on:

March 20, 2026

Job Type:

Full-Time

Role Type:

Care Management

License:

RN

State License:

Compact / Multi-State

Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic, and comprehensive approach to kidney care. We believe patients living with kidney disease deserve the best care. We are committed to improving patient outcomes and improving quality of life by delaying disease progression, shifting care to the home, and accelerating kidney transplants. We help nephrologists focus on the right patients at the right time across the full care spectrum. We do this by providing them with the best-in-class interdisciplinary clinical resources, analytical insight and tools, and services to patients. We listen to the needs of our patients, our employees, and our client partners, continually working to push beyond the status quo in which the care system manages patients today.

You are devoted, compassionate, and enjoy being on the front lines of healthcare, changing the lives of patients by supporting them and the team by focusing on customers. You’re excited about being part of a team that is building a healthcare delivery model that ensures the highest possible quality of life and best outcomes for those in our care. You believe people living with kidney disease deserve the best person-centered, holistic, comprehensive care and want to influence the healthcare system to drive towards that. You thrive in innovative and evolving environments with high rates of change. Your Role: As the Program Manager of Chronic and Complex Patient Management (CCPM) and Transitions of Care (TOC) with Evergreen Nephrology, you will lead a team focused on delivering longitudinal, patient-centered care for individuals with complex and chronic conditions, including kidney disease, diabetes, heart failure, and other comorbidities. In this role, you will provide collaborative, supportive leadership and oversee the day-to-day operations of the care management team, ensuring consistent execution of proactive care strategies that improve patient outcomes. You will leverage your clinical and operational expertise to guide the management of high-risk populations, ensure adherence to established care pathways, and reduce complications, avoidable hospital admissions, and overall healthcare utilization. You will be accountable for CCPM and TOC program performance, driving results against key performance indicators (KPIs) and quality metrics. Additionally, you will support ongoing team development through coaching, training, and performance management to ensure delivery of high-quality, efficient, and patient-centered care aligned with Evergreen’s standards.

Bachelor’s degree in healthcare or nursing (BSN required) Active state nursing license in good standing 3+ years of longitudinal clinical nursing care management experience required 2+ years of experience in a clinical nursing managerial or leadership role Experience in longitudinal care management Strong business acumen of value-based healthcare operations in disease management and population health programs Understanding of Business Continuity and how to build resiliency into business processes / systems Ability to develop talent, know when to delegate, innovate and iterate with your team, leveraging their strengths Exceptional relationship-building, communication, and change management skills, with the ability to influence effectively and establish trust and credibility quickly with internal and external partners Strong leadership presence which inspires others and instills confidence in peers, external partners, board members, and team members Execution-focused and hands-on, with the ability to effectively balance strategic priorities and detailed, day-to-day operational work (“in the weeds”). Able to motivate staff; influence people and outcomes, you promote team building Demonstrated ability to work effectively independently and as part of a team, in collaborative settings Commitment to maintaining highest level of confidentiality Organizational skills, operational rigor, resilience, and commitment to the business Intermediate skills with MS Office Suite of products including Outlook and Teams Able to work effectively in a primarily remote environment: Home internet must support a minimum download speed of 25 Mbps and upload speed of 10 Mbps. Cable, Fiber, or DSL connections hardwired to the internet device are recommended Evergreen will provide remote employees with telephony applications and equipment to meet the business requirements for their role Employees must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Preferred Qualifications: Master's Degree in Nursing or Healthcare Administration or related field Experience with quality improvement using data to track and improve program performance Previous experience working within a managed care environment especially with experience in administrative/management capacity Experience in leading the clinical function of a Value Based Care organization

Oversee day-to-day operations for the CCPM and TOC care management teams, ensuring efficient workflows, standardized processes, and consistent achievement of program goals. Ensure delivery of high-quality longitudinal chronic/complex care management and best-in-class transitions of care, including adherence to clinical pathways, protocols, and documentation standards. Continuously evaluate and improve the performance of CCPM and TOC programs and team members, consistent with Evergreen’s performance management philosophy. Develop and implement collaborative strategies to improve program performance and patient outcomes (e.g., chronic disease control, complication prevention, and reduced readmissions) while ensuring patient and provider partner satisfaction. Support newly hired CCPM/TOC team members through orientation and onboarding; provide ongoing training, coaching, and development for established team members. Perform regular call and documentation (chart) audits to support performance management and identify opportunities for continuous improvement. Prepare performance reports, dashboards (as applicable), and meeting materials for CCPM and TOC programs for internal and external audiences. Oversee TOC workflows that support timely post-discharge outreach, medication reconciliation support, follow-up appointment coordination, and issue escalation to reduce avoidable readmissions. Develop and foster relationships with key stakeholders (e.g., IDT members, market leaders, and other program leaders) to drive outcomes through collaboration and cross-program partnership across CCPM and TOC. Build and maintain effective communication strategies between Evergreen and market stakeholders to foster strong relationships that support improved patient outcomes, in collaboration with market leaders. Be a Culture Champion by cultivating a culture of high performance, transparency, trust, and collaboration. Other duties consistent with this role, as assigned.

Evergreen Nephrology

Remote Licensed Practical Nurse - Pacific Time

Posted on:

March 20, 2026

Job Type:

Full-Time

Role Type:

Case Management

License:

LPN/LVN

State License:

California

Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic, and comprehensive approach to kidney care. We believe patients living with kidney disease deserve the best care. We are committed to improving patient outcomes and improving quality of life by delaying disease progression, shifting care to the home, and accelerating kidney transplants. We help nephrologists focus on the right patients at the right time across the full care spectrum. We do this by providing them with the best-in-class interdisciplinary clinical resources, analytical insight and tools, and services to patients. We listen to the needs of our patients, our employees, and our client partners, continually working to push beyond the status quo in which the care system manages patients today.

You are devoted, compassionate, and enjoy being on the front lines of healthcare, changing the lives of patients by supporting them and the team by focusing on customers. You’re excited about being part of a team that is building a healthcare delivery model that ensures the highest possible quality of life and best outcomes for those in our care. You believe people living with kidney disease deserve the best person-centered, holistic, comprehensive care and want to influence the healthcare system to drive towards that. You thrive in innovative and evolving environments with high rates of change. Your Role: As a Licensed Practical Nurse (LPN) with Evergreen Nephrology, you are responsible for conducting monthly clinical check-ins, identifying and addressing clinical concerns, reinforcing care plans, escalating issues appropriately, and ensuring clinical documentation accuracy across both the EHR and partner technology platform. This position requires clinical judgment, licensed expertise, and the ability to support patients between office visits while collaborating closely with Evergreen’s providers, care teams, and leadership. LPNs are essential to delivering a safe, compliant, clinically credible Connected Care Program. The program uses SMS as the first-line channel for patient engagement, with phone outreach used when appropriate. While this position is fully remote, you must be able to work from 8:30am – 5pm in the Eastern time zone.

Active LPN or Licensed Vocational Nurse (LVN) license Minimum 1–2 years of clinical experience in: Ambulatory care Population health Care coordination Case management Strong clinical assessment, communication, and documentation skills. Comfortable working in two systems (EHR + CCM platform) simultaneously. Ability to manage a structured, metric-driven workflow with reliability. Intermediate skills with MS Office Suite of products including Outlook and Teams Able to work effectively in a primarily remote environment: Home internet must support a minimum download speed of 25 Mbps and upload speed of 10 Mbps. Cable, Fiber, or DSL connections hardwired to the internet device are recommended Evergreen will provide remote employees with telephony applications and equipment to meet the business requirements for their role Employees must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Preferred Qualifications: Experience in chronic disease management Prior work in virtual care, remote nursing, or telehealth programs. Familiarity with CCM regulatory requirements. Strong patient education and motivational interviewing skills.

Patient Engagement & Outreach Perform monthly CCM touchpoints for assigned patient panels. Build strong, ongoing relationships with patients and caregivers through regular outreach. Review patient chart data (diagnoses, kidney disease history, medications, labs, imaging, treatment cycles) before calls. Explain CCM participation and reinforce program benefits. Clinical Assessments & Judgment Conduct structured symptom assessments (pain, fatigue, neuropathy, SOB, nausea, etc.). Evaluate changes in condition using licensed clinical judgment. Assess medication adherence issues, side effects, or confusion about regimen. Identify clinical red flags requiring escalation (e.g., worsening symptoms, new SOB, uncontrolled pain, concerning vitals). Escalation, Coordination & Provider Communication Escalate urgent issues based on defined triage pathways (same-business-day or immediate). Collaborate with the provider team on symptom changes, new concerns, or medication-related issues. Route EHR messages with clinically relevant documentation. Assist in coordinating care: scheduling follow-up, arranging labs, ensuring nephrology appointments are kept, and reducing missed care. Care Plan Reinforcement & Patient Education Reinforce provider-developed CKD and chronic disease care plans. Provide clinical explanation of symptom management instructions (within LPN scope). Support adherence to medications, lifestyle changes, and follow-up instructions. Identify social, behavioral, or access barriers and determine appropriate interventions or referrals. Documentation, EHR Updates & Compliance Document all patient interactions clearly in both the EHR and CCM patient management platform. Track and log qualifying CCM time accurately for billing compliance. Ensure documentation meets regulatory, internal QA, and partner expectations. Maintain high call quality and adherence to scripting and workflow pathways. Quality, Performance & Continuous Improvement Maintain or exceed: ≥80% monthly engagement ≥90% billable conversion High QA/documentation accuracy scores Participate in peer reviews, QA audits, coaching sessions, and continuous education. Identify recurring patient needs and communicate trends to the Program Manager. Other duties consistent with this role, as assigned.

Yoh, A Day & Zimmermann Company

RN Complex Case Manager

Posted on:

March 20, 2026

Job Type:

Contract

Role Type:

Case Management

License:

RN

State License:

California

Yoh delivers expertise, methodology, and momentum to keep work moving forward. From strategy to execution, we deliver bold ideas and big results through consulting, staffing, and enterprise solutions. Nearly a century after our founding, Yoh remains STEM-centered, collaborative, and committed to client success. Yoh is a proud member of the Day & Zimmermann family of companies.

Registered Nurse Complex Case Manager needed for a full-time, 6 month, remote temp contract opportunity with Yoh’s well-known client based out of Alameda, CA. * Although this is remote - you MUST have experience with CM within California.* Provide case management services for health plan members with highly complex medical and psychiatric conditions. Work closely with a team comprised of the Complex Case Manager, a Medical Social Worker, and a Health Navigator to collaborate with key departments at the health plan, including Utilization Management and Pharmacy. Externally, team will work closely with community partners to make referrals for care and resources and to best manage members across the care spectrum. The goal of the Complex Case Management program is to improve members' quality of life and assure cost-effective outcomes by utilization all available and appropriate resources.

Active/unrestricted Registered Nurse (RN) license in state of California Minimum (3) years' experience in clinical case management Certified Case Manager (CCM) preferred Knowledge of Medi-Cal and Medicare regulations a plus Demonstrate ability to critically think, problem solve, and make independent decisions supporting the case management process Must be able to consistently work Monday-Friday 8:00am to 5:00pm Required: Bachelor's Degree in Nursing (BSN) or Master's Degree in Nursing (MSN) Computer savvy (including EMR and Microsoft Office products) Demonstrate effective oral and written communication skills (communicate effectively with employees, providers, and operational leaders) Three years of clinical experience in an acute care setting (desired) Excellent organizational and time-management skills

Assessment, planning, facilitation and advocacy through collaboration with the member and other health care resources involved in the member's care Work closely with licensed and unlicensed staff to co-manage the care of complex cases telephonically through regular contact with members, caretakers, healthcare professionals and others involved in the member’s care The nurse will be responsible for triage and all aspects of the nursing process, including assessing, diagnosing, planning, implementing, and evaluating care Develop multi-disciplinary care plans with the input of the member and PCP to address identified member problems using evidence-based goals and interventions Participate in the ongoing process of identifying the health plan’s members who are most at-risk of poor health outcomes and in need of care management services Communicate with providers, members, and community resources as necessary, to support the planning, implementation and evaluation of care management programs Complete other duties and special projects as assigned

Strategic Staffing Solutions

Registered Nurse Case Manager (Compact License)

Posted on:

March 20, 2026

Job Type:

Contract

Role Type:

Case Management

License:

RN

State License:

Compact / Multi-State

RN Case Manager – Compact License required Duration: Long-term contract with opportunity to convert to FTE Location(s): Remote (Compact States) Pay Rate: $35-40/hour 100% remote - Compact/multi-state nursing license required. RN must reside in the state for which they are licensed. Must have diverse case management experience; hospice, hospital, home care, medical (acute care, ER, ICU, Med surg, etc.). Case management experience Must have multi state compact license ROLE SUMMARY: The Care Manager RN leads the coordination of a multidisciplinary team to deliver a holistic, person centric care management program to a diverse health plan population with a variety of health and social needs. They serve as the single point of contact for members, caregivers, and providers using a variety of communication channels including phone calls, emails, text messages and the online messaging platform. The Care Manager RN uses the case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize the member’s health across the care continuum. They work in partnership with the member, providers of care and community resources to develop and implement the plan of care and achieve stated goals.

EDUCATION AND EXPERIENCE: Nursing Diploma or Associate’s degree in nursing required. Bachelor’s degree in nursing strongly preferred. 3 years of clinical nursing experience in a clinical, acute/post-acute care, and community setting required. 1 year of case management experience in a managed care setting strongly preferred. Experience managing patients telephonically and via digital channels (mobile applications and messaging) preferred. CERTIFICATES, LICENSES, REGISTRATIONS: Current, active, and unrestricted Registered Nurse license required (Compact License) Certification in Case Management (CCM) required or to be obtained within 18 months of hire Certification in Chronic Care Professional (CCP) preferred

Lead the coordination of a regionally aligned, multidisciplinary team to provide holistic care to meet member needs telephonic and/or digitally. Use the case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize the members’ health across the care continuum. Assess the member's health, psychosocial needs, cultural preferences, and support systems. Engage the member and/or caregiver to develop an individualized plan of care, address barriers, identify gaps in care, and promotes improved overall health outcomes. Arrange resources necessary to meet identified needs (e.g., community resources, mental health services, substance abuse services, financial support services and disease-specific services). Coordinate care delivery and support among member support systems, including providers, community-based agencies, and family. Advocate for members and promote self-advocacy. Deliver education to include health literacy, self-management skills, medication plans, and nutrition. Monitor and evaluate effectiveness of the care management plan, assess adherence to care plan to ensure progress to goals and adjust and reevaluate as necessary. Accurately document interactions that support management of the member. Prepare the member and/or caregiver for discharge from a facility to home or for transfer to another healthcare facility to support continuity of care. Educate the member and/or caregiver about post-transition care and needed follow-up, summarizing what happened during an episode of care. Secure durable medical equipment and transportation services and communicate this to the member and/or caregiver and to key individuals at the receiving facility or home care agency. Adhere to professional standards as outlined by protocols, rules and guidelines meeting quality and production goals.

Medica Talent Group

LVN Case Manager (Utilization Review)

Posted on:

March 20, 2026

Job Type:

Full-Time

Role Type:

Utilization Review

License:

LPN/LVN

State License:

Compact / Multi-State

Job Title: LVN Case Manager (Utilization Review) Location: Remote Schedule: Monday – Friday, 8:00 AM – 5:00 PM Pay Rate: $33 – $45 per hour Job Type: Temporary Assignment Overview: We are seeking an experienced LVN Case Manager to support care coordination and utilization review for patients admitted to hospitals and Skilled Nursing Facilities (SNFs). This role works closely with an interdisciplinary care team to manage patient care across the continuum, ensure appropriate level of care, and facilitate safe and timely discharges. The position is fully remote and requires strong inpatient utilization review and care coordination experience.

Graduate of an accredited LVN nursing program. Active California Licensed Vocational Nurse (LVN) license. BLS certification (American Heart Association or American Red Cross). Minimum 3 years of clinical experience in public health, acute care, case management, or home health. At least 2 years of managed care case management experience with a focus on inpatient utilization review and/or ambulatory care. Experience working within a multidisciplinary care team. Bilingual English/Spanish preferred. Experience working with geriatric or medically complex populations preferred. Skills & Knowledge: Strong knowledge of utilization review, case management processes, and discharge planning. Understanding of managed care regulations, health plan requirements, and community resources. Excellent communication, critical thinking, and problem-solving skills. Ability to prioritize, multitask, and manage cases efficiently in a fast-paced environment. Proficiency with computer systems and medical documentation. Work Environment: Fully remote position supporting hospital and SNF care coordination. Works as part of a collaborative care team including RN Case Managers, social workers, and care coordinators. Ideal Candidate: A self-sufficient LVN with strong inpatient utilization review and care coordination experience who can quickly integrate into the team with minimal training.

Conduct daily concurrent and retro utilization reviews for hospitalized and SNF patients using evidence-based criteria (e.g., InterQual). Coordinate care and discharge planning to ensure appropriate level of care and prevent avoidable readmissions. Collaborate with hospitalists, Regional Medical Directors, social workers, ambulatory case management, and hospital nursing staff. Review and process pre-certifications, prior authorizations, and referral authorizations within required turnaround times. Identify California Children’s Services (CCS) cases, manage patient transfers, and support ambulatory case management enrollment when appropriate. Coordinate support services such as home health, durable medical equipment (DME), and follow-up PCP appointments. Conduct telephonic outreach to patients, providers, and caregivers to support care transitions. Participate in interdisciplinary rounds, discharge planning discussions, and care coordination meetings.

Paradigm Corp

Triage RN - Part-Time

Posted on:

March 20, 2026

Job Type:

Part-Time

Role Type:

Triage

License:

RN

State License:

Compact / Multi-State

Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The company has been a pioneer in value-based care since 1991 and has an exceptional track record of generating the very best outcomes for patients, payers, and providers. Deep clinical expertise is the foundation for every part of Paradigm’s business: risk-based clinical solutions, case management, specialty networks, home health, shared decision support, and payment integrity programs. We’re proud to be recognized—again! For the fourth year in a row, we’ve been certified by Great Place to Work®, and for the third consecutive year, we’ve earned a spot on Fortune's Best Workplaces in Health Care™ list. These honors reflect our unwavering commitment to fostering a positive, inclusive, and employee-centric culture where people thrive. The Surprising Truth About Case Management - Paradigm Watch this short video for a brief introduction to role of a nurse case manager at Paradigm.

We are seeking a part-time Triage Nurse. A Triage Nurse takes calls from injured workers, assesses their current medical status, applies appropriate triage protocols, and directs the injured worker to seek the appropriate level of care. The Triage Nurse follows specific account guidelines to complete the triage process. The Triage Nurse works with the injured person, the claim’s examiner, employers, and medical providers. Schedule: Minimum one evening shift per week Minimum every fourth weekend Availability to pick up additional shifts (day, evening, night) as determined by business needs Shift differentials are included

Current, unencumbered compact RN license required Bilingual (Spanish speaking) a plus Professional licenses or certifications required to meet qualifications for this position must be current, unrestricted and allow for practice within a state or territory of the United States.

Elite Care Provider Network

Remote CCM LPN

Posted on:

March 20, 2026

Job Type:

Full-Time

Role Type:

Telehealth

License:

LPN/LVN

State License:

Mississippi

In this role, you will support Remote Therapeutic Monitoring (RTM) and Chronic Care Management (CCM) programs by connecting with patients from the comfort of your home. You will assist with patient follow-ups, care coordination, and documentation while working alongside supervising healthcare providers.

Active LPN license in Louisiana or Mississippi (Required) 1–2 years of clinical experience Telehealth experience preferred Strong communication and patient engagement skills Reliable internet connection and quiet work-from-home environment Preferred Experience Experience with Chronic Care Management (CCM), RTM, or Remote Patient Monitoring (RPM) is a plus. Schedule: Can be flexible, you will work on a number of patients over the course of the month

Conduct outbound and inbound patient calls Document patient interactions in EHR systems Support Remote Therapeutic Monitoring (RTM) programs Follow up with patients regarding treatment plans and care instructions Maintain HIPAA compliance Coordinate with supervising providers and care teams

Coastal Care Services, Inc.

Utilization Management Nurse Reviewer (LPN) Part-time (remote FL residents only)

Posted on:

March 19, 2026

Job Type:

Part-Time

Role Type:

Utilization Review

License:

LPN/LVN

State License:

Florida

Utilization Management Nurse Reviewer (LPN) (Part-time up to 24 hours a week) (remote/Work from home position for FL residents only) Currently seeking a (PART-TIME) FL licensed LPN for Utilization Management/ Review for a great opportunity working remotely (FROM HOME) at a dynamic healthcare organization based in Miami, FL area. The ideal candidate will possess 3 years of experience managing the treatment plan and utilization for members receiving Home Health Care / Infusion Services. JOB SUMMARY: Manages the treatment plan and utilization for all members receiving Home Health Care / Infusion Services and Durable medical equipment and supplies. Conducts the review process for those requests that appear not to be medically necessary; facilitates, coordinates and evaluates the ongoing care of a specific caseload of patients to collaborate with physicians, the patient and the family to assure cost-effective, high quality, appropriate home care for the patient during the entire episode of illness and for post discharge services and to monitor and evaluate patient outcomes, including self-management.

PHYSICAL REQUIREMENTS: The physical activities of this position involve fingering, grasping, talking, hearing, repetitive motions that may include the wrists, hands and/or fingers, sedentary work. The physical demands of this position involve sedentary work constantly remaining in a stationary position, sitting for prolonged periods of time. It may include exerting up to 10 pounds of force occasionally to lift, carry, push, pull or otherwise move objects, including the human body. Constantly communicating with others to express or exchange information by means of the spoken word and/or in writing. The visual acuity requirements of this position involve (including color, depth perception, and field of vision) to have close visual acuity to perform an activity such as: preparing and/or analyzing data and figures; constantly viewing a computer terminal and/or extensive reading. Working Conditions of this position involve constant typical office or administrative work. No adverse environmental conditions expected. MINIMUM QUALIFICATIONS: LPN license required (active and clear) 3 years of Home Health Managed Care experience. Medicare/Medicaid Managed Care experience Experience with InterQual (IQ), Milliman Care Guidelines (MCG) or other criteria used to determine medical necessity. preferred. Possess excellent customer service skills. Bilingual (English/Spanish) preferred. Effective verbal and written communication skills. Proficient in MS Outlook, MSWord and Internet Explorer. WAH (Work at Home) Requirements - Must have reliable high-speed internet. Minimum standard speed for optimal performance of 10 x 1 (10mbs download x 1mbs upload) required. Must have a separate private workspace / desk area designated for home office to ensure absolute and continuous privacy while at work.

Duties of the Home Health Case Manager include but are not limited to: Receive updated orders and medical information from all referral sources, i.e. Hospitals, Physician’s offices, Skilled Nursing Facilities, Rehabilitation Centers, Health Plans, PHOs, CM Departments, Home Health Agencies and others. Perform clinical review, to ensure that pre-established medical necessity/appropriateness criteria are met. Refer reviews that do not meet coverage criteria to Medical Director and/or Health Plan. Review and evaluates home health admission for clinical appropriateness of the continued care. Identifies and engages patients in appropriate care. Develop coordinated, collaborative care plans with all involved providers. Perform reviews telephonically using the member’s medical records, discussion with the member’s physician and/or discussion with Home health agency staff. Facilitate timely discharges and transfers based on individual needs and care requirements Educate patients to help them understand their health choices and assist them in making informed decisions about their health care. Serve as information resource and liaison to patients, health care professionals, facilities, health plan representatives, care givers, agencies and family members. Monitor cost-effective use of resources. Monitor health care service delivery and utilization according to the plan of care Provide authorizations and notifications in a timely manner. Maintain/update active patient list Document and resolve first line patient treatment plan. Prepare concise clinically based rationales that support clinical criteria such as: CMS, Medicaid, Health Plan Benefits, and InterQual Maintain a working knowledge of, and adheres to applicable federal/state regulations including but not limited to, laws related to patient confidentiality, release of information, and HIPAA Input the pertinent information and authorization into the appropriate software Maintain files. Participate in department meetings and in-services

Puzzle Healthcare

District Clinical Supervisor (NP License Required)

Posted on:

March 19, 2026

Job Type:

Full-Time

Role Type:

Leadership / Management

License:

NP/APP

State License:

Georgia

Puzzle Healthcare is hiring a District Clinical Supervisor! Must reside in Atlanta, GA. Position Summary: The District Clinical Supervisor oversees and supports the day-to-day operations of clinical team members to ensure high-quality patient care. This role coordinates clinical activities, evaluates performance, ensures compliance with practice standards, and provides direct patient care as needed. The Clinical Supervisor serves as a key liaison between the clinical team, facility leadership, and supervising physicians.

Master's degree in Nursing and current certification as a Nurse Practitioner (NP) from an accredited program. Active, unrestricted NP license in the relevant state(s) of employment, with prescriptive authority. Minimum of 2-3 years of experience in PM&R, geriatrics, post-acute care, or a related field; experience in nursing facilities strongly preferred. Strong clinical skills in assessing and managing barriers to recovery, including rehabilitation, pain, and chronic conditions. Excellent communication and time-management abilities to handle brief, efficient patient encounters. Proficiency with EHR systems and remote documentation. Ability to work independently with a high level of autonomy and consistency.

Clinical Team Leadership & Oversight: Coordinate and supervise the activities of clinical team members providing patient care under the direction of a physician or provider for the diagnosis, treatment, and prevention of disease. Monitor daily performance of clinical team members to ensure duties are completed accurately, efficiently, and on time; intervene or provide support as needed. Supervise assigned staff, including assigning and reviewing work schedules, training team members in proper work methods, and implementing corrective or disciplinary actions when necessary. Evaluate team member performance and conduct verbal and written performance evaluations as required. Provide program oversight for assigned areas, monitor clinical outcomes, identify improvement opportunities, and implement process enhancements. Direct Patient Care: Serve as a back-up clinician for providers as needed to support staffing needs due to vacations, illness, or other absences. Function as a healthcare provider for patients undergoing rehabilitation in Skilled Nursing Facilities (SNFs). Coordinate patient care with the facility Director of Nursing, nursing staff, unit managers, and supervising physicians to ensure alignment across the care continuum. Operational & Administrative Responsibilities: Participate in Puzzle leadership meetings and provider staff meetings, offering input and updates on clinical operations. Ensure encounter thresholds are met in alignment with practice goals and productivity expectations. Maintain HIPAA-compliant use of all computer systems, records, and electronic communications. Perform other duties as assigned.

Mytherapeace Inc.

Nurse Practitioner

Posted on:

March 19, 2026

Job Type:

Part-Time

Role Type:

Telehealth

License:

NP/APP

State License:

Compact / Multi-State

Join our dynamic healthcare team as a Nurse Practitioner, where your expertise will directly impact patient outcomes and elevate the standard of care. This role offers an exciting opportunity to work across diverse clinical settings, utilizing advanced skills in patient assessment, diagnosis, and treatment. You will collaborate with multidisciplinary teams to deliver comprehensive, compassionate care while leveraging cutting-edge electronic health record (EHR) systems and clinical protocols. If you’re passionate about making a difference in patients’ lives and thrive in a fast-paced environment, this position is your next great challenge!

Valid Nurse Practitioner license with current state certification; experience in acute care or hospital medicine strongly preferred. Demonstrated proficiency with EMR/EHR systems such as Epic or Cerner; familiarity with Athenahealth is a plus. Critical care experience including ICU or Level I/II trauma center exposure; hospital or emergency room experience highly desirable. Skills in advanced procedures such as IV insertion, phlebotomy, venipuncture, sterile processing techniques, and airway management. Knowledge of medical terminology, physiology, anatomy, CPT coding, ICD coding (ICD-10/ICD-9), and documentation standards aligned with NCQA standards. Experience working in diverse settings including nursing homes, assisted living facilities, hospice & palliative medicine environments or outpatient clinics. Ability to handle complex cases involving infectious disease care, occupational health issues like Workers' Compensation law compliance, or post-acute care scenarios. Strong communication skills for triage assessments and patient education; ability to work effectively within multidisciplinary teams. Embark on a rewarding career where your expertise fuels better health outcomes! We are committed to supporting your professional growth through ongoing training opportunities in areas such as esthetic laser treatments, gastroscopy procedures like gastric lavage or spinal taps, and advanced pain management techniques. Join us to make a meaningful difference every day!

Conduct thorough patient assessments, including vital signs, physical examinations, and medical histories to determine appropriate care plans. Diagnose acute and chronic conditions across various specialties such as emergency medicine, geriatrics, pediatrics, and behavioral health. Administer medications, injections, IV infusions, dermal fillers, botulinum toxin treatments, and perform suturing with precision and sterile technique. Manage complex cases involving pain management, wound care, catheterization, tube feeding, ventilator management, and spinal taps. Utilize EMR (Electronic Medical Records) systems like Epic or eClinicalWorks for documentation, coding (ICD-10/ICD-9), CPT procedures, and compliance with HIPAA regulations. Coordinate with specialists for diagnostic evaluations including sonography and laboratory testing; interpret results for informed decision-making. Provide telehealth consultations and participate in clinical research studies to advance evidence-based practices. Support discharge planning, case management, utilization review, and working with individuals with disabilities or developmental disabilities.

Elevance Health

Clinical Quality Consultant 100% Virtual, CareBridge

Posted on:

March 19, 2026

Job Type:

Full-Time

Role Type:

Clinical Operations

License:

RN

State License:

Compact / Multi-State

CareBridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. CareBridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through home-care and community based services.

Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Work Shift: Monday through Friday, 8AM to 5PM local time. No weekends or holidays. The Clinical Quality Consultant is responsible for quality documentation, coding and value capture.

Minimum Requirements: Requires an MS in Nursing and minimum of 3 years experience in applying appropriate diagnosis in the Medicare HCC model and/or CMS Risk Adjustment Model; or any combination of education and experience, which would provide an equivalent background. Requires a current, active, valid and unrestricted RN license and NP license in applicable state(s). Multi-state licensure is required if this individual is providing services in multiple states. For Carelon Health, satisfactory completion of a Tuberculosis test is a requirement for this position. Preferred Skill, Capabilities & Experiences: Prefer AAPC Certified Risk Adjustment Coder.

Focus on chart reviews by supplying clinical expertise to ensure full accurate and appropriate diagnosis, documentation, coding and care. Will review all provider visit medical encounters and apply most appropriate diagnosis codes. Overall accountability for the HCC/Risk Adjustment of goals and workflows to support value capture initiatives and high-quality clinical documentation. Liaison to coding team. Chart reviews for closing HEDIS care opportunities to ensure practice and health plan success. Participate in peer review of medical documentation for completed visit notes and patient profile information in EMR. Reviews and corrects any ICD-10 codes that have been assigned in charts. Provide feedback to the provider for improved documentation to support specific codes.

TEEMA Group

RN Case Manager – Managed Care REMOTE

Posted on:

March 19, 2026

Job Type:

Contract

Role Type:

Case Management

License:

RN

State License:

Compact / Multi-State

The Registered Nurse (RN) Disease Manager is responsible for coordinating care and managing the health outcomes of patients with chronic or complex health conditions. This role involves assessing, monitoring, educating, and supporting patients in managing their diseases to improve overall health and quality of life while reducing unnecessary hospitalizations and emergency care.

Education: Bachelor’s Degree in Nursing (BSN) or an Associate's Degree in Nursing (ADN) with appropriate certifications. Licensure: Current Registered Nurse (RN) license in the state of employment. Experience: 3-5 years of clinical nursing experience, preferably in disease management, case management, or a related field. Certifications: Certification in Disease Management (CDM), Case Management (CCM), or other relevant certifications preferred. Skills: Strong communication, problem-solving, and critical thinking skills. Ability to work independently and as part of a team. Proficiency with electronic health records (EHR) and other healthcare technology.

Patient Assessment: Conduct comprehensive assessments of patients’ physical, emotional, and psychosocial needs related to their chronic conditions. Care Coordination: Work closely with interdisciplinary teams, including physicians, case managers, social workers, and other healthcare professionals, to develop and implement individualized care plans for patients. Disease Education: Provide education to patients and their families regarding their diagnoses, treatment plans, and self-management techniques to improve disease outcomes. Case Management: Monitor patient progress and adjust care plans as necessary. Ensure that patients are following their prescribed treatment and managing their conditions effectively. Data Management and Reporting: Track patient outcomes and document interactions accurately. Utilize health information technology to document care, track patient progress, and report to appropriate stakeholders. Advocacy: Advocate for the patient’s needs, including obtaining necessary resources or services that will improve their health outcomes. Prevention and Health Promotion: Promote preventive care, including vaccinations, screenings, and lifestyle modifications to reduce the impact of chronic conditions. Collaboration with Providers: Maintain communication with healthcare providers to ensure continuity of care, timely follow-ups, and updates on patient status.

CorVel Corporation

Care Advocate Nurse

Posted on:

March 19, 2026

Job Type:

Full-Time

Role Type:

Telehealth

License:

RN

State License:

Compact / Multi-State

CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).

The Care Advocate Nurse oversees initiatives surrounding assessing the severity of the injured workers’ reported injury(ies), reviews medical data in CareMC, validates and secures medical information, assesses and evaluates prescribed treatment of work related injury. The Care Advocate Nurse functions as a nurse consultant, supporting the goals of the Claims Management department and of CorVel. This is a remote role.

KNOWLEDGE & SKILLS: Fundamental concepts, practices and procedures of early intervention in the field of Workers’ Compensation (WC) Excellent verbal and written communication skills Ability to skillfully manage multiple, complex projects and competing priorities concurrently while working under pressure to meet production standards deadlines and maintaining strong customer service orientation Computer proficiency and technical aptitude with the ability to utilize Microsoft Office including Outlook, Word, and Excel spreadsheets Strong interpersonal skills Great attention to detail, and results focused Ability to work independently and as part of a team EDUCATION/EXPERIENCE: Minimum of 2 years' clinical nursing experience Graduate of an approved accredited school of nursing Current unencumbered RN Licensure in state of residency and practicing state(s) must be maintained throughout employment with CorVel

Initiates and receives telephonic contact with reported injured worker, employer and medical providers to obtain treatment plan, secures medical documentation, and assesses if injured worker has returned to work Responsible for detailed documentation within the claim system focusing on medical condition, treatment plan and return to work status Directs callers to appropriate medical and/or claim resources Identifies and communicates urgent situations related to treatment or patient condition directly to the claim team Functions as nurse consultant to the claim team Assesses appropriate medical follow-up and makes necessary recommendations to the claim team, working closely with team to assist in identifying potential red flags from the injury that may require further follow-up or additional services Adheres to the Care Advocate Nurse production standards and Account special handling guidelines Additional duties as assigned

Amaze Health

Nurse - Weight Loss and Chronic Care (Remote)

Posted on:

March 19, 2026

Job Type:

Full-Time

Role Type:

Primary Care

License:

RN

State License:

Compact / Multi-State

Amaze Health is revolutionizing the healthcare landscape by empowering patients to take control of their healthcare journeys. Our mission is to simplify access to high-quality medical care while enhancing the patient experience. As a Nurse, you will be at the forefront of this mission, providing critical support and assessment to our patients in a timely and effective manner.

We are seeking an experienced Registered Nurse (RN) or Licensed Practice Nurse (LPN) with 5+ years of clinical experience in Family Medicine or Internal Medicine to support a growing weight management and metabolic health program. This role focuses on medical weight loss, GLP‑1 therapy management, and nutrition-focused patient education, working closely with providers to deliver evidence-based, patient-centered care. The ideal candidate is clinically strong, highly organized, comfortable with chronic disease management, and passionate about helping patients achieve sustainable weight loss and improved overall health. This is a fully remote position and requires strong assessment skills and the ability to collaborate closely with care teams.

Active, unrestricted compact Registered Nurse (RN) or Licensed Practical Nurse (LPN) license 5+ years of clinical experience in Family Medicine, Internal Medicine, or Primary Care Experience supporting patients with chronic disease management, including obesity, diabetes, or metabolic conditions Familiarity with medical weight loss programs and evidence-based obesity treatment Experience with or strong working knowledge of GLP‑1 medications (e.g., semaglutide, tirzepatide, liraglutide), including patient education and monitoring and utilization of compounding pharmacies Background in nutrition counseling, wellness, and preventive care Excellent patient education, communication, and motivational coaching skills Comfort coordinating care, reviewing labs, and supporting medication management Strong organizational skills and ability to thrive in a fast-paced, patient-centered environment Certification or training in wellness, health coaching, or nutrition is a plus but not required

Clinical Care & Weight Management: Support patients in medical weight loss programs, including GLP-1 medications. Conduct assessments, monitor progress, and follow-ups for weight management and chronic conditions. Educate on medication use, side effects, and lifestyle integration. Assist in care planning for obesity, diabetes, and related conditions. Coordinate patient care across providers, pharmacies, and care teams.. GLP-1 & Medication Support: Provide support for GLP-1 medications (e.g., semaglutide, tirzepatide). Triage patient inquiries about weight loss medications and monitor clinical indicators. Ensure safe medication use and advocate for evidence-based practices. Nutrition & Lifestyle Education: Deliver nutrition and lifestyle counseling based on provider recommendations. Encourage behavior change in diet and physical activity for long-term success. Collaborate with providers and other health professionals as needed.

TRILLIUM HEALTH RESOURCES

Registered Nurse

Posted on:

March 19, 2026

Job Type:

Full-Time

Role Type:

Care Management

License:

RN

State License:

North Carolina

Make an Impact Trillium Health Resources is a Tailored Plan and Managed Care Organization (MCO) serving 46 counties across North Carolina. We manage services for individuals with serious mental health needs, substance use disorders, traumatic brain injuries, and intellectual/development (IDD) disabilities. Our mission is to help individuals and families build strong foundations for healthy, fulfilling lives.

Pay Plan Title: RN Working Title: Complex Transitional Care Nurse Position Number: 91208, 81282 FLSA Status: Exempt Posting Salary Range: $ 66,240 - $ 88,595 Office Location: Remote within Trillium’s Mid State Region (See requirements section for included counties) Trillium Health Resources has a career opening for a Complex Transitional Care Nurse to join our team! The Complex Transitional Care Nurse is responsible for providing Complex Care Coordination targeting those with chronic, unresolved or complex physical, behavioral health and social determinant needs. This includes providing care planning with foundations in national evidence based and informed standards to do whole person care. The Complex Transitional Care Nurse completes required documentation/paperwork/tasks in a software platform according to timelines.

Required: Fully licensed by the North Carolina State Board of Nursing as a Registered Nurse (RN) with a minimum of one (1) year experience as a Registered Nurse. Must have a valid driver’s license. Must reside within Trillium’s Mid State Region, which includes the following counties: Anson, Guilford, Montgomery, Randolph, and Richmond. Must be able to travel within catchment as required. Preferred: Experience working with BH/MH/SU/IDD population. Knowledge of QM, UM procedures as well as experience in using data analytics for population health management. Experience assessing and coordinating care for members in adult care homes, family care homes, home residence or other settings.

Complex care coordination to assigned individuals who may have identified needs with mental health, physical health, co-occurring, co-morbid or multi-morbid conditions. Collaborate with Internal Staff across discipline/teams (Care Coordinators, Clinicians, OT, COTA, Housing Specialists, Peers, etc.) to facilitate integrated care. Monitor the Care Plan (physical, behavioral health and social determinant concerns), service delivery and health and safety of the members. Perform clinical functions of discharge/transition planning and diversion including clinical interviewing; obtaining and reviewing clinical records; identifying potential treatment needs; assessing barriers to treatment and recommending solutions; and assessing general health needs and recommending referrals. Provide education about all available services and natural and community supports, treatment options, diagnosis, etc.

Medcor Inc

Bilingual Remote Triage RN - FT

Posted on:

March 18, 2026

Job Type:

Full-Time

Role Type:

Triage

License:

RN

State License:

Illinois

At Medcor, we’re passionate about caring for our advocates as much as you are passionate about caring for your patients! Join our team and receive the support you need to be successful in your practice and to focus on your patients. In addition to a collaborative work environment, we offer great pay and benefits and emphasize your wellness. Here’s why people love working for Medcor: Stability! We’ve been around since 1984. Potential for retention and performance incentives Opportunities galore! Medcor has a lot more to offer than just this job. There are opportunities to move vertically, horizontally, and geographically. Annually, 20% of our openings are filled by internal employees. The fact is, opportunity exists here! Training! We believe in it and we’ll train and support you to be the best you can be. We feel we offer more training than most other companies. We have an open-door policy. Do you have something to say? Speak your mind! We encourage it and we look forward to how you can help our organization.

Medcor is looking to hire full-time bilingual Spanish-speaking Registered Nurses for our remote 24/7 Occupational Health triage call center! The hours for this position include 8 to 10 hour shifts between 7:00am to 7:00pm CST. For example, shifts could include 7:00am-5:00pm or 11:00am-07:00pm. The start date for this triage class will be 04/27/2026. Job Type: Full-time - 40 hours per week Salary: $30 per hour with additional shift differential pay available for evenings, nights & weekends By joining our nursing team, you will be helping thousands of employers better manage their workplace injuries and improve the quality of healthcare for their employees. Nurses who are successful in this position must be able to talk on the phone for long periods while typing and navigating through various software applications simultaneously. Our nurses must be able to visualize an injury while on the phone and clarify details about the injury while following our propriety algorithms to guide the triage of the injured worker. Training: Training for this role will last 5-6 weeks, with 2.5 weeks of classroom instruction and 2.5 weeks of precepting. These first 5-6 weeks of training are held Monday through Friday, from 8a-4p CST. The training schedule is non-negotiable, and all training must be successfully completed within a 6-week time frame. Following training, you will transition to your permanent schedule between the hours of 7a and 7p CST with an every-other-weekend requirement and holiday rotation. Changes to the permanent schedule are not allowed within the first 12 months of employment as these are based on our business needs.

Be bilingual, fluent in both the English and Spanish language Have a valid RN license and current BLS (CPR) certification Be able to handle a high volume of consecutive calls Have strong technological skills as well as a typing speed of at least 30 WPM Work a major U.S. holiday rotation Work every other weekend Have effective written, verbal, and interpersonal communication skills. Ability to read, analyze, and interpret triage tools and information along with care instructions to injured employees and their managers. Be able to talk and/or hear. You are required to sit and use your hands. Specific vision abilities required by this job include close vision for computers and written work with the ability to adjust focus Be able to work on a computer for long periods Have a private space in your home with 4 walls and a door for patient privacy Have access to high-speed internet (no satellite) within your primary residence Be able to receive and apply feedback It's a Plus If: You have call center experience You have occupational health experience

Manage a rapid flow of incoming telephone calls from Medcor customers in a call center environment Document each call efficiently and accurately Monitor and track individual as well as call center goals, productivity metrics, and statistics Reflect all shift activities using the phone system and be responsible for personal schedule adherence Provide superior customer service to Medcor’s clients and employees Complete accurate assessment of symptoms and/or concerns utilizing Medcor’s Triage Algorithms Follow HIPAA Compliance Policies

AdventHealth Medical Group Central Florida

RN Urology Clinical Contact Center - Remote

Posted on:

March 18, 2026

Job Type:

Full-Time

Role Type:

Clinical Operations

License:

RN

State License:

Florida

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits

Schedule: Full time Shift: Day (United States of America) Address: 2600 WESTHALL LN City: MAITLAND State: Florida Postal Code: 32751 Job Description: AHMG Urology Clinical Contact Center 2600 Westhall Lane, Maitland, FL 32751 Monday - Friday 8am - 5pm

Knowledge, Skills, and Abilities: Organizational and multi-tasking skills Knowledge of nursing care methods and procedures Ability to work as a Team player within a unit Effective verbal and oral communication and problem-solving skills EKG (based on patient ; see document EKG and Advanced Life Support Requirements) Must be fluent in English (read, verbal and written skills) Basic computer skills – must be able to navigate Microsoft windows based programs Must be able to use a high level of abstract reasoning to assess patient, evaluate interventions, and revise plan of care according to patient outcomes Education: Associate's of Nursing [Required] Bachelor's of Nursing [Preferred] Field of Study: N/A Work Experience: 1+ acute care hospital setting [Preferred] Additional Information: Additional Licensure or certification requirements may apply depending on the specific unit or state in which this position is located. Please consult the relevant credential grid for detailed information regarding these requirements Licenses and Certifications: Registered Nurse (RN) [Required] Basic Life Support - CPR Cert (BLS) [Required] Physical Requirements: (Please click the link below to view work requirements) Physical Requirements – https://tinyurl.com/49cf4xnf

Conduct comprehensive assessments to evaluate the physiological, psychological, developmental, sociocultural, spiritual, and lifestyle factors of patients. Develop and implement individualized care plans based on patient needs and standards of care, regularly evaluating and revising these plans as necessary. Administer medications and treatments accurately and safely, following physician orders and hospital protocols, and monitor for adverse reactions. Educate patients and families about health conditions, treatments, medications, and self-care strategies to promote understanding and compliance. Collaborate with medical staff and ancillary departments to coordinate and optimize patient care, ensuring effective communication and teamwork.

Genworth Financial

Claims Clinical Specialist

Posted on:

March 18, 2026

Job Type:

Full-Time

Role Type:

Clinical Operations

License:

RN

State License:

Virginia

At Genworth, we empower families to navigate the aging journey with confidence. We are compassionate, experienced allies for those navigating care with guidance, products, and services that meet families where they are. Further, we are the spouses, children, siblings, friends, and neighbors of those that need care—and we bring those experiences with us to work in serving our millions of policyholders each day. We apply that same compassion and empathy as we work with each other and our local communities. Genworth values all perspectives, characteristics, and experiences so that employees can bring their full, authentic selves to work to help each other and our company succeed. We celebrate our diversity and understand that being intentional about inclusion is the only way to create a sense of belonging for all associates. We also invest in the vitality of our local communities through grants from the Genworth Foundation, event sponsorships, and employee volunteerism. Our four values guide our strategy, our decisions, and our interactions: Make it human. We care about the people that make up our customers, colleagues, and communities. Make it about others. We do what's best for our customers and collaborate to drive progress. Make it happen. We work with intention toward a common purpose and forge ways forward together. Make it better. We create fulfilling purpose-driven careers by learning from the world and each other.

POSITION TITLE: Claims Clinical Specialist POSITION LOCATION: This position is available to Virginia residents as Richmond or Lynchburg, VA Hybrid in-office applicants or remote applicants residing in states/locations under Eastern or Central Standard Time: Alabama, Arkansas, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Virginia, Washington DC, Vermont, West Virginia or Wisconsin. YOUR ROLE: As an Operations team member, you will play a crucial role in delivering world class customer service and capabilities to our policyholders – now and in the future. The In-House Certification Specialist is an excellent opportunity for a Registered Nurse or Licensed Social Worker. You will be responsible for improving our in-house certification functions by providing updates to the plan of care, in-house certifications, completing telephonic assessments, and monitoring claimants with multiple health conditions. This position will promote the provision of evidence-based, short-term case management services to long-term care insurance policyholders.

Active Licensed Social Worker or Registered Nurse At least two years-experience working in a role that required an understanding of single and cumulative medical conditions (particularly those common in the aging process), including their effect on physical/cognitive function, as well as their prognosis and rehabilitative potential. Able to understand and interpret MDS, Plan of Care, Physician Records and Occupational/Physical Therapist records and understand disease progression and recovery expectations. Demonstrated experience in making sound business decisions using risk management and quality protocols. Able to manage and prioritize work queues and multiple job responsibilities. You will be expected to have consistent, reliable, and predictable attendance to support the needs of the business. Ability to understand and interpret insurance contracts and Long-Term Care benefits. Good working knowledge of systems applications (e.g., WORD, EXCEL, PowerPoint, etc.).

You will be responsible for communicating with medical personnel at Long Term Care Facilities by conducting telephonic assessments for claimants to develop the plan of care and provide tax qualified certifications as required by the policy. You will be responsible for obtaining information about the medical status and care needs of the insured to best understand the disease progression, ADL/IADL loss and cognitive status. You will be responsible for making decisions about the care need expectations and benefit eligibility of the insured as it aligns with specific policy requirements and the HIPAA regulations related to Tax Qualification Certification. You will be responsible for identifying, requesting, and analyzing pertinent medical records required to best understand the disease progression, ADL/IADL loss and potential for recovery. You will be responsible for working within a structured environment with established Standard Operating Procedures to ensure consistency of claims practices. You will identify process improvement opportunities, provide feedback on processes and case management model as well as be a critical team member in enhancing the team’s performance and results. You will be responsible for communication, teamwork and collaboration, and partnering with other teams or departments to achieve common goals and support continuous improvement initiatives.

Orlando Health

RN, Remote Patient Monitoring - Day - Ambulatory Medical Group

Posted on:

March 18, 2026

Job Type:

Full-Time

Role Type:

Clinical Operations

License:

RN

State License:

Florida

Orlando Health proudly embraces and honors the individuality of our team members. By sharing different ideas and perspectives and working together as a team, we are better able to relate to, care for and authentically serve our patients and families who make up the collective populations in our community. So, no matter who you are, what you believe or how you express yourself, you are welcome here. ORLANDO HEALTH - BENEFITS & PERKS: Competitive Pay Evening, nights, and weekend shift differentials offered for qualifying positions. All Inclusive Benefits (start day one) Student loan repayment, tuition reimbursement, FREE college education programs, retirement savings, paid paternity leave, fertility benefits, back up elder and childcare, pet insurance, PTO/Holidays, and more for full time and part time employees. Forbes Recognizes Orlando Health as a Best-In-State Employer Forbes has named Orlando Health as one of America's Best-In-State Employers for 2021. Orlando Health is the top healthcare organization in the Metro Orlando area to make the prestigious list. "We are proud to be named once again as a best place to work," said Karen Frenier, VP (HR). "This achievement reflects our positive culture and efforts to ensure that all team members feel respected, supported and valued. Employee-centric Orlando Health has been selected as one of the “Best Places to Work in Healthcare” by Modern Healthcare.

The Remote Patient Monitoring (RPM) RN delivers expert virtual nursing care across a population of patients with complex, chronic, or transitional health needs. This role integrates advanced clinical judgment, care coordination, and digital health tools to proactively manage patient conditions, reduce avoidable utilization, and improve outcomes. The position includes flexible work arrangement, supporting a virtual-first care delivery model.

Education/Training: For Team Members hired into this job prior to January 1, 2020: Graduate of an approved school of nursing. Bachelor of Science in Nursing degree (BSN). Based on area of assignment, specialty courses and specialty experience may be required. Must meet unit-specific performance competencies. Licensure/Certification: Maintains current RN license in the State of Florida. Maintains Multistate Nursing License and is obtained within first 90 days of hire. Ambulatory Care Nursing Certification (AMB-BC) completion required within 36 months of hire. Maintains current BLS/Healthcare Provider certification. Experience: Three (3) years of clinical experience in area of specialty or five (5) years of clinical experience when covering multiple specialties/service lines. Bilingual skills not required but are preferred.

Welcomes newly enrolled patients into Remote Patient Monitoring (RPM) or continuous care programs; reviews program benefits, expectations, and how remote care supports chronic disease management and prevention. Educates patients and caregivers on the use, purpose, and frequency of in-home monitoring devices; assists with troubleshooting and escalates technical issues to ensure uninterrupted data transmission. Creates a personalized, patient-centered care plan during initial onboarding and updates it regularly via phone or video based on biometric trends, self-reported symptoms, and patient goals. Conducts comprehensive nursing assessments to identify clinical needs, gaps in care, or social determinants impacting health; coordinates appropriate resources or referrals to address barriers. Provides condition-specific education and motivational coaching to promote self-management, improve adherence, and prevent disease progression—focusing on chronic conditions such as CHF, COPD, hypertension, and diabetes. Acts as the patient’s primary clinical contact for non-emergent needs, including medication refills, symptom concerns, appointment scheduling, and care navigation across the health system. Monitors in-home device readings in real time during normal business hours; follows established protocols to document trends, assesses symptoms, and escalates concerning data to the appropriate provider or team. Performs proactive outreach to review biometric data, assess symptom control, and delivers monthly care plan updates; adjust care pathways based on ongoing risk evaluation and patient response. Applies care management principles to coordinate across levels of care—helping patients transition between acute, ambulatory, and post-acute services while reducing avoidable utilization and supporting timely follow-up. Collaborates cross-functionally with virtual team members, in-office staff, primary and specialty providers, case managers, and population health teams to align care delivery and ensure continuity. Anticipates patient needs by reviewing utilization history and care gaps (e.g., overdue screenings, specialty referrals, or medication reconciliation); partners with clinical teams to close those gaps. Builds and sustains meaningful patient relationships to foster trust, engagement, and accountability in long-term health improvement. Participates in innovation pilots, Epic workflow testing, and quality improvement initiatives that advance the design and scalability of virtual care models. Documents all patient interactions, interventions, assessments, and care plan updates accurately and in a timely manner within the electronic health record. Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state, and local standards. Maintains compliance with all Orlando Health policies and procedures. Performs all other duties as assigned. Other Related Functions Troubleshoots device or connectivity issues to ensure uninterrupted biometric data transmission; escalate unresolved technical issues appropriately. Screens and processes incoming RPM referrals for program eligibility and appropriateness based on diagnosis, risk factors, and provider orders, ensuring timely documentation, patient onboarding, and device setup Participates in performance improvement projects, chart audits, and clinical reporting for quality assurance and process optimization. Cross-trained to support TeleCare triage, including after-hours nurse advice, Schmitt-Thompson-based dispositioning, and urgent symptom management. Maintains clinical and technical competence in remote monitoring equipment, documentation systems, and virtual communication platforms. Performs all other duties as assigned.

Deacon Health

Patient Coordinator (Overnight Role)

Posted on:

March 18, 2026

Job Type:

Full-Time

Role Type:

Clinical Operations

License:

RN

State License:

Tennessee

The Patient Coordinator (RN) serves as the primary point of contact for patients participating in value-based care programs beginning at the onset of a care episode and continuing through recovery. This person will provide proactive clinical support, education, and care coordination, designed to improve patient outcomes while reducing unnecessary utilization and hospital readmissions. This role is responsible for engaging patients as early as possible in their healthcare journey – often immediately following diagnosis, hospital admission, or referral into the care management program. – to ensure patients understand their care plan, access the right resources, and receive appropriate support throughout the episode of care. The Patient Coordinator builds trusted relationship with patients and caregivers, proactively identifying clinical or social barriers that could lead to complications, avoidable emergency visits, or hospital readmissions. Through continuous engagement, education, and clinical assessment, the coordinator helps guide patients through the healthcare system, ensuring timely follow-up care and adherence to treatment plans. Because this role requires overnight patient engagement and triage support candidate must hold an active Registered Nurse (RN) license and demonstrate strong clinical assessment skills.

Qualifications: Associate’s or Bachelor’s degree in Nursing (BSN preferred) An active nursing license in good standing is REQUIRED for this role 3+ years of clinical nursing experience preferred Experience in care management, case management, population health, or telehealth. Experience working with high-risk patient populations Familiarity with value-based care models (ACO, Medicare Advantage, bundled payment, or risk contracts preferred) Strong clinical triage and patient assessment skills Exceptional patient communication and empathy Ability to establish trust quickly with patients and caregivers Strong care coordination and organizational skills Comfort working with remote care technologies and EMR systems is a must Ability to remain calm and decisive in overnight clinical situations.

Early Episode Engagement: Initiate patient outreach at the beginning of the care episode, including hospital admission, discharge planning, referral into our value-based care program, or identification as a high-risk patient. Introduce the Patient Coordinator program and establish a trusted relationship with patients and caregivers from the outset of care. Ensure patients understand their diagnosis, care plan, medications, and next steps. Identify potential barriers to recovery early, including transportation, medication access, social determinants of health, or caregiver support needs. Patient Coordination and Ongoing Support: Serve as primary clinical contact for patients throughout their episode of care, providing guidance and support from initial engagement through recovery and program graduation. Respond to patient concerns or symptoms that arise outside of normal provider office hours. Provide clinical triage and guidance, including: Self-care instructions Urgent care referral Escalation to on-call physicians or clinical teams Offer reassurance and coaching to patients experiencing symptoms or uncertainly overnight Conduct proactive outreach calls to monitor patient progress and ensure adherence to care plans. Provide coaching, education, and support to patients and families navigating complex healthcare systems. Act as a consistent point of contact to help patients avoid unnecessary emergency department visits or hospital readmissions. Conduct structured post-discharge follow-up and monitoring to identify early signs of complications. Ensure patients complete timely follow-up appointments with primary care providers and specialists Address medication adherence issues Escalate clinical concerns to physicians or care teams when early warning signs are identified Document all patient interactions, risk factors, and interventions within the care management platform Coordinate closely with physicians, discharge planners, case managers, and other healthcare providers to ensure continuity of care. Facilitate access to services such as home health, rehabilitation, transportation, and durable medical equipment. Connect patients with community resources and support services when needed.

Alignment Healthcare USA, LLC

Remote Bilingual Spanish Telephonic RN Nurse Case Manager -Special Needs Plan (California RN Required)

Posted on:

March 18, 2026

Job Type:

Full-Time

Role Type:

Telehealth

License:

RN

State License:

California

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

Location: Fully Remote (Must be licensed in California) Schedule: Monday–Friday, 8:00 AM – 5:00 PM PT Language: Bilingual candidates strongly preferred (Spanish and Vietnamese) Join the Team That’s Redefining Healthcare! Are you a compassionate Registered Nurse with a passion for improving the lives of seniors and complex care patients? Join Alignment Health as a Telephonic RN Case Manager for our Special Needs Plan (SNP) members — all from the comfort of your home! This is a fully remote, phone-based position where you'll play a vital role in helping members navigate their care journeys, close gaps in care, and overcome barriers to better health. (HIPAA compliant work space)

Must-Haves: Active, unrestricted RN license in California (Non-Compact) Minimum 2 years of clinical nursing experience At least 1 year of case management experience Proficiency with Microsoft Office (Word, Excel, Outlook) Nice-to-Haves: Bilingual (Spanish, Korean, Mandarin, etc.) Previous health plan or IPA experience Bachelor's Degree in Nursing (BSN) Licensure Requirement Upon Hire: Active, unrestricted RN license in California (Non-Compact) Must be willing to obtain RN licensure in Nevada, Arizona, North Carolina, and Texas (company reimburses costs) Work Environment: Fully remote — work from anywhere in the U.S., but must work Pacific Time hours All communication is conducted via phone, email and Teams. Company-provided equipment and IT support included

Provide telephonic case management to medically complex and chronically ill members Conduct comprehensive health assessments and create individualized care plans Coordinate care with internal and external partners, including physicians and specialists Educate members and caregivers on disease management and preventive care Monitor member progress and advocate for timely, appropriate interventions Identify and help resolve service or access issues impacting care quality

Alignment Healthcare USA, LLC

Inpatient Review Nurse (Remote, California LVN or RN License Required)

Posted on:

March 18, 2026

Job Type:

Full-Time

Role Type:

Case Management

License:

RN

State License:

California

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

Alignment Health is seeking an inpatient review nurse to join the remote utilization management team. As an inpatient review nurse, you will assist patients through the continuum of care in collaboration with the patient’s primary care physician, facility case manager, discharge planner and employing contracted ancillary service providers and community resources as needed. Assures that services are provided at the most appropriate, cost effective level of care needed to meet the patient’s medical needs while maintaining safety and quality. Schedule: Monday - Friday, 8:00 AM - 5:00 PM Pacific Time (Required)

Experience Required: Minimum 3 years of general case management skills. Minimum of two years of experience utilizing Milliman Care Guidelines to justify Inpatient versus Observation Length of stay: including review of diagnosis and length of stay. Two consecutive years related experience in a managed care setting as an inpatient case manager Preferred: Experience with a Senior population. Education Required: Successful completion of an accredited Licensed Vocational Nursing Program Preferred: Associates or Bachelors Degree Specialized Skills Required: Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others. Excellent critical thinking skills related to nursing utilization review Knowledge of Medicare Managed Care Plans Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors; Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution. Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment. Report Analysis Skills: Comprehend and analyze statistical reports. Preferred: Knowledge and experience in complex/catastrophic case management preferred Licensure Required: Must have and maintain an active, valid, and unrestricted LVN or RN license in California (Non-Compact) Immediately upon hire, must be willing to obtain LVN and / or RN licensure in Nevada, (Non-compact), Arizona (Compact), North Carolina (Compact), and Texas (Compact) which will be reimbursed by company. Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate. Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit; use hands to finger, hand, or feel and talk or hear. The employee is frequently required to reach with hands and arms The employee is occasionally required to climb or balance and stoop, or kneel The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus.

Performs reviews of inpatients with complex medical and social problems. Generates referrals to contracted ancillary service providers and community agencies with the agreement of the patient’s primary care physician. Performs follow-up reviews and evaluations of patients in the ambulatory care or lower level of care setting. Reviews inpatient admissions timely and identifies appropriate level of care and continued stay based on acceptable evidence-based guidelines used by AHC. Effectively communicates with patients, their families and or support systems, and collaborates with physicians and ancillary service providers to coordinate care activities. Identifies Members who may need complex or chronic case management post discharge and warm handoff to appropriate staff for ambulatory follow up, as necessary. Communicates and collaborates with IPA/MG as necessary for effective management of Members. Assigns and provides daily oversight of the activities and tasks of the CCIP Coordinator. Records communications in EZ-Cap and/or case management database. Arranges and participates in multi-disciplinary patient care conferences or rounds. Monitors, documents, and reports pertinent clinical criteria as established per UM policy and procedure. Monitors for any over utilization or underutilization activities. Generates referrals as appropriate to the QM department. Enters data as necessary for the generation of reports related to case management. Reports the progress of all open cases to the Medical Director, Director of Healthcare Services and Manager of Utilization Management. Performs other duties as assigned.

CINQCARE

Transition of Care Nurse - Central

Posted on:

March 18, 2026

Job Type:

Full-Time

Role Type:

Telehealth

License:

RN

State License:

Compact / Multi-State

Grace At Home is a provider-led, community-based health and care partner dedicated to improving the health and well-being of those who need care the most, with a deep commitment to high-needs, urban and rural communities. Our local physicians, nurses, and caregivers work together to serve people and the communities they live in, beyond just treating symptoms. We remove barriers by delivering personalized care as close to home as possible, often in-home, because we know a deep understanding of our patient’s race, culture, and environment is critical to delivering improved health outcomes. By empowering patients, providers, and caregivers with the support they need, we strive to make health and care a reality—not a burden—every single day. Join us in creating a better way to care.

The Transitions of Care (TOC) Nurse provides timely, telephonic clinical outreach to family members following acute care, skilled nursing, or facility-based discharges to support safe and effective transitions across care settings. This role focuses on reducing avoidable readmissions, closing quality care gaps, and improving patient outcomes through assessment, education, care coordination, and escalation as needed. The TOC Nurse serves as a critical clinical touchpoint during high-risk transition periods and collaborates closely with interdisciplinary teams to ensure continuity of care. This role supports value-based care objectives by improving utilization outcomes and quality performance.

Qualifications Licensure: Active Registered Nurse (RN) license in good standing required; ability and willingness to obtain multi-state licensure as needed. Nurse Licensure Compact (NLC) license preferred. Education: Bachelor of Science in Nursing (BSN) required. Experience: Clinical nursing experience required; experience in care management, transitions of care, case management, or population health preferred. Experience providing telephonic or remote patient support preferred. Familiarity with post-acute care settings, discharge planning, or care coordination strongly preferred. Skills: Strong clinical assessment and critical thinking skills. Excellent communication and patient education abilities. Ability to manage multiple patients and priorities in a remote environment. Proficiency with EHRs, care management systems, and documentation tools. Comfort working independently while collaborating with interdisciplinary teams. The working environment and physical requirements of the job include: Work is performed indoors in a setting with air conditioning and artificial light. Travel to and work in offices or other environments is required. In this position you will need to communicate with customers, vendors, management, and other co-workers in person and over devices, sometimes with people who are agitated. Regular use of the telephone and e-mail for communication is essential. Sitting for extended periods is common. Must be able to receive ordinary information and to prepare or inspect documents. Lifting of up to 10 lbs. occasionally may be required. Good manual dexterity for the use of common office equipment such as computer terminals, calculator, copiers, and FAX machines. Good reasoning ability is important. Able to understand and utilize management reports, memos, and other documents to conduct business.

Transitions of Care Outreach & Clinical Support: Conduct timely post-discharge telephonic outreach in accordance with established TOC workflows and timelines. Perform comprehensive clinical assessments to identify post-discharge risks, unmet needs, and barriers to recovery. Complete medication reconciliation, reinforce discharge instructions, and assess understanding of care plans. Educate family members on symptom monitoring, red flags, follow-up care, and self-management strategies. Coordinate follow-up appointments with primary care providers, specialists, and ancillary services as appropriate. Care Coordination & Escalation: Identify and escalate clinical concerns, care gaps, or social barriers to appropriate care team members. Collaborate with primary care practices, care managers, pharmacists, social workers, and other partners to ensure continuity of care. Facilitate referrals to community-based resources or internal programs to address identified needs. Document and communicate actionable information to support timely intervention and risk mitigation. Quality & Value-Based Care Support: Support closure of quality gaps related to transitions of care, medication adherence, and follow-up. Contribute to reduction of hospital readmissions, emergency department utilization, and total cost of care. Adhere to evidence-based TOC models and organizational protocols aligned with value-based care programs, including ACO and MSSP requirements. Participate in quality improvement initiatives and feedback loops to enhance TOC effectiveness. Documentation & Reporting: Accurately document all outreach, assessments, interventions, and outcomes in designated EHRs or care management platforms. Ensure timely, complete, and compliant documentation to support reporting, audits, and performance monitoring. Communicate key findings and trends to leadership and interdisciplinary teams as required. Professional Practice: Maintain active RN licensure and adhere to professional nursing standards and scope of practice. Participate in onboarding, training, and ongoing education related to transitions of care and value-based care models. Support a culture of patient-centered, high-quality, and accountable care delivery.

ProgenyHealth LLC

Nurse Case Manager - Maternity (Remote-CST/MST/PST)

Posted on:

March 18, 2026

Job Type:

Full-Time

Role Type:

Case Management

License:

RN

State License:

Compact / Multi-State

ProgenyHealth is a leading provider of care management solutions for premature and medically complex newborns positively impacting maternal and infant health outcomes across America. Our program builds a network of support for an uninterrupted continuum of care from prenatal health, through any resultant NICU stay, and all the way to one full year of life. Our team of neonatologists, pediatricians, and NICU nurses provide continuity of care in collaboration with providers from hospital to caregivers at home and throughout the first year of life. We help overcome systemic barriers to support healthier pregnancies and healthier starts to life for all moms and babies, one family at a time.

The Case Manager is a Registered Nurse in a telephonic managed care setting combining strong clinical knowledge and critical thinking to facilitate a care plan that will ensure quality medical care for the member population serviced by ProgenyHealth. The Case Manager for Maternity program will focus on empowering the member to support optimal wellness while advocating for necessary medical services.

Registered Nurse (RN) with a current, unrestricted compact license is required. College degree is preferred. Scheduled hours will be in central, mountain or pacific time zone. Three or more years of experience in a Case Management role is required. Previous experience in a maternity management program preferred. Three or more years of clinical experience in OB/L&D or related area is required. CCM certification required within the timeframe specified by company policy. Experience with data entry into a database or EHR required. Must be computer literate. Excellent communication skills and organizational ability are required. Must be self-motivated and willing to learn multiple tasks. Must be well organized and able to prioritize tasks. Must demonstrate accuracy in spelling and documentation. Demonstrated strength in working independently as well as collaboratively within a team. Must have excellent interpersonal skills, telephone etiquette, and maintain positive communication at all times. Must have commitment to excellence in customer service.

Assesses the physical, functional, psychological, environmental, educational, and financial needs of members referred to the Case Management program. Completes needs assessments for all members in CM and develops care plans individualized to the needs of each member as per ProgenyHealth policies and procedures. Assigns risk stratification based on complexity of medical and social needs and determines ongoing frequency of calls to continually assess plan of care. Monitors the care plan to ensure effective, appropriate provision of services and adequacy of benefits. Interfaces with providers to assist with care coordination activities, which can include appointments, transportation, DME, etc. Provides education to members regarding condition, treatment plan, benefits, services, and how to access needed care. Monitors ongoing progress towards goal achievement and reassess changes in health status throughout continuum of care. Provides referrals to appropriate community resources; facilitates access and communication when multiple services are involved; monitors activities to ensure that services are actually being delivered and meeting the needs of the member. Participates in interdisciplinary and client rounds with pertinent health care team members to identify, clarify, and/or prevent risk, quality, or plan of care variances.

MEDLOGIX, LLC

Precertification Nurse (Remote - East coast)

Posted on:

March 18, 2026

Job Type:

Full-Time

Role Type:

Utilization Review

License:

RN

State License:

New Jersey

Medlogix, LLC delivers innovative medical claims solutions through a seamless collaboration of our Medlogix® technology, our highly skilled staff, access to our premier health care provider networks, and our commitment to keeping our clients’ needs as our top priority. Medlogix has a powerful mix of medical expertise, proven processes and innovative technology that delivers a more efficient, disciplined insurance claims process. The result is lower expenses and increased productivity for the auto insurance and workers’ compensation insurance carriers; third party administrators (TPAs); and government entities we serve.

The role of Precertification Nurse is to perform Pre-Certification determining the medical necessity of requested services for New Jersey Auto No-Fault injuries. Knowledge: New Jersey Auto PIP / No-Fault - Preferred InterQual/Review Manager/CERME CPT and ICD-9/ICD-10 diagnosis coding Medical management related to auto claims – Preferred Microsoft Office Suite programs Structure and content of the English language including the meaning and spelling of words, rules of composition and grammar

Skills: Strong interpersonal skills, communication and presentation Ability to use logic and reasoning to identify appropriate alternative course of care based on individual clinical outcomes Ability to work independently Ability to provide instruction and direction to support staff Will be required to have the ability to educate patients and the provider community regarding the Pre-Certification process and its governing laws Must be detail oriented and able to multi-task Must be able to type 45-50 words per minute Experience: 3 Years Med-Surg – Required Utilization Review – Preferred Ortho/Rehab – Preferred Job Type: Full Time; home based Required Education: Graduate of an accredited school of nursing Required License or certification: Active Nursing License in good standing – LPN/RN

Trinity Health

Registered Nurse (RN) - Internal Medicine - FULLY REMOTE

Posted on:

March 18, 2026

Job Type:

Full-Time

Role Type:

Telehealth

License:

RN

State License:

New York

Trinity Health is one of the largest not-for-profit, Catholic health care systems in the nation. It is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians caring for diverse communities across 25 states. Nationally recognized for care and experience, the Trinity Health system includes 88 hospitals, 131 continuing care locations, the second largest PACE program in the country, 125 urgent care locations and many other health and well-being services. Based in Livonia, Michigan, its annual operating revenue is $20.2 billion with $1.2 billion returned to its communities in the form of charity care and other community benefit programs.

RN – Internal Medicine Office FULLY REMOTE If you are looking for an RN II position in an Internal Medicine Office, this could be your opportunity. Here at St. Peter's Health Partner's, we care for more people in more places. Position Highlights: Quality of Life: Where career opportunities and quality of life converge Advancement: Strong orientation program, generous tuition allowance and career development Work/Life: Monday – Friday What you will do: The Registered Professional Nurse has the responsibility and accountability to utilize the nursing process to diagnose and treat human responses to actual or potential problems of individuals or groups. The Registered Professional Nurse works within and contributes to an environment where the St. Peter's Healthcare Services mission is actualized, patient outcomes are achieved, and professional practice is realized.

What you will need: Associates or Bachelor’s degree in Nursing preferred HS Diploma/equivalent required Current unencumbered NYS RN license Basic Life Support certification 6 months previous RN experience Must be able to lift 20 lbs.

Brings patient to exam room, takes appropriate vital signs and documents in electronic medical record. Review and update medication list to ensure accurate and complete list in electronic medical record (EMR) available for provider review and submission. Complete referrals and tracks patients' compliance. Review prescriptions electronically and send prescriptions to providers for review and submission. Obtains patient consent for procedures as directed by provider. Performs pre-visit planning and reviews quality metrics. Retrieves telephonic clinical information from patients who call into the office. Monitors task list and completes tasks assigned by provider in a timely manner based on urgency. Educates patients regarding medication, testing procedures and home care techniques. Ensure proper labeling, handling and documentation for patient specimens. Follow up with patient regarding test results based on advice given by provider. Maintains a clean and safe work environment including disinfecting patient care areas and equipment. In conjunction with other nursing colleagues, maintains the medical supply cabinet and drug cabinet. Uses the electronic medical record to communicate effectively. Performs quality assurance duties as assigned. Provides a clinical visit summary (Patient Plan) to patient as requested including educational materials. Participates in daily Patient Care huddles as appropriate. Works cooperatively with all colleagues to ensure quality patient care at all times. Performs other duties as assigned.

AnswerPro

Remote Triage Nurse

Posted on:

March 18, 2026

Job Type:

Contract

Role Type:

Triage

License:

RN

State License:

Oregon

Are you a caring person who enjoys helping people? AnswerPro is seeking a Telephone Triage Registered Nurse to join our family! Your duties would include fielding incoming Nurse Triage calls.

Oregon License *Required Bilingual a plus Can-Do Attitude Maintain accurate patient records Previous experience in triage nursing or other medical fields Familiarity with medical software and equipment Ability to build rapport with patients Strong problem solving and critical thinking skills Ability to thrive in a fast-paced environment Knowledge of Triage Logic software Hours Available: Varies - Must be able to work weekends

Administer nursing care to ill, injured, or disabled patients Monitor and report changes in patient symptoms or behavior Communicate patient care with established protocols Educate patients about health maintenance and disease prevention Maintain accurate patient medical records Provide advice and emotional support to patients and their family members

SYSTEM West Virginia University Health System

Population Health Nurse Navigator - rotating

Posted on:

March 17, 2026

Job Type:

Full-Time

Role Type:

Triage

License:

RN

State License:

Compact / Multi-State

Welcome! We’re excited you’re considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you’ll find other important information about this position. Responsible for triaging incoming patient referrals, assessing needs, giving appropriate clinical dispositions and facilitating referrals to WVU Medicine primary care and specialty care providers. This position will educate the patient when appropriate regarding immediate care advice and preventive behaviors. Accompanies patients to appointments and coordinates travel, accommodations, and itinerary.

EDUCATION, CERTIFICATION, AND/OR LICENSURE: Current unencumbered licensure with the WV Board of Registered Professional Nurses, or appropriate state board where services will be provided, as a registered professional nurse OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC). EXPERIENCE: Three (3) years of registered nursing experience. PREFERRED QUALIFICATIONS : EDUCATION, CERTIFICATION, AND/OR LICENSURE: Bachelors of Science in Nursing Degree (BSN). Obtain certification in Basic Life Support within 30 days of hire date. EXPERIENCE: Care coordination experience. Outpatient/clinic experience. PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Frequent walking, standing, stooping, kneeling, reaching, pushing, pulling, lifting, grasping are necessary body movements utilized in performing duties through the work shift. Ability to sit for extended periods of time. WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Standard office environment. Multiple different clinic offices and ancillary testing departments. SKILLS AND ABILITIES: Ability to handle and maintain confidential information. Ability to work in a fast paced and rapidly changing environment. Excellent oral and written communication skills as well as strong organizational and motivational skills. Additional Job Description: primarily working 7a-7p with rotation of weekends and an occasional rotation to 7p-7a.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned. Assess and facilitate coordination of multidisciplinary care across the care continuum. Provide communication, advocacy, and education in a culturally competent manner. Clinically triages new patient referrals efficiently, to ensure timely access to care. Collaborate with multidisciplinary care team and expedite sequence of patient's workup, active treatment, survivorship, and/or end of life care. May facilitate referrals within clinics by scheduling and coordinating clinic appointments, e-visits or telehealth visits with a provider. Provide communication and reinforcement of clinical information and serve as a conduit between patient and providers/clinicians to address needs of patients. Assess health literacy and educational needs of patient. Provide clinical education about diagnosis, treatment, side effects, and post- treatment care. Assess and document patient's needs, goals, and preferences and work to ensure such are integrated into treatment and care delivery. Bridge gaps in care and assesses/troubleshoots care transitions and barriers to care. Documents all conversations with patients to maintain a comprehensive medical record. Provides communication with referring providers and primary care providers. Provides direction/guidance to Patient Navigators. Participates in all service line team meetings.

Grady Insurance LLC

Virtual Nurse Advisor – Client & Family Education (PT/FT)Flexible Hours

Posted on:

March 17, 2026

Job Type:

Full-Time

Role Type:

License:

None Required

State License:

Florida

We’re seeking licensed nurses interested in educating families about health and life insurance from home. This is a non-clinical, 1099 contractor role with flexible part-time or full-time hours. You’ll have the opportunity to use your nursing knowledge and compassion to support families—no bedside care, no quotas, no pressure. Successful candidates must be willing to obtain a life insurance license in their resident state (if not already licensed) and complete a background check. Position Highlights: Fully remote with a flexible schedule 1099 commission-based income with high earning potential Non-clinical, supportive role—no bedside nursing Comprehensive training, mentorship, and ongoing support provided Ideal for nurses seeking a flexible part-time, full-time, or career transition opportunity What’s in It for You: Work from home on your schedule No prior insurance experience required—just your nursing knowledge and willingness to learn Residual income potential based on your effort Step-by-step guidance to help you feel confident and supported

doxy.me

Clinic Advisory Board Member

Posted on:

March 17, 2026

Job Type:

Full-Time

Role Type:

Telehealth

License:

RN

State License:

South Carolina

Doxy.me (doc-see-me) is a telemedicine company committed to making telemedicine simple, free, and accessible worldwide. Telehealth.org is part of doxy.me. While doxy.me delivers secure, reliable telehealth technology, Telehealth.org provides the knowledge, training, and resources healthcare providers need to stay compliant, improve care quality, and build sustainable programs — no matter what technology they use. Together, we go beyond technology to help clinicians and organizations succeed with telehealth. Our shared mission is simple: to connect the world to the future of telehealth. We are seeking experienced clinicians to serve on the Clinical Advisory Board for Doxy.me and Telehealth.org. This board will provide real-world clinical insight to help guide product development, telehealth strategy, and educational initiatives across both organizations. This is a paid independent contractor advisory role designed to complement an active clinical career, requiring an average commitment of approximately four hours per month.

Clinical Advisory Board Member – Doxy.me & Telehealth.org United States (Independent Contractor) Who you are: You are an actively practicing healthcare professional who brings thoughtful perspectives on how telehealth technology can better support clinicians and patients. You are comfortable sharing constructive feedback, participating in strategic conversations, and helping bridge the gap between healthcare delivery and digital health innovation.

Licensed healthcare professionals currently practicing in the United States (part-time or full-time), or licensed professionals who are in administrative roles but not currently practicing. Meaningful experience delivering or overseeing telehealth services. Clinical experience in one of the following areas is essential: Behavioral health (e.g., psychologists, social workers) Primary care or internal medicine Psychiatry or neurology Nursing (registered nurses or nurse practitioners) A thoughtful perspective on how technology affects clinical workflows and patient care. Willingness to share candid feedback and contribute constructively to strategic discussions. Comfort collaborating with clinicians and technology teams in a professional advisory setting.

Participate in quarterly virtual advisory board meetings to discuss product direction, clinical workflows, and emerging telehealth needs. Provide practical clinical insight that helps inform product development and feature improvements within the doxy.me platform. Identify friction points in telehealth workflows and recommend opportunities to improve usability, efficiency, and patient experience. Offer perspective on emerging trends and challenges in telehealth delivery across healthcare settings. Participate in occasional product feedback sessions, surveys, or targeted testing of new features. Provide consistent guidance on Telehealth.org educational initiatives, including webinars, courses, and continuing education offerings. Occasionally participate in webinars, discussions, or other professional engagements that support clinician education and telehealth advancement.

NavistaCare

APRN/PA - Telemedicine Provider - After Hours| 7 On/7 Off Schedule

Posted on:

March 17, 2026

Job Type:

Full-Time

Role Type:

Telehealth

License:

NP/APP

State License:

Akansas

NavistaCare is a company specializing in the clinical and administrative management of all Post-Acute Long-Term Care (PALTC) services. Program lines include medical management, mental health, dementia care and palliative care, population health and care management, on-site dialysis, wound care, Program of All-Inclusive Care for the Elderly (PACE), home health, hospice and personal care, referral management, and quality and data analytics.

We are seeking a Telemedicine Provider to join our long-term care team in an after-hours schedule working 7 days on / 7 days off supporting skilled nursing facilities in Arkansas. This role combines clinical expertise with the convenience of telehealth to improve access, reduce unnecessary hospitalizations, and enhance continuity of care for our nursing home patients. WORK ENVIRONMENT: Telemedicine-based care for Arkansas long-term care residents. Work from home; 7 days on / 7 days off; After-hours coverage with Typical shifts: 11:30 PM – 8:00 AM, 11:00PM - 07:00AM.

Schedule & Compensation: Flexible scheduling (daytime, evening, or weekend coverage available). Competitive compensation based on experience and productivity. Malpractice coverage and training provided. QUALIFICATIONS AND EDUCATION REQUIREMENTS DEGREE REQUIRED: BS-PAS/MPAS/DMSc/MSN-NP/DNP EXPERIENCE LEVEL: 2 years. Long-term care experience highly desirable BOARD CERTIFICATION: AANP/ANCC/PA-C EXPERIENCE LEVEL: 2 years of PALTC care experience is highly desirable. Our ideal candidate will possess a strong knowledge of chronic disease management, post-acute care, and geriatric syndromes; be comfortable using telehealth technology and electronic documentation systems; have excellent communication and interpersonal skills; and be able to work collaboratively with interdisciplinary teams.

Patient Care: Diagnose and treat acute and chronic illnesses, prescribe medications, and order/interpret diagnostic tests. Conduct virtual rounds with on-site nursing staff. Document all encounters accurately in the electronic medical record (EMR). Self-directed Practice: Independently assess and treat patients within the provider’s scope of practice, following facility protocols and regulations. Make clinical decisions regarding patient care in the absence of immediate supervision. Compliance & Documentation: Ensure compliance with all federal and state regulations, including OTLC, HIPAA, and OSHA guidelines. Maintain accurate, detailed, and timely medical records. Remain current with continuing education and maintain all licensure and certifications required for practice. Self-directed Work Capability: Ability to work independently, managing patient care without direct supervision. Strong clinical decision-making skills and the ability to act decisively in urgent or emergency situations. Demonstrated ability to receive constructive criticism positively. Interpersonal and Communication Skills: Excellent verbal and written communication skills to effectively interact with facility leadership, staff, patients, and families. Ability to build and maintain strong working relationships with an interdisciplinary team. Strong leadership skills to serve as a medical authority within the facility while fostering collaboration. Technology Proficiency: Experience with EHR systems and electronic documentation processes. Competency in telemedicine tools and virtual care platforms. Physical Requirements: Ability to stand, walk, and move for extended periods. Capability to respond to patient needs quickly, especially in emergency scenarios.

Trio Health Partners

Transitional Care Management Nurse Practitioner Remote

Posted on:

March 17, 2026

Job Type:

Full-Time

Role Type:

Care Management

License:

NP/APP

State License:

Illinois

Trio Health Partners embodies the fundamental philosophy of prioritizing the three pillars crucial to exceptional patient care: facility, family, and provider. As a multi-specialty clinical service provider, we are dedicated to improving clinical outcomes and preventing re-hospitalizations for patients in skilled nursing and long-term care facilities. Through our full-time clinicians dedicated to your facility, Providers are seamlessly integrated into their respective disciplinary teams, working collaboratively and fully aligned towards a shared vision and common goals.

Nurse Practitioner (NP) — Transitional Care Management (TCM) Provider (Remote) Position Overview: We are seeking a licensed Nurse Practitioner (NP) to provide Transitional Care Management (TCM) services for patients discharged from our partner skilled nursing facilities. This role focuses exclusively on conducting post-discharge patient visits via telehealth (video or phone) to support continuity of care, improve outcomes, and reduce readmissions.

Required Qualifications: Active and unrestricted Nurse Practitioner license Experience reviewing and synthesizing clinical information from hospital and post-acute care settings Strong clinical judgment and patient care skills Excellent communication and patient engagement abilities Highly tech-savvy and comfortable using digital health platforms Ability to manage schedules independently and maintain productivity Comfortable working exclusively in a remote, telehealth-based environment Preferred Qualifications (Optional): Prior experience with Transitional Care Management (TCM) services Experience in skilled nursing, post-acute care, or care coordination Telehealth or virtual care delivery experience

Conduct Transitional Care Management (TCM) visits for patients following discharge from skilled nursing facilities Perform patient encounters via video or phone (fully remote role) Review and synthesize clinical data from hospital and post-acute care stays Assess patient status, address clinical needs, and provide appropriate care guidance Document visits accurately and efficiently within the designated platform Communicate clearly with patients, caregivers, and care teams Manage and maintain a full patient schedule based on availability Navigate clinical situations appropriately and escalate when necessary Utilize technology platforms to deliver care and manage workflows Deliver high-quality patient care exclusively in a virtual environment Visit Structure & Work Environment Visits typically last up to 20 minutes per patient Flexible patient volume based on provider schedule and availability 100% remote — no field work, bedside care, or in-person clinical responsibilities Fully technology-enabled care delivery model

Medcorps Asthma and Pulmonary Specialists

Pulmonary Telemedicine Nurse Practitioner

Posted on:

March 17, 2026

Job Type:

Full-Time

Role Type:

Telehealth

License:

NP/APP

State License:

New Jersey

We’re hiring Remote Pulmonary Telemedicine Providers to join our skilled nursing facility (SNF) care team. You’ll conduct daily virtual rounds in collaboration with on-site Respiratory Therapists, helping manage patients with chronic and acute pulmonary issues — all from the comfort of your home. This role is perfect for providers seeking work-life balance, a consistent schedule, and a rewarding clinical impact without the demands of full-day shifts.

Schedule & Work Environment Monday–Friday, flexibility to start anywhere between 7:30am-2pm. 4–6 hours per day from start to finish, depending on provider efficiency Remote/Work-from-Home Most providers finish their day by early to mid-afternoon Physician support available 24/7/365 for clinical backup and complex case guidance Ideal Candidate: Active NP or PA license in New Jersey & New York. Experience in pulmonary, ICU, emergency medicine, or urgent care Proficiency in Athena EMR Comfortable using Microsoft Excel for clinical tracking/logs Strong communication and decision-making skills in a remote setting We are recruiting up to 20 providers in a staggered rollout as we expand our SNF telemedicine program across these states. Apply early to secure your role in this high-impact, flexible-care model.

Conduct remote daily pulmonary rounds for SNF patients Collaborate with Respiratory Therapists and facility staff to guide care Manage a wide range of pulmonary conditions in the post-acute setting Document encounters in Athena EMR Coordinate labs, imaging, and medication changes as needed Enjoy 24/7/365 access to physician backup for escalations, second opinions, and support

ColigoMed

Remote Care Coordinator - RPM/CCM (Licensed Practical Nurse - LPN)

Posted on:

March 17, 2026

Job Type:

Contract

Role Type:

Care Management

License:

LPN/LVN

State License:

Compact / Multi-State

ColigoMed is a US digital health company. At ColigoMed, our AI enabled continuum platform connects patients, medical providers and payers and provides the scale for at-home/virtual care programs to improve the quality of healthcare and make a meaningful impact on patient lives. Our application is driven by our AI engine “ColigoAssist” and serves as the digital virtual assistant to both patients and providers enabling them to better manage medical conditions. Our provider portal provides the most up-to-date real-time visibility on patient data across various hospitals, clinics and devices etc. ColigoMed strives to enable patients to live healthier and happier lives, and to achieve this goal, we need the very best people to enhance our cutting-edge technology, medical services and importantly help deliver the best possible quality of care in compassionate ways.

We are looking for experienced LPN’s who have current compact multistate licensure and will support our remote chronic care management (CCM) and remote patient monitoring (RPM) operations in the US. The LPN will work with a team of other nurses and healthcare assistants who work remotely in their care of a designated roster of patients. The role assesses patient conditions, and then plans, implements, provides, and documents patient care in a manner that follows professional standards and outlined practices.

LPN/LVN with an active compact multistate license is mandatory Minimum of 6-10 years of nursing experience including chronic disease management At least 1 year of experience conducting remote patient outreach or care coordination in CCM, RPM, telehealth, or case management programs Proven experience and knowledge with a range of different EMR systems Demonstrated stable employment history Knowledge and Skills: Ability to work remotely & effectively in a remote team to deliver required results Excellent organizational skills including prioritizing, scheduling, time management, and meeting deadlines Strong comprehension and communication skills to receive and convey information effectively to patients, team members and medical providers. Proven ability to build relationships and earn trust with patients and healthcare providers and to manage changing priorities in an effective and organized manner Broad clinical knowledge to help support patient questions, comments and build confidence with patients and medical providers Maintain patients’ privacy, confidentiality and adhere to ethical and legal requirements A team player with high level collaboration skills Bilingual skills in Spanish are preferred

Program Enrollment, Onboarding & Initial Care Coordination (Transitional Phase) During the initial phase of this role, the Care Coordinator LPN will support program enrollment, patient onboarding, and initial clinical setup for ColigoMed’s Remote Patient Monitoring (RPM) and Chronic Care Management (CCM) programs as the company scales with larger clients. Key responsibilities during this phase include: Initiating first outreach and introductory calls to newly enrolled Medicare and Medicare Advantage patients Explaining RPM and CCM programs clearly, including program goals, patient expectations, device usage, and ongoing support Obtaining and documenting patient consents in accordance with CMS guidelines and ColigoMed policies Conducting initial patient assessments to support care coordination activities Creating and documenting appropriate care plans in collaboration with the care team and supervising providers Identifying and documenting chronic conditions to support CCM eligibility and ongoing care management Performing medication reconciliation, identifying discrepancies, and escalating concerns to the appropriate provider Ordering and coordinating appropriate RPM devices based on patient conditions and program protocols Answering patient questions related to enrollment, devices, care plans, and program participation Ensuring accurate and timely documentation of all onboarding, consent, and clinical setup activities within the ColigoMed platform Collaborating closely with providers and internal teams to ensure a seamless transition into ongoing RPM and CCM services Role Evolution: This position is structured as a transitional role during a period of growth and expansion. As enrollment volumes stabilize and operational workflows mature, the role will transition into a dedicated CCM/RPM Care Coordinator position with responsibility for managing an assigned patient panel. At that time, additional training will be provided.

The Sleep Reset

Nurse Practitioner - Telemedicine Sleep Medicine Specialist (Remote, US)

Posted on:

March 17, 2026

Job Type:

Contract

Role Type:

Telehealth

License:

NP/APP

State License:

Texas

At Sleep Reset, we're transforming how healthcare is delivered—by helping people reclaim their sleep. We are a health tech company dedicated to improving sleep and overall well-being through personalized cognitive behavioral therapy for insomnia (CBTI). Our mission is to provide patients with innovative, science-based, and holistic solutions for better sleep.

As we expand, we're looking for passionate and driven NPs licensed in Texas to join our remote telemedicine team. If you’re an empathetic clinician who’s eager to make a tangible impact in the lives of patients suffering from sleep disorders, we want to hear from you!

Licensed Nurse Practitioner (NP) in Texas with current and unrestricted state licensure. Commitment to Preventive and Personalized Care: We believe in treating the whole person, not just symptoms. You should be passionate about preventive care and using a personalized, root-cause approach to sleep health. Empathetic and Patient-Centered: You are a compassionate provider who is skilled in listening to patients and offering actionable solutions. You will build long-term relationships with patients and support them throughout their treatment journey. Telemedicine Experience: Comfortable with telehealth platforms, conducting remote consultations, and documenting care electronically. You should be adept at building rapport and maintaining a strong "webside manner." Strong Communication Skills: You excel in communication and can explain complex medical concepts to patients in an easy-to-understand and empathetic way. Technology-Savvy: Familiar with using video calls, scheduling tools, and digital health platforms. Experience with electronic health records (EHRs) is a plus.

Provide Remote Consultations: Conduct thorough patient assessments, gather health history, and evaluate sleep patterns and symptoms via telemedicine. You’ll develop and implement personalized treatment plans that may include lifestyle changes, behavioral therapy, and appropriate medical interventions. Collaborate Across Disciplines: Work alongside a team of sleep professionals, including behavioral health specialists, sleep technologists, and health coaches to offer holistic care. Offer Preventive Care: Help patients address sleep hygiene, stress management, and other lifestyle factors that impact sleep. Engage in proactive care to prevent sleep disorders from escalating. Monitor and Adjust Treatment Plans: Follow up with patients through video calls to track progress, adjust treatment strategies, and provide ongoing support to ensure optimal results. Stay Updated: Participate in continuous education and training to remain on the cutting edge of sleep medicine, functional medicine, and telehealth. Document Care: Maintain accurate, up-to-date patient records in compliance with HIPAA standards. Provide concise, detailed progress notes after each consultation.

Wheel

Telemedicine Nurse Practitioner - 1099 Contract (Massachusetts License Required)

Posted on:

March 17, 2026

Job Type:

Contract

Role Type:

Telehealth

License:

NP/APP

State License:

Massachusetts

Wheel Medical Group is a physician owned professional corporation that serves patients across the United States; evolving the traditional care ecosystem by equipping the nation's most innovative companies with a premier platform to deliver high-quality virtual care at scale. We offer proven strategies and cutting-edge technologies to foster consumer engagement, build brand loyalty, and maximize return on investment. Wheel solutions include configurable virtual care programs, an intuitive consumer interface, and access to a nationwide network of board-certified clinicians. Discover how Wheel is transforming the future of healthcare by visiting www.wheel.com.

You’ll begin by providing virtual care for patients enrolled in our standard weight loss program with an emphasis on GLP-1s and preferred experience with Metformin and Contrave, supporting safe and effective medication management and patient education to promote sustainable weight loss. Over time, you’ll also have the opportunity to participate in additional programs and clients across Wheel’s network — expanding your scope into primary care, urgent care, women’s health, men’s health and dermatology.

Board certified as a Family or Adult Nurse Practitioner Must be licensed in Massachusetts with Massachusetts Controlled Substance Registration (CSR) and independent supervision status 2+ years of clinical experience as a nurse practitioner in family medicine, primary care or internal medicine Available a minimum of 20 hours per week; Must schedule between 8am-8pm M-F or Saturdays 8am-3pm in your time zone; 1099 Contract Position Weight management / obesity medicine experience required. Must have 1+ years of experience prescribing GLP-1s in a telehealth setting Ability to perform both synchronous and asynchronous consults Outstanding clinical expertise Strong verbal and written communication skills Warm and empathic web-side manner

Deliver high-quality, evidence-based asynchronous and synchronous virtual care. Review comprehensive patient intake information, including medical and surgical history, medications, allergies. Perform physical exams via telemedicine as appropriate in the synchronous environment Construct clinical assessments and plans on patients using the information provided from patient reports as well as internal guidelines. Wheel also provides access to UpToDate. Independently prescribe medications as appropriate to eligible patients Document each patient encounter using a complete and structured SOAP note, detailing medical decision-making and recommended follow up Engage in clear and compassionate communication with patients through secure messaging or live video visits, maintaining a professional and supportive web-side manner​. Refer patients to in-person care when clinical guidelines are not met, documenting rationale and providing clear patient instructions​. Maintain compliance with quality assurance standards, incorporating feedback from periodic chart audits and actively participating in continuous improvement efforts​. Escalate urgent clinical concerns such as suicidal ideation or harassment according to platform protocols, ensuring patient safety and clinician protection​. Collaborate with Wheel’s clinical operations team for onboarding, platform support, and guideline updates to ensure consistent, high-quality care delivery.

Wheel

Night Shift Telemedicine Nurse Practitioner - 1099 Contract (CA and TX)

Posted on:

March 17, 2026

Job Type:

Contract

Role Type:

Telehealth

License:

NP/APP

State License:

Compact / Multi-State

Wheel Medical Group is a physician owned professional corporation that serves patients across the United States; evolving the traditional care ecosystem by equipping the nation's most innovative companies with a premier platform to deliver high-quality virtual care at scale. We offer proven strategies and cutting-edge technologies to foster consumer engagement, build brand loyalty, and maximize return on investment. Wheel solutions include configurable virtual care programs, an intuitive consumer interface, and access to a nationwide network of board-certified clinicians. Discover how Wheel is transforming the future of healthcare by visiting www.wheel.com.

Wheel Medical Group is seeking nurse practitioners licensed in both California and Texas to join our network of world-class clinicians delivering virtual care. Wheel Medical Group offers a better way to work in virtual care by enabling clinicians to work with multiple telehealth companies — all in one platform. Clinicians in our nationwide network are credentialed, trained, and matched with vetted companies delivering the highest quality patient care. You could have the opportunity, based on experience and interest, to provide care in a number of programs such as: Primary Care Urgent Care Women’s Health Men’s Health Weight Management Dermatology Pediatrics

Board certified nurse practitioner (Family, Internal Medicine, Emergency Medicine) Must be licensed in CA and TX 2+ years of clinical experience as a nurse practitioner in emergency, urgent care, or family medicine/primary care experience Experience/ comfortability providing medical weight management Available a minimum of 12 hours per week (flexible scheduling); 20+ hours preferred; 1099 Contract Position Scheduling: 4 hours per day, 3x per week Hours: 7pm to 1am CST timeframe Must be willing to work weekends Ability to perform both synchronous and asynchronous consults Experience treating pediatric patients preferred Outstanding clinical expertise Strong verbal and written communication skills Comfortable with technology

Deliver high-quality, evidence-based asynchronous and synchronous virtual care. Review comprehensive patient intake information, including medical history, medication lists, and patient-submitted photos, to ensure safe and appropriate prescribing decisions​. Conduct thorough clinical assessments aligned with Wheel clinical guidelines, utilizing clinical snippets and workflows to tailor education and treatment plans​. Prescribe medications responsibly, ensuring alignment with patient eligibility, formulary guidance, and safety parameters such as blood pressure ranges, contraindicated medications, and clinical red flags. Document each patient encounter using a complete and structured SOAP note, including rationale for prescribing or referring, patient counseling, and follow-up recommendations​. Engage in clear and compassionate communication with patients through secure messaging or live video visits, maintaining a professional and supportive web-side manner​. Refer patients to in-person care when clinical guidelines are not met, documenting rationale and providing clear patient instructions​. Maintain compliance with quality assurance standards, incorporating feedback from periodic chart audits and actively participating in continuous improvement efforts​. Escalate urgent clinical concerns such as suicidal ideation or harassment according to platform protocols, ensuring patient safety and clinician protection​. Collaborate with Wheel’s clinical operations team for onboarding, platform support, and guideline updates to ensure consistent, high-quality care delivery.

Wheel

Remote Nurse Practitioner - 1099 Contract (7+ state licenses)

Posted on:

March 17, 2026

Job Type:

Contract

Role Type:

Telehealth

License:

NP/APP

State License:

Compact / Multi-State

Wheel Medical Group is a physician owned professional corporation that serves patients across the United States; evolving the traditional care ecosystem by equipping the nation's most innovative companies with a premier platform to deliver high-quality virtual care at scale. We offer proven strategies and cutting-edge technologies to foster consumer engagement, build brand loyalty, and maximize return on investment. Wheel solutions include configurable virtual care programs, an intuitive consumer interface, and access to a nationwide network of board-certified clinicians. Discover how Wheel is transforming the future of healthcare by visiting www.wheel.com.

Clinicians must have at least 7 active state NP licenses to be eligible Wheel Medical Group is seeking nurse practitioners with multiple state licenses to join our network of world-class clinicians delivering virtual care. Wheel Medical Group offers a better way to work in virtual care by enabling clinicians to work with multiple telehealth companies — all in one platform. Clinicians in our nationwide network are credentialed, trained, and matched with vetted companies delivering the highest quality patient care. You could have the opportunity, based on experience and interest, to provide care in a number of programs such as: Primary Care Urgent Care Women’s Health Men’s Health Weight Management Dermatology Pediatrics

Board certified nurse practitioner Multiple state licenses: 7 minimum with at least 4 in the following independent practice states: AK, AZ, DE, HI, ID, IA, KS, ME, MD, MA, MI, MT, NE, NV, NH, NM, ND, OR, RI, SD, UT, VT, WA, WY We will prioritize candidates with the following states: CA, TX, NY, FL, GA, PA, IL, NJ Available a minimum of 10 hours per week (flexible scheduling); 20+ hours preferred. 80% of hours must be scheduled after 12pm CT. Experience/ comfortability providing medical weight management Ability to perform both synchronous and asynchronous consults 2+ years of clinical experience as a nurse practitioner in emergency, urgent care, or family medicine/primary care experience At least 1 year of telemedicine experience preferred Experience treating pediatric patients preferred Outstanding clinical expertise Strong verbal and written communication skills Comfortable with technology

Deliver high-quality, evidence-based asynchronous and synchronous virtual care. Review comprehensive patient intake information, including medical history, medication lists, and patient-submitted photos, to ensure safe and appropriate prescribing decisions. Conduct thorough clinical assessments aligned with Wheel clinical guidelines, utilizing clinical snippets and workflows to tailor education and treatment plans. Prescribe medications responsibly, ensuring alignment with patient eligibility, formulary guidance, and safety parameters such as blood pressure ranges, contraindicated medications, and clinical red flags. Document each patient encounter using a complete and structured SOAP note, including rationale for prescribing or referring, patient counseling, and follow-up recommendations. Engage in clear and compassionate communication with patients through secure messaging or live video visits, maintaining a professional and supportive web-side manner. Refer patients to in-person care when clinical guidelines are not met, documenting rationale and providing clear patient instructions. Maintain compliance with quality assurance standards, incorporating feedback from periodic chart audits and actively participating in continuous improvement efforts. Escalate urgent clinical concerns such as suicidal ideation or harassment according to platform protocols, ensuring patient safety and clinician protection. Collaborate with Wheel’s clinical operations team for onboarding, platform support, and guideline updates to ensure consistent, high-quality care delivery.

ONclick Healthcare

Telehealth Nurse Practitioner - Oklahoma Licensed Bilingual

Posted on:

March 17, 2026

Job Type:

Contract

Role Type:

Telehealth

License:

NP/APP

State License:

Compact / Multi-State

ONclick Healthcare is a leader in Transitional Care Management, providing telehealth services, committed to delivering high-quality healthcare to patients from the comfort of their own homes. We leverage cutting-edge technology to connect patients with experienced healthcare professionals, ensuring convenient and accessible medical care.

We are seeking dedicated and experienced independent physician contractors to join our growing telehealth team. This role offers the flexibility to work from anywhere with an internet connection, providing virtual medical consultations to patients. Our ideal candidates are licensed nurse practitioners with a passion for patient care and a commitment to leveraging technology to improve healthcare delivery.

Board-certified patient care providers (e.g., NP, PA-C, or similar credentials). Active medical license in the state of CA. Active Oklahoma PTAN is preferred not required Minimum of 2 years of clinical experience Prior experience in telehealth is preferred but not required. Excellent communication and interpersonal skills. Proficiency with electronic health records (EHR) and telemedicine platforms. Reliable internet connection and a quiet, private workspace. Speak, along with English, one of the following languages: Farsi, Armenian, and Spanish.

Good Care Management. Leverages a pre-existing relationship with the patient and feels connected to the clinicians and other health care professionals who are caring for them. Use all available data to build a composite view of what is happening with a patient and communicating that view. Deliver proactive continuous management of needs based on deep knowledge of a patient’s clinical condition. Allow creative problem solving (“whatever it takes”) to go above and beyond when needed Conduct virtual consultations and follow-up appointments via our telehealth platform. Diagnose and treat a variety of medical conditions, providing high-quality patient care. Maintain accurate and detailed patient records in compliance with HIPAA and other regulatory requirements. Collaborate with other healthcare professionals to ensure comprehensive patient care.

Voice Exchange

Telehealth Triage Registered Nurse (RN) - Full-Time, Remote (Evening/Weekend)

Posted on:

March 17, 2026

Job Type:

Full-Time

Role Type:

Triage

License:

RN

State License:

Compact / Multi-State

Voice Exchange is seeking a highly skilled and independent Registered Nurse to join our Nurse Triage Call Center. In this full-time, fully remote position, you will serve as the critical first point of contact for patients requiring immediate medical guidance. Utilizing industry-gold-standard Schmitt-Thompson protocols and our intuitive Keona software platform, you will conduct thorough telephone assessments, prioritize patient needs, and direct them to the appropriate level of care. We are looking for the absolute best—a critical thinker who excels in a fast-paced telehealth environment and values clinical excellence. **Nusres MUST have Compact Nursing License.** Your Schedule: This position is designed for a nurse seeking a non-traditional schedule with mid-week days off. The schedule is set and requires availability for the following shifts (All times listed in CST): Monday: 4:00 PM – Midnight Tuesday: 4:00 PM – Midnight Friday: 4:00 PM – 8:00 PM Saturday: 8:00 AM – 5:00 PM Sunday: 8:00 AM – 5:00 PM What We Offer:We value our nursing staff and provide a robust compensation and benefits package to support your professional and personal well-being: Competitive Pay: $30.00/hour, including fully paid training hours. Healthcare Benefits: Comprehensive health coverage. Retirement: 401(k) plan with a 3% company match. Continuing Education: Full annual CME hours covered to maintain your clinical edge. Licensure Support: Complete financial reimbursement and administrative support for obtaining non-compact state nursing licenses required for our service areas.

Licensure: Must possess an active, unrestricted Compact Nursing License (eNLC). Flexibility: Must be willing to obtain and maintain additional nursing licenses in non-compact states that Voice Exchange serves (all fees reimbursed by the company). Experience: Minimum of 2 years of clinical nursing experience. Previous telephone triage, ER, or ambulatory care experience is highly preferred. Technical Skills: Comfortable navigating telehealth software, electronic health records, and working in a fully digital environment. Skills: Exceptional communication, autonomous decision-making, and critical thinking abilities without visual patient cues.

Perform comprehensive, protocol-driven telephone triage using Schmitt-Thompson guidelines. Accurately and efficiently document all patient encounters within Keona software. Provide clear, empathetic, and evidence-based home care advice or direct patients to the appropriate emergency, urgent, or primary care settings. Maintain a quiet, HIPAA-compliant remote workspace.

AristaMD

Nurse Care Manager (Temporary, Remote)

Posted on:

March 17, 2026

Job Type:

Full-Time

Role Type:

Care Management

License:

RN

State License:

Compact / Multi-State

AristaMD is dedicated to improving access to timely, cost-effective specialty care while maintaining care continuity. We achieve this by delivering PCP-centered specialty care solutions, including eConsults and robust care coordination. Become a part of our transformative mission to revolutionize healthcare access.

AristaMD is seeking a passionate, patient-centered Care Manager to join our virtual specialty care program, as part of AristaMD’s SpecialtyCare360 services platform. The Care Manager acts as the primary advocate and coordinator for members with complex health or social needs. You will be responsible for assessing member requirements, designing personalized care plans, and collaborating with multidisciplinary teams to ensure high-quality, cost-effective outcomes. Your goal is to bridge the gap between providers and patients.

Required: Diploma or Associates Degree in Nursing required Minimum of 3 years’ experience as a Registered Nurse Holds an active, unrestricted license in their state of residence, and willingness to receive multi-state/compact privileges and can be licensed in all non-compact states. Familiarity with remote physiological monitoring, electronic medical record (EMR) or electronic health record (EHR) systems, and patient engagement tools Preferred: Bachelor’s degree in Nursing (BSN) Minimum of 3 years of experience in healthcare case management, clinical nursing, or community health Experience in a multi-specialty medical practice setting (virtual, telehealth medical practice experience a plus) Bilingual or multilingual proficiency Skills & Competencies: Comprehensive understanding of chronic disease management, health coaching, and motivational interviewing techniques. Thorough knowledge of clinical guidelines, standards of care, and utilization management principles. Thorough knowledge of HIPAA regulations and a commitment to compliance. Exceptional organizational skills, meticulous attention to detail, and strong time management abilities. Excellent written and verbal communication and interpersonal skills, especially in therapeutic communication with patients and families. Adept problem-solving capabilities in complex clinical and social situations. Technically adept with a focus on practical application of digital tools (e.g., telephone and text etiquette, virtual visit platforms, etc.). Ability to work collaboratively and build strong relationships across the healthcare team (physicians, social workers, specialists). Ability to adapt and thrive in a dynamic, frequently changing environment, including prioritizing and multitasking effectively in a fast-paced, growth-oriented setting. Comfortable and capable of participating in video meetings with your camera on. Success Factors: Highly self-motivated, proactive, and takes initiative with a "can-do" attitude. Self-directed and capable of working independently in a remote environment. Strong sense of urgency, effective follow-up, and commitment to meeting deadlines. Accountable and resourceful in identifying and resolving issues independently. Work Environment: This is a fully remote position. Standard Monday-Friday schedule; 8:00 - 5:00pm local standard time. Some non-major holiday and after hours coverage may be required. Must possess reliable high-speed internet access and a quiet, dedicated workspace. Candidates must be physically located within the United States.

Conduct comprehensive physical, mental, and social health assessments, developing individualized care plans with measurable goals. Act as the "hub" between doctors, specialists, insurance providers, and families to streamline communication and treatments. Ensure patients understand their medical conditions and rights, empowering members to make informed decisions about their care. Identify and connect patients with community resources, such as home health services, transportation, or financial assistance. Regularly review patient progress, adjusting care plans as medical conditions or social situations change. Maintain precise, HIPAA-compliant electronic health records (EHR) and provide regular reports on outcomes. Maintain positive and effective relationships within the multidisciplinary Care Coordination and broader AristaMD team to ensure a streamlined and supportive experience for patients. Work with partners to facilitate referral intake processes and patient communication workflows Other duties as needed

CVS Health

Case Manager, Registered Nurse (Remote, New York)

Posted on:

March 17, 2026

Job Type:

Full-Time

Role Type:

Case Management

License:

RN

State License:

New York

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.

*Must be RN licensed in New York* The Care Manager—Registered Nurse is a key member of our Special Needs Plan (SNP) care team, responsible for coordinating care for members who often face multiple chronic medical and behavioral health conditions, as well as various social determinants of health (SDoH) needs. This role involves conducting comprehensive assessments to evaluate members’ needs and addressing SDoH challenges by connecting them with appropriate resources and support services. The Social Worker provides education and guidance to members and their families on managing chronic conditions and navigating the healthcare system. Additionally, the Care Manager develops and implements individualized care plans, monitors member progress, advocates for necessary services, and collaborates with the interdisciplinary care team to ensure optimal health outcomes. Accurate and timely documentation of assessments and interventions is essential, as is participation in team meetings to discuss member status and care strategies.

Required Qualifications: Must have active and unrestricted Registered Nurse (RN) licensure in the state of NY Proficient in Microsoft Office Suite, including Word, Excel, Outlook, OneNote, and Teams, with the ability to effectively utilize these tools within the context of the CM RN role. Access to a private, dedicated space to conduct work effectively to meet The requirements of the position. Confidence working at home / independent thinker, using tools to collaborate and connect with teams virtually. Minimum 3+ years of nursing experience Minimum 2+ years of case management, discharge planning and/or home healthcare coordination experience Preferred Qualifications: Experience providing care management for Medicare and/or Medicaid members. Experience working with individuals with SDoH needs, chronic medical conditions, and/or behavioral health. Experience conducting health-related assessments and facilitating the care planning process. Bilingual skills, especially English-Spanish Education: Associate’s of Science in Nursing (ASN) degree and relevant experience in a health care-related field (REQUIRED) Bachelor’s of Science in Nursing (BSN) (PREFERRED) License: Must have active and unrestricted Registered Nurse (RN) licensure in the state of NY

50-75% of the day is dedicated to telephonic engagement with members and the coordination of their care. Compiles all available clinical information and partners with the member to develop an individualized care plan that encompasses goals and interventions to meet the member’s identified needs. Provides evidence-based disease management education and support to help the member achieve health goals. Ensure the appropriate members of the interdisciplinary care team are involved in the member’s care. Provides care coordination to support a seamless health care experience for the member. Meticulous documentation of care management activity in the member’s electronic health record. Collaborate with other participants of the Interdisciplinary Care Team to address barriers to care and develop strategies for maintaining the member’s stable health condition. Identifies and connects members with health plan benefits and community resources. Meets regulatory requirements within specified timelines. The Care Manager RN supports other members of the Care Team through clinical decision making and guidance as needed. Additional responsibilities as assigned by leadership to support team objectives, enhance operational efficiency, and ensure the delivery of high-quality care to members. This may include participating in special projects, contributing to process improvement initiatives, or assisting with mentoring new team members. Essential Competencies and Functions: Ability to meet performance and productivity metrics, including call volume, successful member engagement, and state/federal regulatory requirements of this role. Conduct oneself with integrity, professionalism, and self-direction. Experience or a willingness to thoroughly learn the role of care management within Medicare and Medicaid managed care. Familiarity with community resources and services. Ability to navigate and utilize various healthcare technology tools to enhance member care, streamline workflows, and maintain accurate records. Maintain strong collaborative and professional relationships with members and colleagues. Communicate effectively, both verbally and in writing. Excellent customer service and engagement skills.

Evergreen Nephrology

Nurse Care Manager - Central Time Zone

Posted on:

March 17, 2026

Job Type:

Full-Time

Role Type:

Care Management

License:

RN

State License:

Compact / Multi-State

Evergreen Nephrology partners with nephrologists to transform kidney care through a value-based, person-centered, holistic, and comprehensive approach to kidney care. We believe patients living with kidney disease deserve the best care. We are committed to improving patient outcomes and improving quality of life by delaying disease progression, shifting care to the home, and accelerating kidney transplants. We help nephrologists focus on the right patients at the right time across the full care spectrum. We do this by providing them with the best-in-class interdisciplinary clinical resources, analytical insight and tools, and services to patients. We listen to the needs of our patients, our employees, and our client partners, continually working to push beyond the status quo in which the care system manages patients today.

You are devoted, compassionate, and enjoy being on the front lines of healthcare, changing the lives of patients by supporting them and the team by focusing on customers. You're excited about being part of a team that is building a healthcare delivery model that ensures the highest possible quality of life and best outcomes for those in our care. You believe people living with kidney disease deserve the best person-centered, holistic, comprehensive care and want to influence the healthcare system to drive towards that. You thrive in innovative and evolving environments with high rates of change. Your Role: As a Nurse Care Manager with Evergreen Nephrology, you are responsible for managing an assigned patient panel and addressing each patient's specialized needs based on their individual conditions, healthcare needs, goals, and wishes. You will collaborate with a team of physicians, Advanced Practice Providers (APPs), and Interdisciplinary Team (IDT) members. Nurse Care Managers at Evergreen often focus on patients targeted for specific programs such as Chronic Complex Care Management, Compassionate Care Management, Post Acute Care, Transitions of Care, and CKD Management. While our Nurse Care Manager positions are fully remote, this specific position will support patients in the Central Time Zone and must be able to work 8:30a - 5p CT.

Associate degree in nursing Current RN License is required, Compact License preferred Care management experience required Certified Case Manager preferred Intermediate skills with MS Office Suite of products including Outlook and Teams Able to work effectively in a primarily remote environment: Home internet must support a minimum download speed of 25 Mbps and upload speed of 10 Mbps. Cable, Fiber, or DSL connections hardwired to the internet device are recommended Evergreen will provide remote employees with telephony applications and equipment to meet the business requirements for their role Employees must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Some responsibilities may vary based on specific patient programs, but this role's primary duties include the following: Managing the overall care management of patient panel by leveraging experience, expertise, and knowledge in both the nursing field and value-based care operations. Establishing trusting and empathetic relationships with patients and families to provide clinical and emotional support and foster collaboration throughout their care journey. Serving as an advocate and community liaison for patients to ensure proper and timely resources and support while navigating the health care system and maintaining compliance with the primary care team's/nephrologist's treatment plan. Performing assessments and identifying the needs, including social determinants of health, of panel patients and caregivers based on values, care goals, and individual preferences, and translating these into patient-centric actionable care plans through comprehensive evaluations. Coordinating the interdisciplinary approach to achieving continuity of care and reducing fragmentation, focusing on kidney disease progression management, utilization management, and provider coordination through active care plan management. Monitoring and evaluating the effectiveness of care management plans regularly, modifying interventions as necessary. Following evidence-based care management guidelines and established workflow protocols to deliver high quality, efficient, patient-centered care that aligns with Evergreen's goals, quality metrics, and regulatory and payer requirements. Collaborating with physician partners, community providers, APPs, and other clinical disciplines to create, implement, and manage integrated care plans. Identifying cost-effective measures for patients that support value-based care goals of improving patient outcomes and quality while effectively managing resource utilization. Facilitating patient and caregiver education on treatment options and empowering patients to make informed decisions about their care. Supporting seamless transitions of care as patients move between care settings, proactively addressing potential barriers and collaborating with IDTs. Actively participating in clinical huddles, and patient care conferences for patients under your care management as needed. Engaging in continuous, organizational process improvement to identify opportunities for improvement and execute action plans to optimize care management workflows, patient engagement processes, customer/patient care efforts, and other protocols. Preparing reports and other deliverables to communicate program changes or developments to appropriate stakeholders. Collecting data to prepare and deliver reports alongside program leaders on program success, patient outcomes, and patient/caregiver satisfaction. Other duties consistent with this role, as assigned.

Somatus, Inc.

Case Manager RN

Posted on:

March 16, 2026

Job Type:

Full-Time

Role Type:

Case Management

License:

RN

State License:

Virginia

As the largest and leading value-based kidney care company, Somatus is empowering patients across the country living with chronic kidney disease to experience more days out of the hospital and healthier at home. It takes a village of passionate and tenacious innovators to revolutionize an industry and support individuals living with a chronic disease to fulfill our purpose of creating More Lives, Better Lived. Does this sound like you? Showing Up Somatus Strong We foster an inclusive work environment that promotes collaboration and innovation at every level. Our values bring our mission to life and serve as the DNA for every decision we make: Authenticity: We believe in real dialogue. In any interaction, with patients, partners, vendors, or our teammates, we are true to who we are, say what we mean, and mean what we say. Collaboration: We appreciate what every person at Somatus brings to the table and believe that together we can do and achieve more. Empowerment: We make sure every voice gets heard and all ideas are considered, especially when it comes to our patients’ lives or our partners’ best interests. Innovation: We relentlessly look for ways to improve upon the status quo to continuously deliver new solutions. Tenacity: We see challenges as opportunities for growth and improvement — especially when new solutions will make a difference for our patients and partners. Showing Up for You We offer more than 25 Health, Growth, and Wealth Work Perks to help teammates learn, grow, and be the best version of themselves, including: Subsidized, personal healthcare coverage (medical, dental vision) Accrual of 3 weeks’ Vacation (PTO) Professional Development, CEU, and Tuition Reimbursement Curated Wellness Benefits supporting teammates physical and mental well-being Community engagement opportunities And more!

This position is responsible for ensuring the continuity of care in both the inpatient and outpatient setting utilizing the appropriate resources within the parameters of established contracts and patients’ health plan benefits. Facilitates continuum of patients’ care utilizing basic nursing knowledge, experience and skills to ensure appropriate utilization of resources and patient quality outcomes. Performs care management functions on-site or telephonically as the need arises. This is a fully remote role where compact licensure is strongly preferred. **The schedule for this position includes some evening hours where you will be expected to work until approximately 8pm, based on member availability. For example: 11am-8pm OR a split shift 8am-12pm and then 4pm-8pm**

Required Qualifications: Active RN license in current state of residence with the ability to qualify for additional state licenses as requested 2+ years of nursing experience in a hospital, acute care, or direct care setting Renal, Chronic Kidney Disease or Dialysis Care experience as a main focus of your job Computer proficiency utilizing MS Office (Word, Excel, PowerPoint and Outlook), including the ability to type and talk at the same time while navigating a Windows environment Access to dedicated workspace from home for in home office set up Ability to work schedule listed Reside in a location that can receive a high speed internet connection or can leverage existing high-speed internet service Preferred Qualifications: BSN Certified Case Manager (CCM) Diabetic educator experience ICU, Cardiology or Critical Care experience Telephonic case management experience Experience with discharge planning Solid working knowledge of hypertension and/or diabetes

Consistently exhibits behavior and communication skills that demonstrate our company's commitment to superior customer service, including quality, care and concern with each and every internal and external customer. Prioritizes patient care needs upon initial visit and addresses emerging issues. Virtually meets with patients, patients’ family and caregivers as needed to discuss care and treatment plan telephonically. Virtually identifies and assists with the follow-up of high-risk patients in acute care settings, skilled nursing facilities, custodial and ambulatory settings. Consults with physician and other team members to ensure that care plan is successfully implemented. Coordinates treatment plans with the care team and triages interventions appropriate to the skill set of the team members. Uses protocols and pathways in line with established disease management and care management programs and approved by medical management in order to optimize clinical outcomes. Monitors and coaches patients using techniques of motivational interviewing and behavioral change to maximize self-management. Oversees provisions for discharge from facilities including follow-up appointments, home health, social services, transportation, etc., in order to maintain continuity of care. Works in coordination with the care team and demonstrates accountability with patient management and outcome. Maintains effective communication with the physicians, hospitalists, extended care facilities, patients and families. Assist member to maximize benefits according to health plan. Participates actively in assigned Care Management Coordination Committee (CMCC) meetings. Documents pertinent patient information and Care Management Plan in Electronic Health Record and Care Management Systems as appropriate. Coordinates care with larger interdisciplinary team on assigned patient caseload or panel. Adheres to departmental policies and procedures.

Cross Country Medical Staffing Network

Registered Nurse- Transitional Care Unit

Posted on:

March 16, 2026

Job Type:

Contract

Role Type:

Case Management

License:

RN

State License:

California

Cross Country Healthcare, Inc. is a leading tech-enabled workforce solutions and advisory firm with 36 years of industry experience and insight. We solve complex labor-related challenges for customers while providing high-quality outcomes and exceptional patient care. As a multi-year Best of Staffing® award winner, we are committed to an exceptionally high level of service to our clients, our homecare, education, and clinical and non-clinical healthcare professionals. Our locum tenens line of business, Cross Country Locums, has been certified by the National Committee for Quality Assurance (NCQA), the leader in healthcare accreditation, since 2001. We are the first publicly traded staffing firm to obtain The Joint Commission Certification, which we still hold with a Letter of Distinction. Cross Country Healthcare was awarded by Comparably, Best Company Outlook and Best Marketing Team. For four consecutive years, Cross Country has received the Top Workplaces USA award from Energage and has also been received Top Workplaces Culture Excellence recognition for Leadership, Innovation, Work-Life Flexibility, and Purpose & Values. We have a history of investing in diversity, equality, and inclusion as a key component of the organization’s overall corporate social responsibility program, closely aligned with its core values to create a better future for its people, communities, and its stockholders. Cross Country has achieved the great accomplishment of being named by Newsweek Magazine as a Most Loved Workplace! Newsweek's most Loved Workplaces® certification includes companies where employees are the happiest and most satisfied at work backed by the research and analysis of Best Practice Institute (BPI).

Position Title: Integrated Transitional Care Nurse, RN Location: Rancho Cucamonga, CA Schedule: 8a-5p Monday through Friday, some days working from home Pay: $43/hour Job Type: 6 month contract Position Summary: Join our dynamic team in the Integrated Transition Care Department! Under visionary leadership, you’ll collaborate with hospitals and Independent Physician Associations to deliver continuous, quality healthcare to our high-risk Members. As the Integrated Transitional Nurse, Rn, you’ll lead risk assessments, oversee reviews, and ensure seamless transitions between care settings. Dive into collaboration with various departments, identifying outliers, and ensuring compliance. Be the liaison between stakeholders, contributing to effective communication and goal achievement. Join us and be a part of revolutionizing transitional healthcare!

Two (2) or more years of Utilization Management / Case Management in a health care delivery setting in Acute or Skilled nursing, with an emphasis on Concurrent Review and Utilization Management Must have a valid California Driver's license and valid automobile insurance High school diploma RN License

Conduct Integrated Transition Care discharge risk assessment for high risk/ high acuity Members. Oversee and perform concurrent and retrospective reviews for medical necessity per evidenced based criteria, appropriateness of service and level of care, either through Telephonic review, clinical documentation submitted by respective facilities and/or electronic medical records (EMR) access. Conduct reviews to ensure treatment plan is consistent with Diagnosis(es), specifically initial review within twenty-four (24) hours to ensure Members meet specified criteria for the respective admission(s). Work in collaboration with the coordinator to ensure timely arrangements for transitions to higher or lower level of care and assist with transfer orders as needed. Ensure the concurrent or retrospective review process include referring cases that require clinical consultation with the medical director in a timely manner. Ensure cases are appropriately referred to Care Management, Behavioral health, Health Education, Housing, community health. Identify outliers and prepare documentation as well as report on potential quality of care issues as identified. Process timely completion of denials process per policy.

The University of Iowa

Staff Nurse - L11 Pediatric Cancer Center Triage - (Hybrid/Remote)

Posted on:

March 16, 2026

Job Type:

Full-Time

Role Type:

Triage

License:

RN

State License:

Iowa

At the University of Iowa, we prioritize the well-being and success of our faculty, staff, and students. As a leading Big Ten university and premier public research institution, we attract and retain talented individuals from a variety of backgrounds who make a global impact. With more than 30,000 students, we deliver a top-tier education across hundreds of areas of study while providing world-class health care services throughout the state. From the Iowa Writers' Workshop to our renowned medical center, we foster innovation and exploration. UI employees enjoy generous retirement benefits, exceptional health insurance plans, dental and voluntary vision coverage, university-paid life insurance, long-term disability, and optional additional life insurance. We also provide a free 24-hour support line, mental health and well-being resources, and access to UI Health Care experts and services. Eligible employees receive up to five weeks of paid vacation, nine paid holidays, and separate sick leave. Our commitment to well-being includes personal health assessments, confidential health coaches, and discounted recreation memberships. We also support continuous learning through college courses and on-demand training, fostering your professional growth. Iowa City, a top-10 college town, has excellent schools, world-class health care, and a vibrant community with over 100 restaurants, local shops, Big Ten athletics, and music venues. At the University of Iowa, you’ll discover support you can rely on, a community where you can flourish, and a belief that your contributions matter.

University of Iowa Health Care Department of Nursing is seeking an 80-100% Hybrid/Remote Phone Triage Staff Nurses to work in the L11 Pediatric Cancer Center. This role is approved for hybrid or remote work following the completion of a successful orientation period. May be required to come on site for ongoing education, training and orientation needs throughout employment. Sign-on incentive: Qualified candidates are eligible for a sign-on bonus up to $10,000 Summary: This position is primarily responsible in taking live calls for the Pediatric Cancer Center clinic patients; to provide over the phone assessment, and triage through an active listening and questioning process. Assess patients' nursing care needs, evaluate effectiveness of care provided, and integrate nursing theory and research into clinical practice. Provide leadership to members of the nursing team in order to maintain patient care standards. Percent of Time: 80-100% 32-40 hours a week Schedule: Monday-Friday, , 0800-1630. No Nights, no holidays, no weekends. This position is eligible for remote work within Iowa and will require a work arrangement form to be completed upon the start of your employment. Per policy, work arrangements will be reviewed annually, and must comply with the remote work program and related policies and employee travel policy when working at a remote location. Salary: $61,183 minimum at 100% effort to commensurate. Salary will be based on years of experience and percent effort. Location: University Campus Benefits Highlights: Fringe benefit package including paid vacation; sick leave; health, dental, life, and disability insurance options; and generous employer contributions into retirement plans.

Education: An Associate’s Degree in Nursing, a Diploma in Nursing, a Baccalaureate Degree in Nursing, Professional Masters of Nursing and Healthcare Practice (MNHP), MSN/Clinical Nurse Leader or a Master’s Degree in Nursing (MSN, MA) is required. Required Qualifications: Current license to practice in the state of Iowa by the time of hire Minimum 2 years recent (within last 12 months) hem/onc nursing experience Excellent written and verbal communication skills Demonstrates excellent interpersonal skills with patients/families, nursing staff, and interdisciplinary team members as demonstrated through written and verbal interactions General Computer skills: Desired Qualifications Minimum of 2 years pediatric hem/onc nursing experience, preferably with ambulatory experience Prior experience with nurse triage or in a call center setting. Previous experience with EPIC.

Answers telephones, prioritizes clinical triage calls, follows clinical protocols, and coordinates services, as needed for patients. Verifies patient demographic information and accurately document phone encounters into electronic health record. Provide phone-based support for oncology patients managing treatment side effects, pain, medication concerns, and emotional distress. Collaborate closely with oncology physicians, nurse practitioners, and care teams to ensure continuity and quality of care. Serves as an escalation point for clinical patient issues and other team members requiring clinical support, and provides clinical advice based on clinical protocols and procedures. Manages and responds to escalated electronic patient messages whenever not answering inbound patient calls and uses clinical judgment to prioritize and accommodate patients. Creates a positive patient experience at every encounter, attempting to independently resolve any issues or concerns of the patient at the time of the phone call, within the scope of the role. Assist with scheduling appointments or referring patient to outside agencies for care, as appropriate. Incorporates scientific, behavioral and humanistic principles for application to clinical practice. Utilizes, adheres and supports departmental standards and practice guidelines. Applies nursing theory to the assessment, diagnosis, treatment, and evaluation of patient responses to health and illness. Assesses patient health care preferences and expectations. Maintains skills/competency related to special equipment, medications, and procedures common to the patient population of the unit/division. Uses evaluation data to revise and implement change. Assumes accountability for the provision of care for patients. Participates as a member of the health care team utilizing effective communication skills. Participates in the development of unit, division, department and hospital policies, procedures and protocols. Participates in the development and implementation of computer applications. Participates in the orientation of new nursing staff and the ongoing education of nursing personnel, as directed by the Nurse Manager or designee. Participates in formal and informal teaching with health care students. Functions as a patient advocate. Incorporates the principles of Service Leadership to ensure positive patient/customer relations. Maintains confidentiality. Practices within legal boundaries of the Nurse Practice Act. Evaluates and validates performance with Nurse Manager or designee and sets goals for work performance. Adheres to UI Health Care policies regarding personal conduct, including follows established leadership, remaining responsive to instruction and coaching from supervisors and meeting the standards of personal appearance, attendance and punctuality.

Advocate Aurora Health

Remote Triage Registered Nurse (RN) - Patient Access and Care Team FT

Posted on:

March 16, 2026

Job Type:

Full-Time

Role Type:

Triage

License:

RN

State License:

Wisconsin

Reshaping Access We offer more sites of care than any other health system in the Midwest, but we're also exploring the latest technologies to deliver care to patients exactly where they are and exactly when they need it. Inspiring Professionals With our dynamically inclusive workforce and strong connections to the places where we live and work, we'll touch lives and contribute to stronger and more vibrant communities. Transforming Care We're redefining the standard for care with world-class doctors and caregivers, innovative solutions, outstanding outcomes, and leading-edge research and clinical trials. Combined, Advocate and Aurora are recognized for clinical excellence in a dozen specialties.

Looking for full time RNs - Position is 100% remote **Candidate MUST have 2+ years' acute care experience (ED, Urgent Care, ICU and some Med/Surg will be considered) is required within the last 4 years to be considered.** Due to complex requirements, remote work is NOT permitted from the following states: CA, CO, CT, HI, MA, MD, MN, NJ, MY, OR, RI, VT, WA Schedule: Full time position Start times days: 8a-10a or PM 12p-2p (or later) 8 hour or 10 hour shifts are available for different shifts MUST be available to work every 4th weekend and holiday rotation.

Licensure, Registration, and/or Certification Required: Registered Nurse license issued by the state in which the team member practices. Education Required: Associate's Degree (or equivalent knowledge) in Nursing. Experience Required: Typically requires 2+ years' of acute care experience, preferably within the last 4 years (ED, Urgent Care, ICU and some Med Surg will be considered). Knowledge, Skills & Abilities Required: Critical thinking skills necessary to independently determine and prioritize the needs of patients using sound judgment and strong problem-solving skills. Knowledge of a variety of healthcare specialties, including levels of care, symptom identification and proven treatment recommendations. Ability to incorporate past experience with established protocols. Excellent verbal communication skills demonstrating empathy, respect, restatement, open-ended questions, active listening and diplomacy with a diverse customer population. Ability to develop rapport and maintain positive, professional relationships with a variety of patients, staff and physicians. Proven ability to independently organize and prioritize work, managing multiple priorities and maintaining a flexible schedule in a fast paced, dynamic customer service environment. Excellent customer service and follow-up skills including the ability to stay calm during stressful situations. Demonstrated proficiency as a technology user with computers, internet, desktop software packages and multiple-line telephone systems. Ability to converse with customers/patients while researching and documenting calls on multiple systems. Knowledge of documentation techniques for communication Physical Requirements and Working Conditions: Required stable and secure internet connection Must have functional vision, touch, speech, and hearing. Required sitting a majority of the workday. Operates all equipment necessary to perform the job. Must have quiet space to make and receive phone calls Ability to lift 15 lbs.

Uses the nursing process and guidance of established protocols to assess the needs of the patient telephonically including the patient, guardian, or family in the conversation when necessary. Determines most appropriate level of care needed, provides detailed education, establishes a plan of care including interventions, and communicates follow up instructions to the patient. Escalates and collaborates with the appropriate on call provider when additional guidance is needed. Prioritizes patient interactions by acuity and need considering all available information and resources. Applies evidence-based practice to deliver patient care. Implements strategies to reduce patient risk and increase patient safety. Assesses patient and family readiness to learn and individualizes the approach as necessary. Works collaboratively to develop strategies to meet the learning needs of the patient and family. Supports shared governance activities and initiatives to improve processes and patient outcomes. Participates in department quality/process improvement initiatives aimed at enhancing the patient care experience. Participates in professional activities which contribute to personal professional development and the development of others. Seeks opportunities to be taught, coached, and mentored. Attends required meetings/educational programs and completes annual competencies in a timely manner. Demonstrates effective communication, feedback, and conflict resolution skills. Promotes collaboration with clinicians and other healthcare team members to coordinate patient-centered care. Promotes a culture of safety through identifying threats to patient safety and intervening to prevent patient harm. Reports patient safety events and near misses in a timely manner. Seeks to identify potential safety issues and assists in the implementation of corrective action. Applies ethical decision making, demonstrates respect and understanding for peers, and other clinical disciplines. Participates as an effective member of the patient care team to formulate an integrated, unbiased, individualized approach to care. Must be able to demonstrate knowledge and skills necessary to provide care appropriate to the age of the patients served. Must demonstrate knowledge of the principles of growth and development over the life span and possess the ability to assess data reflective of the patient’s status and interpret appropriate information needed to identify each patient’s requirements relative to his/her age specific needs and provide the care advice/disposition outlined in the departments policies, procedures, and protocols. Schedules appointments with emphasis on making the appointment in correlation to the recommended end point of the protocol used. Collaborates with other health care team members to coordinate medical and nursing management of patient care, including procedures and medication refills. Accurately maintains and updates the patient’s clinical records according to agency, State and Federal guidelines. Documents all call encounters utilizing the patient’s Electronic Medical Record at the time of the call. Communicates information relating to the patient’s physical and psychological status to the physician, Advanced Practice Clinician and/or additional members of the interdisciplinary team as appropriate. Provides pertinent and concise reports describing patient’s response to medical and nursing plans of care. Participates in team meetings and works on special projects/tasks as assigned by leadership. Participates in the ongoing development of comprehensive health information resources, system and operational efficiencies and resources. Assists in interpreting department policies and procedures and advises staff on procedural changes.

Stormont-Vail HealthCare, Inc.

Ambulatory Registered Nurse (Remote) - 823 Internal Medicine - FT - Day

Posted on:

March 16, 2026

Job Type:

Full-Time

Role Type:

Triage

License:

RN

State License:

Kansas

Stormont-Vail Health helps to take care of the health of residents in northeastern Kansas. Its facilities include the 590-bed hospital, an emergency and trauma center, an outpatient surgery center, and a network of community clinics located throughout the 12-county region. Its Cotton-O'Neil centers treat heart disease, cancer, skin problems, and digestive system ailments, as well as various clinics and ExpressCare locations. Specialized services include behavioral health, obstetrics, orthopedics, and physical and occupational rehabilitation. Geographic Reach: Stormont-Vail Health serves a 12-county area in northeast Kansas. Strategy: The health system pursues strategic partnerships and organic growth to keep up with demand. The system has partnerships with the Baker School of Nursing, Kansas Rehabilitation Hospital, and Mayo Clinic. In 2011, Stormont-Vail Health added pediatric critical care services to provide care to infants in the neonatal intensive care unit

Provides professional nursing care for clinic patients following established standard and practices. The delivery of professional nursing care at Stormont Vail Health is guided by Jean Watson's Theory of Human Caring and the theory of Shared governance, both of which are congruent with the mission, vision, and values of the organization.

Education Qualifications Bachelor's of Science in Nursing (BSN) Preferred Experience Qualifications 1 year Nursing experience. Preferred Skills and Abilities: Skill in applying and modifying the principles, methods and techniques of professional nursing to provide on-going patient care. (Required proficiency) Skill in establishing and maintaining effective working relationships with patients, medical staff and the public. (Required proficiency) Ability to maintain quality control standards. (Required proficiency) Ability to react calmly and effectively in emergency situations. (Required proficiency) Licenses and Certifications: Registered Nurse - KSBN Required Required for All Jobs: Complies with all policies, standards, mandatory training and requirements of Stormont Vail Health Performs other duties as assigned: Patient Facing Options Position is Not Patient Facing Remote Work Guidelines: Workspace is a quiet and distraction-free allowing the ability to comply with all security and privacy standards. Stable access to electricity and a minimum of 25mb upload and internet speed. Dedicate full attention to the job duties and communication with others during working hours. Adhere to break and attendance schedules agreed upon with supervisor. Abide by Stormont Vail’s Remote Worker Policy and will review and acknowledge the Remote Work Agreement annually. Remote Work Capability Full-Time Scope No Supervisory Responsibility No Budget Responsibility Physical Demands Balancing: Rarely less than 1 hour Carrying: Rarely less than 1 hour Eye/Hand/Foot Coordination: Occasionally 1-3 Hours Feeling: Rarely less than 1 hour Grasping (Fine Motor): Occasionally 1-3 Hours Grasping (Gross Hand): Rarely less than 1 hour Handling: Rarely less than 1 hour Hearing: Occasionally 1-3 Hours Kneeling: Rarely less than 1 hour Sitting: Frequently 3-5 Hours Standing: Rarely less than 1 hour Stooping: Rarely less than 1 hour Talking: Frequently 3-5 Hours Walking: Rarely less than 1 hour

Triage of all incoming phone calls by evaluating the physical and psychosocial health status of patients. Follows nursing protocols and guidelines for answering and directing calls. Record and reports patient’s condition and reaction to drugs and treatments to interdisciplinary team. Provide instruction to patients/family regarding treatment. Maintains and reviews patient records, charts, and other pertinent information. Oversee appointment bookings and ensure preferences are given to patients in emergency situations. Arranges for patient testing and admissions. Refill prescribed medications per standing orders. Clarify medication orders and refills to pharmacies as directed by providers. Perform medication prior authorizations as needed by providing needed clinical information to insurance. Maintain timely flow of patient to include scheduling of follow up appointments if needed. Working of in-basket medication refill requests for providers. Provide education to patient and family on medications, treatments and procedures. Record and report patient’s condition and reaction to drugs and treatments to interdisciplinary team, reviewing patient records and other pertinent information. Ensure patients receive appointments that align with triage disposition and that maintain timely flow of patients. Coordinate patient testing, referrals, and admissions Work collaboratively with on-site staff to provider coordinated patient care

Prisma Health

Registered Nurse (RN)- Population Health, Remote, Full-Time, Days

Posted on:

March 16, 2026

Job Type:

Full-Time

Role Type:

Telehealth

License:

RN

State License:

Compact / Multi-State

Prisma Health is the largest not-for-profit health organization in South Carolina, serving more than 1.2 million patients annually. Our 32,000 team members are dedicated to supporting the health and well-being of you and your family.

Responsibility for initiating phone contact with discharged patients from specified units, conducting query on patient experience and recovery, and providing needed follow up to patients and/or family members. Coordinates patient responses requiring further intervention with appropriate Nurse Manager. Works independently and/or under indirect supervision of the Nurse Manager.

Minimum Requirements Education - Associate degree in Nursing. Bachelor's degree in Nursing preferred. Experience - One (1) year experience as a registered nurse. In Lieu Of: In lieu of an associate’s degree in nursing (AD N), will accept an RN diploma or certificate with a current RN compact/multistate license recognized by the NCSBN Compact State or a license to practice as an RN in the state the team member is working. Required Certifications, Registrations, Licenses: Holds a current RN compact/multistate license recognized by the NCSBN Compact State or is licensed to practice as an RN in the state the team member is working. Knowledge, Skills and Abilities: N/A

All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. Conduct non–face-to-face post-discharge outreach calls to patients within the CMS-required timeframe. Review discharge summaries, medication lists, and follow-up instructions prior to patient contact. Medication reconciliation and coordination support. Assess patient understanding of discharge plan, symptom management, and medication adherence. Records patient responses and advice provided, documents any variations. Provides appropriate follow up as indicated by patient responses and needs. Identify early signs of potential complications and escalate concerns to the provider or care team. Schedule appointments directly with the patient’s primary care provider. Coordinate with front desk and clinical teams to secure timely appointment availability. Document all outreach attempts, patient interactions, and outcomes in the EHR according to Prisma Health and CMS requirements. Provide/Reinforce education provided at discharge, including when to contact the provider versus seek emergency care. Support readmission prevention efforts by ensuring appropriate follow-up and addressing barriers to care. Review and address open care gaps (e.g., hypertension control, diabetes monitoring, preventive screenings, wellness visits). Educate patients on the importance of completing overdue screenings or visits and assist in scheduling. Collaborate with providers, care coordinators, and case management teams to ensure continuity of care. Participate in team discussions and quality improvement initiatives related to department effectiveness and patient outcomes. Maintain awareness of required documentation and billing requirements to ensure compliance. Provide hypertension-focused education on home blood pressure monitoring, medication adherence, lifestyle modifications, and follow-up importance. Assess and intervene for elevated blood pressure readings or medication concerns by escalating to the provider and facilitating appropriate follow-up. Collects patient data and completes required forms with appropriate responses according to the unit standards; identifies patient's problems/needs and sets priorities; identifies problems requiring further referral and/or follow-up; observes and records latest diagnostic results; performs advanced nursing observations using critical thinking skills. Develops a plan for follow up care based on nursing process, and which incorporate the plans of other disciplines and continuing or emerging care needs; include the patient/family in developing or revising plan. Care provided conforms to accepted practice standards; provides correct telephonic care advice and other follow up instructions according to patient care standards; demonstrates understanding of age-related characteristics and needs of patients served; explains nursing procedures and discharge teaching in appropriate forms; evaluates care measures instituted; identifies situations that require immediate action and provides appropriate plan; understands and demonstrates respect for patient rights and confidentiality, and identifies mechanism for management of any ethical issues. Performs other duties as assigned. Supervisory/Management Responsibilities: This is a non-management job that will report to a supervisor, manager, director or executive.

St. Luke's University Health Network

Clinical Triage Specialist (RN) - Primary Care (PA & NJ Residents Only)

Posted on:

March 16, 2026

Job Type:

Part-Time

Role Type:

Triage

License:

RN

State License:

Compact / Multi-State

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.

The Clinical Triage Specialist (CTS) (RN) - Access Center will compassionately deliver an exceptional patient experience and provide clinical support to CTS-MA team members by serving as a clinical resource. The CTS-RN is responsible for using nursing judgment in answering/returning patient calls related to direct care provided by the practices. When appropriate, the caller’s symptoms will be assessed and triaged using approved nursing protocols and guidelines to assist in obtaining the appropriate level of care and/or self-care advice.

EDUCATION: Graduate of an accredited nursing program. Active Registered Nurse licensure in the state of Pennsylvania and New Jersey or other nursing compact state and other states as deemed necessary by state law. TRAINING AND EXPERIENCE: Minimum 2 years recent clinical experience in a physician office, home health, critical care and/or emergency room is required. Strong communication skills Focused on compliance Demonstrates continuous growth Quality-driven Service-oriented Excels at time management Strong problem-solving skills Ability to work from home in accordance with the Network Work from Home Policy if needed.

Answers telephones, prioritizes clinical triage calls, follows clinical protocols, and coordinates services, as needed. Verifies patient demographic information and accurately enters the updated information into electronic health record. Serves as an escalation point for clinical patient issues and other POD team members requiring clinical support, and provides clinical advice based on clinical protocols and procedures. Manages and responds to escalated electronic patient messages whenever not answering inbound patient calls and uses clinical judgment to prioritize and accommodate patients. Creates a positive patient experience at every encounter, attempting to independently resolve any issues or concerns of the patient at the time of the phone call, within the scope of the role. Consistently meets productivity, schedule adherence, and quality standards as set by the Access Center. Utilizes all resources and guidelines at his/her disposal to effectively assess, prioritize, advise, schedule appointments, or refer calls when necessary to the appropriate medical facility or personnel. Accurately documents symptoms/complaints, nursing assessment, advice provided and patient/caller response. Partners with other Access Center teams/PODs and respective practice clinical team on behalf of the patient to assist with clinical concerns, medication refills, or scheduling appointments. Other duties as assigned.

Gentiva

Telephonic Triage Nurse

Posted on:

March 16, 2026

Job Type:

Part-Time

Role Type:

Triage

License:

RN

State License:

Compact / Multi-State

At Gentiva, it is our privilege to offer compassionate care that’s close to home – and close to the heart. We are a close-knit family of industry-leading hospice, palliative, and home health providers, with more than 550 locations and thousands of clinicians across 38 states. Our place is by the side of those who need us – from helping people recover from illness, injury, or surgery in the comfort of their homes to guiding patients and their families through the physical, emotional, and spiritual effects of a serious illness or terminal diagnosis. With corporate headquarters in Atlanta, Georgia, and providers delivering care across the U.S., we are proud to offer rewarding careers in a collaborative environment where inspiring achievements are recognized – and kindness is celebrated.

We are seeking a dedicated Telephonic Triage RN to join our clinical call center team. This position is responsible for providing high-quality triage and nursing support over the phone for hospice patients and families during after-hours, holidays, and peak volume times. If you're an experienced, compassionate RN with strong clinical judgment and excellent communication skills, we invite you to bring your expertise home—literally. We have two shifts available: Shift 1: Sun: 8pm-4:30am Tues: 5pm-9pm Thurs: 5pm-9pm Sat: 6pm-2:30am Shift 2: Sun: 10am - 6:30pm Tues: 5am-9am Wed: 4am-8am Sat: 10am-6:30pm About the Role: The Telephonic Triage Nurse provides timely, expert guidance and support over the phone to hospice patients and families. This critical nursing role includes assessing symptoms, prioritizing calls, managing urgent care needs, and determining when an in-person visit is necessary.

Graduate of an accredited nursing program Current Registered Nurse (RN) license in a NLC Compact State Three (3) years of clinical nursing experience At least two (2) years of experience in hospice, oncology, long-term care, or home health Bachelor’s degree in nursing (BSN) preferred Prior experience in telephone triage strongly preferred Proficiency in EMR systems and Microsoft Office Suite Current CPR certification, valid driver’s license, and automobile insurance Work From Home Requirements: Reliable high-speed internet (minimum 10 MBPS download / 5 MBPS upload) Dedicated, quiet workspace Comfortable wearing a headset up to 12 hours Ability to navigate multiple computer screens (dual monitors + laptop) Ability to report to nearest Gentiva branch if needed due to equipment issues Skills and Traits for Success: Deep knowledge of hospice care and end-of-life needs Strong patient assessment and communication skills Ability to remain calm, clear, and compassionate in emotional or urgent situations Adaptable, dependable, and solutions-focused Strong documentation and time management capabilities Sensitivity to diverse backgrounds and experiences

Receive and respond to calls for assigned hospice service areas Prioritize urgent needs and assess callers’ symptoms to guide care decisions Assign on-call staff or provide treatment guidance per Plan of Care Provide education, emotional support, and continuity of care Collaborate with the interdisciplinary team to manage symptoms and avoid crises Document all calls accurately in electronic medical record systems Promote patient/family choices and quality of life at end of life Participate in Quality Assessment and Performance Improvement programs Maintain professional and compassionate communication with all stakeholders Provide triage coverage for multi-state/multi-agency network

CVS Health

Case Manager Registered Nurse (Remote, New York License)

Posted on:

March 16, 2026

Job Type:

Full-Time

Role Type:

Case Management

License:

RN

State License:

New York

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.

The Care Manager—Registered Nurse is a key member of our Special Needs Plan (SNP) care team, responsible for coordinating care for members who often face multiple chronic medical and behavioral health conditions, as well as various social determinants of health (SDoH) needs. This role involves conducting comprehensive assessments to evaluate members’ needs and addressing SDoH challenges by connecting them with appropriate resources and support services. The Social Worker provides education and guidance to members and their families on managing chronic conditions and navigating the healthcare system. Additionally, the Care Manager develops and implements individualized care plans, monitors member progress, advocates for necessary services, and collaborates with the interdisciplinary care team to ensure optimal health outcomes. Accurate and timely documentation of assessments and interventions is essential, as is participation in team meetings to discuss member status and care strategies.

Required Qualifications: Must have active and unrestricted Registered Nurse (RN) licensure in the state of NY Proficient in Microsoft Office Suite, including Word, Excel, Outlook, OneNote, and Teams, with the ability to effectively utilize these tools within the context of the CM RN role. Access to a private, dedicated space to conduct work effectively to meet The requirements of the position. Confidence working at home / independent thinker, using tools to collaborate and connect with teams virtually. Minimum 3+ years of nursing experience Minimum 2+ years of case management, discharge planning and/or home healthcare coordination experience Preferred Qualifications: Experience providing care management for Medicare and/or Medicaid members. Experience working with individuals with SDoH needs, chronic medical conditions, and/or behavioral health. Experience conducting health-related assessments and facilitating the care planning process. Bilingual skills, especially English-Spanish Education: Associate’s of Science in Nursing (ASN) degree and relevant experience in a health care-related field (REQUIRED) Bachelor’s of Science in Nursing (BSN) (PREFERRED) License: Must have active and unrestricted Registered Nurse (RN) licensure in the state of NY

50-75% of the day is dedicated to telephonic engagement with members and the coordination of their care. Compiles all available clinical information and partners with the member to develop an individualized care plan that encompasses goals and interventions to meet the member’s identified needs. Provides evidence-based disease management education and support to help the member achieve health goals. Ensure the appropriate members of the interdisciplinary care team are involved in the member’s care. Provides care coordination to support a seamless health care experience for the member. Meticulous documentation of care management activity in the member’s electronic health record. Collaborate with other participants of the Interdisciplinary Care Team to address barriers to care and develop strategies for maintaining the member’s stable health condition. Identifies and connects members with health plan benefits and community resources. Meets regulatory requirements within specified timelines. The Care Manager RN supports other members of the Care Team through clinical decision making and guidance as needed. Additional responsibilities as assigned by leadership to support team objectives, enhance operational efficiency, and ensure the delivery of high-quality care to members. This may include participating in special projects, contributing to process improvement initiatives, or assisting with mentoring new team members. Essential Competencies and Functions: Ability to meet performance and productivity metrics, including call volume, successful member engagement, and state/federal regulatory requirements of this role. Conduct oneself with integrity, professionalism, and self-direction. Experience or a willingness to thoroughly learn the role of care management within Medicare and Medicaid managed care. Familiarity with community resources and services. Ability to navigate and utilize various healthcare technology tools to enhance member care, streamline workflows, and maintain accurate records. Maintain strong collaborative and professional relationships with members and colleagues. Communicate effectively, both verbally and in writing. Excellent customer service and engagement skills.

Optum

Remote Intake RN I - Hematology/Oncology - Kelsey Seybold Clinic: Fort Bend Campus

Posted on:

March 16, 2026

Job Type:

Full-Time

Role Type:

Triage

License:

RN

State License:

Texas

Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation’s leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together.

Required Qualifications: Graduate from an approved RN program Valid and current Texas RN license Basic Life Support (BLS) certification through the American Heart Assoc. Completion of ONS Chemotherapy Immunotherapy Fundamentals of Administration or Certificate Course within 3 months of employment 2+ years of clinical RN experience 1+ years of oncology experience and/or related Experience with EMRs Basic computer skills Able to use equipment and related supplies for selected patient population Proven clear communication skills, both written and verbal Preferred Qualifications: Bachelor’s Degree in Nursing Oncology Certified Nurse (OCN) certification Ambulatory care experience Patient intake experience Epic experience Experience with Microsoft Office

The RN I Intake is an experienced nurse who serves as the initial point of contact to patients referred to the Hematology/Oncology department. The RN reviews the patient’s clinical status, medical history, and referral order to determine the most appropriate next steps for the patient and then utilizes our departmental guidelines to schedule the patient’s consultation within an appropriate timeframe. The RN collects outside medical records and assists patients to schedule necessary diagnostic tests prior to their consultation. The RN will demonstrate clinical assessment expertise, triage expertise, and outstanding customer service throughout interactions with patients, caregivers, and referring providers. 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.

Christ Community Health Services

RN TELEHEALTH COORDINATOR

Posted on:

March 16, 2026

Job Type:

Full-Time

Role Type:

Telehealth

License:

RN

State License:

Tennessee

At CCHS, our goal is to grant equal access to healthcare no matter the economic, social or employment status of our patients. We aim to provide superior patient care! If you have a passion for helping people, for mission work and would like to combine that passion with your skills, this may be the position for you.

To provide efficient access for patients to an RN for clinical questions and prescription refills. This position will assist in CCHS' ability to improve overall compliance to medical care and obtain shared savings goals by increasing care coordination and risk assessment.

Education: degree in nursing Experience: 2-to-3 years clinical experience in acute or ambulatory care setting; preferred ambulatory care coordination experience Skills/abilities: using an electronic health record to resolve patient concerns; assisting patients over the phone to accomplish training and give/receive instructions; compose coherent written English Licenses/certifications: RN

Function independently in a highly collaborative environment, maintaining personal professional responsibility for assessing all symptom-based encounters. Assess patient issues over the phone to determine appropriate place of care (i.e. clinic appointment, priority care, or ED) Respond to patient requests for refills, results, and other clinical questions Determine patient's perception of his/her immediate needs and concerns, identifying the patient's desired course of action. Collect subjective and objective data from the patient, family, and/or caregiver, and other sources as available and necessary, utilizing critical thinking and interpreting data as collected. Arrange data collected in a sequential manner to address anticipated or immediate needs of patients using critical nursing judgement. Utilize critical thinking and clinical judgement to select and apply the appropriate decision support tools to each patient encounter. Apply evidenced-based decision support tools, instruments, and other resources relevant to the provision of nursing care utilizing telehealth technology, critical thinking, and clinical judgement. Analyze and synthesize available data, information, and nursing knowledge relevant to the presenting health situation to identify patterns and variances in health as well as gaps in care. Utilize clinical reasoning when investigating, focusing, verifying, clarifying, comparing, ruling-out, and processing patient data and information. Document the information and data collected in a telephone encounter that is understandable and clearly follows the SBAR format. Assist clinic staff by completing patient call backs that are overdue or outstanding Provide support to clinic LPNs and CMAs as it relates to clinical questions and situations that require a higher level of clinical judgement or assessment. May perform other duties as necessary

Gundersen Health System

RN, Registered Nurse | Telephone Nurse Advisor

Posted on:

March 16, 2026

Job Type:

Part-Time

Role Type:

Telehealth

License:

RN

State License:

Wisconsin

Emplify Health is comprised of two of the Midwest’s most respected healthcare systems, Bellin Health and Gundersen Health System. Once neighbors, we are now partners, united in our mission to provide exceptional care to our communities. As a not-for-profit, patient-centered healthcare network, we have headquarters in Green Bay and La Crosse, Wisconsin. Our extensive network includes 11 hospitals and more than 100 clinics, serving 67 cities and rural communities across Wisconsin, Iowa, Minnesota and Michigan’s Upper Peninsula. With over 4,500 dedicated nurses and providers, we are committed to delivering primary, specialty and emergency care, along with innovative medical education programs. Join us in making a meaningful difference in the lives of our patients and communities.

Love + medicine is who we are, it's what we do, it's why people want to work here. If you’re looking for a job to love, apply today. Scheduled Weekly Hours: 20 Are you ready to LOVE your job? Emplify Health by Gundersen is looking for a part-time (0.5 FTE) RN, Telephone Nurse Advisor! Join the award-winning culture of love, trust, and connection where compassionate, personalized experiences are always in action. Gundersen Telephone Nurse Advisors provide callers from our community with professional and compassionate communication to enrich the patient experience. If you enjoy helping patients with diverse situations and are skilled the coordination of care, then this job is for you! What you will get: Gundersen's generous compensation and benefit package, including our top-rated retirement plan Growth opportunities and access to Gundersen's Career Development Center to help you navigate your career

What you will need: 3 years’ experience as a Registered Nurse, telehealth experience preferred RN licensure to work in the states of WI, MN, and IA required upon hire Strong critical thinking skills Ability to work autonomously

0.5 FTE (40 hours per two-week pay period) 8-hour shifts, Day/PM rotation, every other weekend Every other holiday Potential to work remotely after meeting competency criteria (must reside in WI, IA, or MN & live within 2 hours of Onalaska, WI) Use the nursing process to assess caller concerns using Schmitt-Thompson clinical protocols to assist in determining the appropriate care recommendations or level of care

Essen Healthcare

Urgent Care Nurse Practitioner (Must have ECW experience and NY license)

Posted on:

March 15, 2026

Job Type:

Part-Time

Role Type:

Care Management

License:

NP/APP

State License:

New York

Essen Health Care is an integrated healthcare delivery organization that provides high quality, compassionate, and accessible medical care to many of the most under-served residents of New York State. Guided by a population health model of care delivery, Essen’s patient-centric approach is focused on meeting patient needs in all care settings. Founded in 1999, Essen clinicians provide care in all five boroughs of New York City. With 150 primary and specialty care physicians and almost 100 advanced clinicians, Essen Health Care is one of the largest, most comprehensive private medical groups in New York City, and is recognized for excellence in patient satisfaction and clinical care.

Join our dynamic healthcare team as an Urgent Care Nurse Practitioner, where your expertise will directly impact patient outcomes in a fast-paced, community-focused environment. You will provide comprehensive urgent care services, perform assessments, and deliver high-quality treatment to diverse patient populations, including pediatrics, geriatrics, and adults. This role offers an exciting opportunity to utilize your broad clinical skills, including acute pain management, triage, and medical documentation, while working with cutting-edge EMR and EHR systems. Be part of a dedicated team committed to delivering prompt, compassionate care that makes a real difference.

Valid Nurse Practitioner license with current certification to practice in an urgent care setting. Proven experience in emergency medicine, hospital medicine, or urgent care environments with familiarity in Level I or Level II trauma centers preferred. Proficiency in medical documentation systems such as Epic, Cerner, or Athenahealth; experience with ICD-10/ICD-9 coding is highly desirable. Strong clinical skills including suturing, IV infusion/insertion, phlebotomy, and sterile processing techniques. Knowledge of physiology and anatomy to perform accurate physical examinations and diagnostic evaluations. Experience working with diverse populations including pediatrics (including toddler care), geriatrics (memory care), and individuals with disabilities or developmental challenges. Ability to handle high-pressure situations involving acute pain management or airway management confidently. Excellent communication skills for triage assessments and patient education; familiarity with telehealth platforms is a plus. Commitment to maintaining HIPAA compliance and practicing infection control standards diligently. Embark on a rewarding career where your skills will be valued every day! Join us in delivering exceptional urgent care services that improve lives through promptness, professionalism, and compassion.

Conduct thorough patient assessments including vital signs, physical examinations, and medical history reviews to determine urgent care needs. Manage acute conditions such as infections, injuries, and chronic exacerbations with appropriate interventions and treatments. Perform procedures including suturing, IV insertion, catheterization, and basic life support to stabilize patients effectively. Utilize telehealth platforms for remote consultations and follow-up care to expand access and improve patient outcomes. Document all patient encounters accurately using EMR systems like Epic or eClinicalWorks, ensuring compliance with HIPAA and other regulations. Collaborate with physicians, specialists, and case managers to coordinate discharge planning and follow-up treatments. Assist with diagnostic evaluations such as laboratory specimen collection/processing and sonography when needed for comprehensive patient care.

Martin's Point Health Care

Utilization Review and Appeals Nurse - Remote

Posted on:

March 15, 2026

Job Type:

Full-Time

Role Type:

Utilization Review

License:

RN

State License:

Compact / Multi-State

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015.

The Utilization Appeals Review Nurse will be responsible for clinical review of member and provider appeals and/or claims disputes. Collaborating with our team of Medical Directors and internal stakeholders, you will use your clinical expertise to apply Martin’s Point medical policies, CMS and TRICARE regulations to deliver accurate, timely, and compliant appeal or claims disputes decisions. Job Description PRIMARY DUTIES AND RESPONSIBILITIES: Employees are expected to work consistently to demonstrate the mission, vision, and core values of the organization.

Education: Associate Degree in Nursing (ADN) Bachelor’s degree in nursing preferred Licensure/certification Active, unrestricted Compact Registered Nurse (RN) license. Experience 3+ years of RN clinical experience, preferably in a hospital setting, along with experience in utilization management in a health plan UM department and in managing appeals or disputes Coding/CPC preferred Knowledge: Thorough understanding of CMS Medicare Advantage regulations (Parts C & D) and NCQA guidelines Thorough knowledge of MCG, Interqual of other clinical guidelines HIPAA & privacy requirements Concurrent, prior authorization and appeals review Critical thinking and case analysis Clinical writing and summarization Electronic UM systems Tricare regulation experience preferred MCQA standards experience preferred Claims disputes review experience preferred Skills: Ability to extract relevant clinical facts from progress notes, labs, imaging, and treatment plans. Correct use of MCG, and Martiin’s Point medical policies to determine medical necessity. Ability to identify inconsistencies, missing information, or red flags in documentation Understanding appeal levels, timeframes, coverage rules, and documentation requirements. Ability to produce rationales that meet CMS, TRICARE, and NCQA standards Ability to write clear, defensible rationales that explain the clinical and regulatory basis for the determination. Ability to write concise, objective, and compliant appeal rationales Abilities Ability to analyze data metrics, outcomes, and trends. Ability to prioritize time and tasks efficiently and effectively. Ability to manage multiple demands. Ability to function independently.

Responsible for the review and resolution of clinical appeals and disputes Reviews documentation and interprets data obtained from clinical records to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and provider issues. Ensures care delivery aligns with specific line-of-business benefits while maintaining full compliance with contractual and regulatory standards, e.g. Department of Defense, Centers for Medicaid and Medicare, NCQA, Employer contracts and state insurance regulations, as applicable. Stays current with industry regulations and accreditation standards to ensure continuous operational compliance Consistently delivers high-quality outcomes that meet or exceed established departmental benchmarks and performance standards. Participates in quality initiatives, committees, work groups, projects, and process improvements that reinforce best practice medical management programming and offerings. Independently coordinates the clinical resolution with internal/external clinician support as required. This position will be accountable for appeals, claims disputes, and QOC review This is a full-time remote position with standard hours of Monday–Friday, 8:00 AM to 5:00 PM (local time). Demonstrates flexibility and agility in working in a fast-paced, team-oriented environment, able to multi-task from one case type to another. Assumes extra duties as assigned based on business needs. Weekend and holiday on-call coverage may be required.

Rising Medical Solutions

Triage Nurse - Remote

Posted on:

March 15, 2026

Job Type:

Full-Time

Role Type:

Triage

License:

RN

State License:

Illinois

As our Triage Nurse, you will be responsible for conducting a focused assessment and prioritizing a patient’s clinical condition to provide immediate care if the patient requires it.

Active appropriate professional nurse license (RN or LPN) in the state of residence Minimum of 1-year clinical nursing experience required Prior remote/telephonic work experience preferred Being bilingual in Spanish is a plus Prior triage experience preferred Experience with Workers’ Compensation, short-term or long-term disability, or liability claims preferred Bill review experience with Workers’ Compensation, Auto, and/or Health Insurance carriers a plus Flexibility in working both autonomously and on a team Maintain confidentiality of all information, policies, and procedures Demonstrate sensitivity to culturally diverse people and situations Well-developed time-management, organization, and prioritization skills Knowledge of utilization management, case management, and healthcare provided throughout the health continuum Excellent oral and written communication skills, over the phone and interpersonal Ability to gather data, compile information and, prepare summary documentation Strong interpersonal and customer service skills Experience in a fast-paced, multi-faceted environment Demonstrated persistence and attention to detail Working knowledge of internet research/navigation, Microsoft Word, Excel, and Outlook Ability to remain calm during stressful situations Customer-service oriented Working Conditions: Remaining in a seated position Entering text or data into a computer Visual Acuity Talking Hearing Repetitive arm, hand, and finger motion Working remotely some or all of the time

Assess injury severity, the extent of disability, treatment plans, functional abilities, and physical job requirements. Utilize sound clinical judgment, careful listening, and critical thinking and assessment skills. Assign files appropriately to an Injury Coordinator or a TCM, based on the injured worker’s needs. Assist with tracking high-risk, high cost and complex patients by assessing the injured/disabled individual’s needs. Post case facts in Rising’s system, as well as the client’s claims system when appropriate. Assist non-clinical staff by reviewing files and recommending an action plan. Provide care direction and/or assist the injured worker in finding a provider when appropriate. Establish collaborative relationships and work as an intermediary between clients, patients, employers, providers, and attorneys. Adhere to quality standards along with state and national standards and guidelines Locate and document appropriate evidence-based and return-to-work guidelines (e.g., ODG). Promote quality, cost-effective care throughout the health continuum to ensure the injured/disabled individual can return to an optimal level of work and functioning. Advise the supervisor of any potential problems as they become evident. Maintain in-depth knowledge of all company products and services as well as customer issues and needs through ongoing training and self-directed research. Continuous professional development about issues and trends in case management. Provide input for policies/procedures, as requested. Adhere to departmental case management standards and guidelines, as well as Company policies, procedures, and reporting requirements. Perform other administrative or corporate duties upon request Reports to: Rising Ultimate Nurse Case Manager

ONclick Healthcare

Telehealth Nurse Practitioner - Oklahoma Licensed Bilingual

Posted on:

March 15, 2026

Job Type:

Contract

Role Type:

Telehealth

License:

NP/APP

State License:

Oklahoma

ONclick Healthcare is a leader in Transitional Care Management, providing telehealth services, committed to delivering high-quality healthcare to patients from the comfort of their own homes. We leverage cutting-edge technology to connect patients with experienced healthcare professionals, ensuring convenient and accessible medical care.

Job Title: Virtual Receptionist and Scheduler Location: Remote Employment Type: Full-Time/Part-Time Position Overview: We are seeking dedicated and experienced independent physician contractors to join our growing telehealth team. This role offers the flexibility to work from anywhere with an internet connection, providing virtual medical consultations to patients. Our ideal candidates are licensed nurse practitioners with a passion for patient care and a commitment to leveraging technology to improve healthcare delivery.

Board-certified patient care providers (e.g., NP, PA-C, or similar credentials). Active medical license in the state of CA. Active Oklahoma PTAN is preferred not required Minimum of 2 years of clinical experience Prior experience in telehealth is preferred but not required. Excellent communication and interpersonal skills. Proficiency with electronic health records (EHR) and telemedicine platforms. Reliable internet connection and a quiet, private workspace. Speak, along with English, one of the following languages: Farsi, Armenian, and Spanish.

Good Care Management. Leverages a pre-existing relationship with the patient and feels connected to the clinicians and other health care professionals who are caring for them. Use all available data to build a composite view of what is happening with a patient and communicating that view. Deliver proactive continuous management of needs based on deep knowledge of a patient’s clinical condition. Allow creative problem solving (“whatever it takes”) to go above and beyond when needed Conduct virtual consultations and follow-up appointments via our telehealth platform. Diagnose and treat a variety of medical conditions, providing high-quality patient care. Maintain accurate and detailed patient records in compliance with HIPAA and other regulatory requirements. Collaborate with other healthcare professionals to ensure comprehensive patient care.

Rite Med Group

TeleHealth Nurse Practitioner- BiLingual

Posted on:

March 15, 2026

Job Type:

Full-Time

Role Type:

Telehealth

License:

NP/APP

State License:

New York

Rite Med Group is a fast-growing company invested in improving the nature of post-acute care management within skilled nursing facilities, adult communities, and assisted living facilities.

Rite Med Group is collaborating with a Clinic located in Williamsburg to hire a Full Time Bilingual Telehealth Nurse Practitioner. This is an in person 9am-5pm position. The overall goal is to work hand in hand with the facility to improve the quality of care, increase patient satisfaction, and reduce hospitalization rates.

Current New York License as a Nurse Practitioner National Board Certified EMR/EHR experience

Conduct routine check-ups to patients to assess their health condition and discover possible issues Give appropriate advice for healthy habits (diet, hygiene etc.) and preventative actions to promote overall health Conduct examinations to ill patients and evaluate symptoms to determine their condition Ask intuitive questions to discover causes of illness Reach an informed diagnosis based on scientific knowledge and the patient’s medical history Prescribe and interpret lab tests to obtain more information for underlying infections or abnormalities Prescribe medications or drugs and provide comprehensive instructions for administration Collaborate with other physicians, physician assistants and nurses to form a high performing medical team Examine and provide treatments to injuries and refer patients to other physicians when needed (ophthalmologists, orthopedists, neurologists etc.) Keep records of patients’ diseases, operations or other significant information (e.g. allergic episodes) Cultivate a climate of trust and compassion for patients Remain up-to-speed with developments and best practices in medicine by attending conferences and seminars

J&B Medical Supply Co Inc

MICHIGAN Registered Nurse REMOTE - Telehealth Pt Assessment

Posted on:

March 15, 2026

Job Type:

Full-Time

Role Type:

Telehealth

License:

RN

State License:

Michigan

Since its inception in 1996, J&B Medical has become a recognized market leader in healthcare. More than a family-owned business, we are a family of businesses that span across all aspects of medical-related care including: insurance covered products, sole source program management and national managed care contracts, medical-surgical products, emergency-medical products, retail home-care products, veterinary products, and technology solutions. J&B Medical is a national certified Women’s Business Enterprise composed of knowledgeable industry professionals. J&B’s passionate teams are motivated to provide exceptional service at every interaction. Our goal is simple: enhance the quality of life, improve clinical outcomes, and reduce healthcare costs. J&B Medical settles for nothing less than the most innovative industry practices and the highest level of integrity.

REMOTE or In Office - MUST HAVE VALID MICHIGAN RN LICENSE Our Nursing Team is growing! Great Benefits after 30 days! PTO & Holiday Pay after 90! Summary: Our Staff Nurse's are responsible for conducting patient assessments by phone (ours) to determine individual needs for incontinence supplies. ARE YOU READY TO MAKE A MOVE? APPLY NOW! NEW HIRE ORIENTATION STARTS MARCH 18TH!!! ***** EQUIPMENT IS NOT PROVIDED FOR REMOTE STAFF, YOU MUST HAVE YOUR OWN COMPUTER. Position Type: This is a full time REMOTE or in office position 40 hours per week. Monday through Friday, hours of work vary between 8:00am to 6:00pm. Occasional early mornings, evening and weekend work may be required as job duties demand.

Requirements: Current Registered Nursing License (RN) with the State of Michigan (MI ONLY - CNL'S ARE NOT ACCEPTED) 2+ years previous work experience demonstrating patience, compassion and strong communication skills Must be great on the computer, able to use multiple databases simultaneously Preferred Education and Experience: 3 years of nursing experience Knowledge of medical terminology Medicare and Medicaid background Durable Medical Equipment (DME)

Consults by phone with client, primary caregiver, primary care physician or specialist, case managers and other community resources to determine if client qualifies for a particular program. Expectation is that Nurse will complete 20-25 assessments daily, on average with 98% accuracy. Conducts clinical assessments by phone and documents the client’s medical history. Monitors success rates. All products ordered must be assessed for use and quantity needs per day. Identifies appropriate product and quantity needs based on assessment. If formulary product will not meet needs, then reviews needs and potential solutions with Nurse Manager. Reassesses if there is a change in a client’s medical condition or an increase in quantity request. Obtains prior authorization from the state contract administrator for off-formulary or over-quantity requests. Reviews letters of medical necessity to determine if client qualifies for product or quantity requested. Reviews accounts for accuracy, reporting any errors to the appropriate department manager/leader. Participates in after-hours emergency call rotation. Understanding of insurance guidelines. Utilize intranet tools to complete assessments. Provides education to other J & B employees or external clients regarding products. Other Duties: All other duties as assigned by management. Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are request of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

J&B Medical Supply Co Inc

INDIANA Registered Nurse REMOTE - Telehealth Pt Assessment

Posted on:

March 15, 2026

Job Type:

Full-Time

Role Type:

Telehealth

License:

RN

State License:

Indiana

Since its inception in 1996, J&B Medical has become a recognized market leader in healthcare. More than a family-owned business, we are a family of businesses that span across all aspects of medical-related care including: insurance covered products, sole source program management and national managed care contracts, medical-surgical products, emergency-medical products, retail home-care products, veterinary products, and technology solutions. J&B Medical is a national certified Women’s Business Enterprise composed of knowledgeable industry professionals. J&B’s passionate teams are motivated to provide exceptional service at every interaction. Our goal is simple: enhance the quality of life, improve clinical outcomes, and reduce healthcare costs. J&B Medical settles for nothing less than the most innovative industry practices and the highest level of integrity.

MUST HAVE VALID INDIANA RN LICENSE. NLC is a Plus! Our Nursing Team is growing in Indiana! Great Benefits after 30 days! PTO & Holiday Pay after 90! NEW HIRE REMOTE TRAINING STARTS MARCH 18TH! Summary: Our Staff Nurse's are responsible for conducting patient assessments by phone (ours) to determine individual needs for incontinence supplies. Essential Functions: Consults by phone with client, primary caregiver, primary care physician or specialist, case managers and other community resources to determine if client qualifies for a particular program. Position Type: This is a full time REMOTE position 40 hours per week. Monday through Friday, hours of work vary between 8:00am to 6:00pm. Occasional early mornings, evening and weekend work may be required as job duties demand. Other Duties: All other duties as assigned by management. Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are request of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Requirements: Current Registered Nursing License (RN) with the State of INDIANA or NLC 2+ years previous work experience demonstrating patience, compassion and strong communication skills Must be great on the computer, able to use multiple databases simultaneously Preferred Education and Experience: 3 years of nursing experience Knowledge of medical terminology Medicare and Medicaid background Durable Medical Equipment (DME)

Expectation is that Nurse will complete 20-25 assessments daily, on average with 98% accuracy. Conducts clinical assessments by phone and documents the client’s medical history. Monitors success rates. All products ordered must be assessed for use and quantity needs per day. Identifies appropriate product and quantity needs based on assessment. If formulary product will not meet needs, then reviews needs and potential solutions with Nurse Manager. Reassesses if there is a change in a client’s medical condition or an increase in quantity request. Obtains prior authorization from the state contract administrator for off-formulary or over-quantity requests. Reviews letters of medical necessity to determine if client qualifies for product or quantity requested. Reviews accounts for accuracy, reporting any errors to the appropriate department manager/leader. Participates in after-hours emergency call rotation. Understanding of insurance guidelines. Utilize intranet tools to complete assessments. Provides education to other J & B employees or external clients regarding products.

1st Call Triage, LLC

Telephone Triage Nurse

Posted on:

March 15, 2026

Job Type:

Full-Time

Role Type:

Triage

License:

RN

State License:

Nebraska

We are seeking a highly skilled Pediatric Registered Nurse to join our remote telephone triage team. This role requires extensive pediatric experience in a clinical office setting, strong assessment skills, and the ability to provide safe, efficient, and compassionate patient care over the phone. As part of our triage team, the RN ensures patients receive timely medical guidance while collaborating with providers to deliver the highest standard of care. Additional duties include inbox message management, lab and medication refill coordination, referrals, and prior authorizations.

Minimum Qualifications: Active RN license Minimum 3 years of clinical office experience Proficiency in EMR systems Excellent communication and interpersonal skills Ability to work independently and as part of a team Preferred Qualifications: Experience in telephone triage or remote patient care Familiarity with Schmitt-Thompson protocols Experience with diverse patient populations across the lifespan

Conduct remote patient assessments and provide triage advice Collaborate with physicians and healthcare professionals Process prescription refills and prior authorizations Document accurately in patient records Provide education and counseling to patients Adhere to clinical guidelines and compliance standards This role requires excellent clinical judgment, strong problem-solving skills, and empathy in patient interactions. The ability to provide safe, accurate, and timely telephone triage is essential for ensuring positive patient outcomes.

Clearlink Partners

Utilization Management RN (Compact Licensed)

Posted on:

March 15, 2026

Job Type:

Full-Time

Role Type:

Utilization Review

License:

RN

State License:

Compact / Multi-State

Clearlink Partners is an industry-leading managed care consultancy specializing in end-to-end clinical and operational management services and market expansion initiatives for Managed Medicaid, Medicare Advantage, Special Needs Plans, complex care populations, and risk-adjusted entities. We support organizations as they navigate a dynamic healthcare ecosystem by helping them manage risk, optimize healthcare spend, improve member experience, accelerate quality outcomes, and promote health equity.

Time Zone: Eastern or Central Other Information: Expected Hours of Work: Monday - Friday 8am – 5 pm with ability to adjust to Client schedules as needed Travel: May be required, as needed by Client Direct Reports: None Salary Range: $70,000 - $100,000

Competencies: Ability to translate member needs and care gaps into a comprehensive member centered plan of care Ability to collaborate with others, exercising sensitivity and discretion as needed Strong understanding of managed care environment with population management as a key strategy Strong understanding of the community resource network for supporting at risk member needs Ability to collect, stage and analyze data to identify gaps and prioritize interventions Ability to work under pressure while managing competing demands and deadlines Well organized with meticulous attention to detail Strong sense of ownership, urgency, and drive The ability to effect change, perform critical analyses, promote positive outcomes, and facilitate empowerment for members/families Excellent analytical-thinking/problem-solving skills The ability to work effectively in a fast-paced environment with frequently changing priorities, deadlines, and workloads The ability to offer positive customer service to every internal and external customer Experience: Current unencumbered Compact RN license Minimum of 5+ years of acute clinical experience Minimum 2 years’ experience in a managed care environment across multiple lines of business (Medicare Advantage, Managed Medicaid, Dual SNP, Commercial, etc.) HMO and risk contracting experience preferred In-depth knowledge of current standard of medical practices and insurance benefit structures. Excellent oral and written interpersonal/communication, internal/external customer-service, organizational, multitasking, and teamwork skills. Proficiency in Microsoft Office Physical Requirements Must be able to sit in a chair for extended periods of time Must be able to speak so that you are able to accurately express ideas by means of the spoken word Must be able to hear, understand, and/or distinguish speech and/or other sounds in person, via telephone/cellular phone, and/or electronic devices Must have ample dexterity which allows entering of text and/or data into a computer or other electronic device by means of a keyboard and/or mouse Must be able to clearly use sight so that you are able to detect, determine, perceive, identify, recognize, judge, observe, inspect, estimate, and/or assess data or other information types Must be able to fluently communicate both verbally and in writing using the English language

Specific: Determine appropriateness of services through the application and evaluation of medical guidelines, benefit determinations and compliance with state mandated regulated based on approved criteria (MCG, InterQual, etc.) Perform 15-30 reviews per day Performs initial and concurrent review of inpatient admissions Performs reviews for outpatient surgeries, and ancillary services Concludes medical necessity and appropriateness of services using clinical review criteria Collaborate with Medical Director(s) for appropriate referrals, complex cases and adverse determinations to ensure timely access to medically necessary/ appropriate services Accurately documents all review determinations, contacting providers and members according to established requirements and timeframes General: Perform daily work with a focus on the core principles of managed care: patient education, wellness and prevention programs, early screening and intervention and continuity of care Work proactively to expedite the care process Identify priorities and necessary processes to triage and deliver work Empower members to manage and improve their health, wellness, safety, adaptation, and self-care Assess and interpret member needs and identify appropriate, cost-effective solutions Identify and remediate gaps or delays in care/ services Advocate for treatment plans that are appropriate and cost-effective Work with low-income/ vulnerable populations to ensure access to care and address unmet needs Gather and evaluate clinical information to assess and expedite referrals within the healthcare system including consideration of alternate levels of care and services Facilitate timely and appropriate care and effective discharge planning Work collaboratively across the health care spectrum to improve quality of care Leverage experience/ expertise to observe performance and suggest improvement initiatives Ensure understanding of industry standard competencies and performance metrics to optimize decisions and clinical outcomes Ensure individual and team performance meets or exceeds the performance competencies and metrics Contribute actively and effectively to team discussions Share knowledge and expertise, willingly and collaboratively Provide outstanding customer service, internally and externally Follow and maintain compliance with regulatory agency requirements

HarmonyCares

Nurse Practitioner (NP) PRN - HRAs Per-visit - Hidalgo

Posted on:

March 14, 2026

Job Type:

Full-Time

Role Type:

Telehealth

License:

NP/APP

State License:

Texas

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.

Hidalgo PRN NP - 8hrs per week, you pick the hours! FNP required. Medicare & Medicaid enrollment required. $145.00 per in-home visit & $85.00 per telehealth visit. 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, 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.

Required Knowledge, Skills, and Experience: Active/unrestricted nurse practitioner license to practice in TX Hidalgo area resident to see patients locally in-person FNP Board certification required 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

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

Alignment Health

Inpatient Review Nurse (Remote, Must have California LVN / RN License)

Posted on:

March 14, 2026

Job Type:

Full-Time

Role Type:

Utilization Review

License:

RN

State License:

California

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

The fully remote inpatient review nurse assists patients through the continuum of care in collaboration with the patient’s primary care physician, facility case manager, discharge planner and employing contracted ancillary service providers and community resources as needed. Assures that services are provided at the most appropriate, cost effective level of care needed to meet the patient’s medical needs while maintaining safety and quality. Schedule: Monday - Friday, 8:00 AM - 5:00 PM Pacific Time (Required)

Experience Required: Minimum 3 years of general case management skills. Minimum of two years of experience utilizing Milliman Care Guidelines to justify Inpatient versus Observation Length of stay: including review of diagnosis and length of stay. Two consecutive years related experience in a managed care setting as an inpatient case manager Preferred: Experience with a Senior population. Education Required: Successful completion of an accredited Licensed Vocational Nursing Program Preferred: Associates or Bachelors Degree Specialized Skills Required: Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others. Excellent critical thinking skills related to nursing utilization review Knowledge of Medicare Managed Care Plans Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors; Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution. Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment. Report Analysis Skills: Comprehend and analyze statistical reports. Preferred: Knowledge and experience in complex/catastrophic case management preferred Licensure Required: Must have and maintain an active, valid, and unrestricted LVN or RN license in California (Non-Compact) Immediately upon hire, must be willing to obtain LVN and / or RN licensure in Nevada, (Non-compact), Arizona (Compact), North Carolina (Compact), and Texas (Compact) which will be reimbursed by company. Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate. Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit; use hands to finger, hand, or feel and talk or hear. The employee is frequently required to reach with hands and arms The employee is occasionally required to climb or balance and stoop, or kneel The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus.

Performs reviews of inpatients in this fully remote position, with complex medical and social problems. Generates referrals to contracted ancillary service providers and community agencies with the agreement of the patient’s primary care physician. Performs follow-up reviews and evaluations of patients in the ambulatory care or lower level of care setting. Reviews inpatient admissions timely and identifies appropriate level of care and continued stay based on acceptable evidence-based guidelines used by AHC. Effectively communicates with patients, their families and or support systems, and collaborates with physicians and ancillary service providers to coordinate care activities. Identifies Members who may need complex or chronic case management post discharge and warm handoff to appropriate staff for ambulatory follow up, as necessary. Communicates and collaborates with IPA/MG as necessary for effective management of Members. Assigns and provides daily oversight of the activities and tasks of the CCIP Coordinator. Records communications in EZ-Cap and/or case management database. Arranges and participates in multi-disciplinary patient care conferences or rounds. Monitors, documents, and reports pertinent clinical criteria as established per UM policy and procedure. Monitors for any over utilization or underutilization activities. Generates referrals as appropriate to the QM department. Enters data as necessary for the generation of reports related to case management. Reports the progress of all open cases to the Medical Director, Director of Healthcare Services and Manager of Utilization Management. Performs other duties as assigned.

Alignment Health

Remote Bilingual Care Coordinator, Outpatient Case Management (Mon-Fri, 8am-5pm Pacific Required)

Posted on:

March 14, 2026

Job Type:

Full-Time

Role Type:

Case Management

License:

NP/APP

State License:

California

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

Job Location: Fully Remote, working PST hours. Alignment Health is seeking an compassionate, customer service oriented, and organized, bilingual Spanish care coordinator to join the remote outpatient case management team. The Remote Care Coordinator works alongside the RN case manager and interdisciplinary care team to support members with complex and chronic health needs. In this role, you will help coordinate services, close care gaps, and ensure members receive timely, appropriate care. You’ll play an important role in supporting members enrolled in case management by assisting with care coordination activities, scheduling and service coordination, and helping members navigate their care plan and available resources. If you are hungry to learn and grow, want to be part of a growing organization, and make a positive impact in the lives of seniors – we’re looking for you! Schedule: Monday - Friday, 8:00 AM - 5:00 PM Pacific Time

Experience Required: Minimum (1) year experience working in health care such as health plan, medical office, Independent Practice Association (IPA), Management Services Organization Minimum (1) year experience assisting members / patients with authorizations, scheduling appointments, identification of resources, etc. Preferred Education Required: High School Diploma or GED. Preferred: Bachelor's degree or four years additional experience in lieu of education. Training Required Preferred: Medical assistant training, medical terminology training. Specialized Skills Required: Able to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Able to write routine reports and correspondence. Communicate effectively using customer relations skills. Able to communicate positively, professionally, and effectively with others; provide leadership, teach, and collaborate with others. Problem-Solving Skills: Effective problem solving, organizational and time management skills and able to work in a fast-paced environment. Knowledge of Managed Care Plans Knowledge of Medi-Cal Basic computer proficiency, type a minimum 35 words per minute (WPM), proficient in Microsoft Office suite (Outlook, Excel, Word) Mathematical Skills: Able to add and subtract two digit numbers and to multiply and divide with 10’s and 100’s. Able to perform these operations using units of American money and weight measurement, volume, and distance. Reasoning Skills: Able to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Able to deal with problems involving a few concrete variables in standardized situations. Preferred: Bilingual English and Spanish Licensure Required: None Preferred: Medical assistant certificate, medical terminology certificate Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. The employee frequently lifts and / or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus. Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Reach out to members telephonically to assist with referrals, authorizations, HHC, DME needs, medication refills, make provider appointments and follow ups, etc. Create cases, tasks, and complete documentation in the case management module for all hospital and skilled nursing facility (SNF) discharges Comply and document tasks assigned by nurse Work as a team, in this fully remote role, with the case manager to engage and manage a panel of members Manage new alerts and update case manager on changes in condition, admission, discharge, or new diagnosis Establish relationships with members, earn their trust and act as patient advocate Escalate concerns to nurse if members appear to be non-compliant or there appears to be a change in condition Assist with outreach activities to members in all levels of case management programs Assist with maintaining and updating members' records Assist with mailing or faxing correspondence to members, primary care physicians (PCP), and / or Specialists Request and upload medical records from PCP’s, specialists, hospitals, etc. Meet specific deadlines (respond to various workloads by assigning task priorities according to department policies, standards, and needs) Maintain confidentiality of information between and among health care professionals Other duties as assigned by case manager (CM) supervisor, manager or director of care management.

Alignment Health

Remote RN Case Manager, SNP (Bilingual Preferred)

Posted on:

March 14, 2026

Job Type:

Full-Time

Role Type:

Case Management

License:

RN

State License:

California

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

The fully remote RN Case Manager SNP (must have RN License in California [Non-Compact]) is responsible for health care management and coordination, within the scope of licensure, for members with complex and chronic care needs. Delivers care to members utilizing the nursing process and effectively interacts with members, care givers, and other interdisciplinary team participants. Assist with closing gaps in care and resolving barriers that prevent members from attaining improved health. Reaches out and connects with members via the telephone. Schedule: Must be willing to work 8:00am - 5:00pm Pacific Time

Experience Required: Minimum 2 years' clinical experience Minimum 1 year case management experience. Preferred: Health Plan experience preferred Education Required: Successfully passing Post High School courses to obtain an RN licensure or AS in Nursing. Preferred: BSN or Bachelor's Specialized Skills Required: Possess a high level of understanding of community resources, treatment options, home health, funding options and special programs Extensive knowledge of the management of chronic conditions Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors; Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others. Ability to operate PC-based software programs including proficiency in Word, Excel and PowerPoint Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution. Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment. Report Analysis Skills: Comprehend and analyze statistical reports. Licensure Required: Must have and maintain an active, valid, and unrestricted RN license in California (Non-Compact) Immediately upon hire, must be willing to obtain LVN and / or RN licensure in Nevada, (Non-compact), Arizona (Compact), North Carolina (Compact), and Texas (Compact) which will be reimbursed by company. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Coordinates care by serving as a resource for the member, their family, and their physician. Ensures access to appropriate care for members with urgent or immediate needs facilitating referrals/authorizations within the benefit structure as appropriate. Completes comprehensive assessments within their scope of practice that includes assessing the member's current health status, resource utilization, past and present treatment plan, and services. Collaborates with the member, the PCP, and other members of the care team to implement a plan of care. Interfaces with Primary Care Physicians, Hospitalists, Nurse Practitioners, and specialists on the development of care management treatment plans. Provides education and self-management support based on the member’s unique learning style. Assists in problem solving with providers, claims or service issues. Works closely with delegated or contracted providers, groups, or entities to assure effective and efficient care coordination. Maintains confidentiality of all PHI in compliance with state and federal law and Alignment Healthcare Policy. Supervisory responsibilities: N/A

Alignment Health

Supervisor, Utilization Management (Hybrid Remote, Must have California LVN / RN License)

Posted on:

March 14, 2026

Job Type:

Full-Time

Role Type:

Leadership / Management

License:

RN

State License:

California

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

The Supervisor, Utilization Management, under the direction of the Manager of UM, is responsible for ongoing management of the UM Department and oversight of preservice processes. Directly supervise licensed and coordinator staff performing UM duties. Accountable for promoting quality patient care outcomes while supporting appropriate resource management along the continuum of care and responsible for auditing and completing reports to meet CMS compliance requirements. Please note: This is an exempt leadership role supporting a clinical team that operates Monday–Friday during Pacific Time business hours. The supervisor is expected to maintain regular availability during these hours to provide leadership oversight, support clinical operations, and partner with interdisciplinary teams. Weekend leadership coverage is shared between the supervisor and director on a rotating basis to provide availability for staff support and escalations. This position is primarily remote; however, in-person attendance at Alignment Health’s headquarters in Orange, CA is required approximately once per quarter for leadership meetings and team collaboration. Candidates located outside of California should expect periodic travel to the Orange office. Travel expenses are reimbursed in accordance with company policy.

Required: Minimum (1) year recent and related supervisor experience Minimum (2) years related experience in a managed care setting, which includes inpatient and preservice utilization management Education Required: Successful completion of an accredited Registered Nursing Program or Vocational Nursing program. Specialized Skills Required: Knowledge of Medicare Managed Care Manuals and CMS regulatory requirements Computer Skills: Word, Excel, Microsoft Outlook Experience with the application of clinical criteria (i.e., MCG, InterQual, Apollo, CMS National and Local Coverage Determinations, etc.) Able to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others. Effective written and oral communication skills; able to establish and maintain a constructive relationship with diverse members, management, employees and vendors Mathematical Skills: Able to perform mathematical calculations and calculate simple statistics correctly Reasoning Skills: Able to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment Report Analysis Skills: Comprehend and analyze statistical reports Licensure Required: Must have and maintain an active, valid, and unrestricted RN / LVN license in California (Non-Compact) Immediately upon hire, must be willing to obtain LVN and / or RN licensure in Nevada, (Non-compact), Arizona (Compact), North Carolina (Compact), and Texas (Compact) which will be reimbursed by company. Preferred: CCM or ABQAURP certification. Essential Physical Functions: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Ensure UM clinical staff members perform Pre-Service reviews on submitted requests within CMS and Alignment Health turnaround timeframes and according to regulatory and Health Plan guidelines. Ensure staff use sound clinical judgment to make final determinations, utilizing Alignment Health approved clinical criteria according to hierarchy. Ensure staff follow pre-service workflows. Ensure staff put the member first while managing benefits appropriately, considering the individual’s unique needs. Ensure assigned staff comply with CMS and Alignment Health interdepartmental processes when participating in the Medical Claims Review process. Ensure staff coordinate care internally and externally. Monitor documentation to ensure alignment with Health Plan and department policies, protocols, and standard operating procedures. Collect, evaluate, and report data and activities as applicable within the UM program (e.g., monthly, quarterly, and annual reports). Perform department quality and vendor audits to assess case timeliness and ensure compliance. Collaborate with primary care physicians, specialty care physicians, mental health professionals, home health professionals, and other healthcare professionals regarding escalated needs. Establish and maintain effective interpersonal relationships with staff at all levels, providers, and internal departments. Attend meetings with vendors and/or other departments regarding UM policies and procedures. Maintain confidentiality of information between and among healthcare professionals. Perform UM reviews when required, including handling escalated cases. Implement Alignment internal and CMS-specific programs (e.g., Medical Claims Review). Develop, review, and revise as necessary policies, procedures, protocols, and processes related to Pre-Service and Claims UM. Other duties as requested or assigned. SUPERVISORY RESPONSIBILITIES: Oversee assigned staff. Responsibilities include recruiting, selecting, orienting, and training employees; assigning workload; planning, monitoring, and appraising job results; and coaching, counseling, and disciplining employees. Recruit, select, onboard, train, mentor, and coach UM clinicians and coordinators to ensure compliance with internal and regulatory guidelines. Assign workload; plan, monitor, and appraise work results. Conduct 1:1 coaching (coach, counsel, and discipline) with employees and create, implement, and track corrective action plans and Objectives and Key Results (OKRs). Manage time-off requests, scheduling, and overtime utilization. Create and maintain an environment that inspires and encourages the growth and engagement of team members.

Optum

Telephonic Nurse Practitioner (Per Diem) - Pennsylvania License Required

Posted on:

March 14, 2026

Job Type:

Part-Time

Role Type:

Telehealth

License:

NP/APP

State License:

Compact / Multi-State

Optum Home & Community Care, part of the Optum family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual’s physical, mental and social needs – helping patients access and navigate care anytime and anywhere. As a team member of our Optum HouseCalls team, together in an interdisciplinary care environment, we help patients navigate the health care system and connect them to key support services. This preventive care can help patients stay well at home. We’re connecting care to create a seamless health journey for patients across settings. Join us to start Caring. Connecting. Growing together.

The Telehealth Urgent Care program is a comprehensive integrated care delivery program. The National On Call advanced practice clinician (APC) is responsible for providing telephonic/telehealth care and direction to patients, caregivers and facility staff providing 24/7 coverage including holidays. In this remote role you will provide virtual care for patients in various settings. This excellent opportunity affords a collaborative role bringing enormous satisfaction in the care and comfort of our patients. In this role you will have the ability to achieve work life balance. Optum is transforming care delivery with innovative and personal care. As one of the largest employers of APCs, Optum offers unparalleled career development opportunities. Scheduling: This is a Per Diem, work from home position. While shift times can vary, we provide coverage to members 24/7 including all company recognized holidays. Availability and Coverage expectations for this role Position requires a minimum commitment of 32 hours per month Standard shifts: weekdays between 8am-5pm business hours Holiday coverage is required by all APCs and is provided beginning at 5pm, the end of the last business day to 8am of the resumption of business hours Holiday scheduling is completed at the beginning of the year for advanced planning. Holiday coverage is provided beginning at 5pm, the end of the last business day, to 8am of the resumption of business hours (1) 8-hour summer holiday (Memorial Day, Labor Day, or July 4th) (1) 8-hour winter holiday (Thanksgiving, Day After Thanksgiving, Christmas, or NYD) Premium pay is paid for holiday coverage

Active and unrestricted license in the state which you reside, as well as State of Pennsylvania, and ability to obtain in other required locations. Ability to gain a collaborative practice agreement, if applicable in your state APCs working in jurisdictions that authorize APCs to practice autonomously or without formal supervision must have obtained approval to practice autonomously or without formal supervision from their licensing board, if applicable. New hires who are eligible and have not applied prior to hire date, must apply to practice autonomously or without supervision within 1 month of hire. If not eligible to practice autonomously or without formal supervision at hire, the APC must begin working towards meeting the requirement within 1 month of hire, if applicable, and apply for approval to practice autonomously or without formal supervision within 3 months of becoming eligible Education: NP: Graduate of an accredited Master of Science Nursing or Doctor of Nursing Practice program Active Nurse Practitioner certification through a national board: NP: Board certified through the American Academy of Nurse Practitioners or the American Nurses Credentialing Center, with certification in one of the following: Family Nurse Practitioner Adult Nurse Practitioner Gerontology Nurse Practitioner Adult-Gerontology Acute Care Nurse Practitioner Current, active DEA licensure/prescriptive authority or ability to obtain post-hire, per state regulations (unless prohibited in state of practice) Ability to work scheduled shifts in accordance with scheduling policies Proficient computer skills including the ability to document medical information with written and electronic medical records Preferred Qualifications: 3+ years of clinical experience as an APC Experience in meeting the medical needs of patients with complex behavioral, social and/or functional needs Experience working in a nursing home, or with seniors in an acute care facility Understanding of Geriatrics, Chronic Illness, and acute disease management Understanding of Advanced Illness and end of life discussions Ability to develop and maintain positive customer relationships Adaptability to change

Available on provided telephonic platform, both taking and placing calls to coordinate and manage care for members between care givers, facilities, hospitals, primary care providers and the Optum field colleagues Available to use video platform based on clinical need Working hours should be performed in a secure location as patient privacy is required Utilize EMR proficiently to provide acute care to members during all shifts and holiday hours Care Delivery Deliver cost-effective, quality care to members Manage both medical and behavioral, chronic, and acute conditions effectively, and in collaboration with a physician or specialty provider Perform comprehensive assessments and document findings in a concise/comprehensive manner that is compliant with documentation requirements and Center for Medicare and Medicaid Services (CMS) regulations Responsible for ensuring encounter is documented appropriately to support the diagnosis at that visit The APC is responsible for ensuring that all quality elements are addressed and documented Utilizes evidenced based practice guidelines Must attend and complete all mandatory educational and MyLearning training requirements Care Coordination Coordinate care as members transition through different levels of care and care settings Monitor the needs of members and families while facilitating any adjustments to the plan of care as situations and conditions change Review orders and interventions for appropriateness and response to treatment to identify the most effective plan of care that aligns with the patients’ needs and wishes Address and be able to have advanced care plan conversations with members and families Evaluate the plan of care for cost effectiveness while meeting the needs of members, families, and providers to decrease high costs, poor outcomes and unnecessary hospitalizations Program Enhancement Expected Behaviors This is a virtual patient facing role that requires excellent customer service to all parties including members/families, facilities, the entire interdisciplinary care team (PCPs/specialists) and Optum staff Regular and effective communication with internal and external parties including physicians, patients, key decision-makers, nursing facilities, field staff and other provider groups Ability to meet shift scheduling requirements, and attendance expectations Exhibit original thinking and creativity in the development of new and improved methods and approaches to concerns/issues Function independently and responsibly with minimal need for supervision Demonstrate initiative in achieving individual, team, and organizational goals and objectives Participate in quality initiatives Availability to check Optum email intermittently for required trainings, communications, and monthly scheduling. 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.

CVS Health

A1A Case Manager RN - Registered Nurse - AZ

Posted on:

March 14, 2026

Job Type:

Full-Time

Role Type:

Case Management

License:

RN

State License:

Compact / Multi-State

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.

This RN Case Manager role is part of Aetna One Advocacy (A1A) and requires in office training and ongoing work in Phoenix, Az. There is a requirement to live within a commutable distance of Phoenix, Az (typically within 45 minutes maximum). The expected start date for the cohort is May 11th 2026. The initial in office training will last for approximately 4 months. Once office training is complete, the role is work from home with occasional in office workdays scheduled in advance with the employee. There will be an expectation that the Case Manager works in the office at least one time per quarter for further training but it may be more often and notice will be provided. Normal Working Hours: 8am-4:30pm AZ Time. Once training is completed, the Case Manager will work occasional later shifts per month on a team rotation. There are no weekend shifts. Flexibility is required for onsite work shifts per the need of the business. What is A1A? Aetna One Advocate is Aetna’s premier service and clinical offering for Aetna nation-wide and creates industry-leading solutions for our customers and members. The model is a fully integrated population health and customer service solution for large plan sponsors. The high-touch, high-tech member advocacy service combines data-driven processes with the expertise of highly trained clinical and concierge member services. Our mission is to meet each member at every aspect of their health care journey. Our embedded customer-dedicated service and clinical pods allow maximization of inbound and outbound touchpoints to solve members’ needs and create behavior change. Our data analytics, white-glove service and end-to-end ownership of member support creates a trusted partner in health. This is an exciting time to join Aetna, a CVS Health company, in our journey to change the way healthcare is delivered today. We are health care innovators. The RN Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness.

Required: A Registered Nurse that must hold an unrestricted license in their state of residence, preferably with multi-state/compact privileges and be willing and able to be licensed in all non-compact states Upon hire, it will be required to obtain all 50 state licenses. 3+ years of clinical practice experience required as an RN There is a requirement to live within a commutable distance of Phoenix, Az(typically within 45 minutes maximum). Preferred: Case Management in an integrated model Certified Case Manager (CCM) certification Oncology Experience Bilingual in English and a 2nd language Education: Associates Degree in Nursing required. BSN preferred.

Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. Through the use of clinical tools and information/data review, conducts an evaluation of member’s needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. Assessments consider information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. Reviews prior claims to address potential impact on current case management and eligibility. Assessments include the member’s level of work capacity and related restrictions/limitations. Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality. Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management. Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.

Fifth Commandment Healthcare Staffing

NP / RN Financial Services Specialist (Remote)

Posted on:

March 14, 2026

Job Type:

Full-Time

Role Type:

License:

RN

State License:

California

Fifth Commandment Healthcare Staffing is the most reliable and trustworthy nurse staffing agency throughout California — providing excellent nursing services to patients who are dealing with injury or illness. We are committed to meeting all of your health needs, and go above and beyond to ensure you get the best care available.

We are seeking motivated and mission-driven Nurse Practitioners (NPs) and Registered Nurses (RNs) to join our growing 100% remote financial services team. In this role, you will leverage your healthcare background to help individuals and families build long-term financial security through education, protection, and strategic planning. Our focus is on life insurance solutions, college planning, and retirement strategies, empowering clients to make confident financial decisions. If you are passionate about helping others, value flexibility, and are ready to grow in a purpose-driven career, we would love to connect with you.

Active Life & Health Insurance License (or willingness to obtain with company support) RN or NP background strongly preferred Experience in financial services, insurance sales, or retirement planning is a plus Basic understanding of 401(k)s, IRAs, 529 plans, and insurance products Strong communication and presentation skills in a virtual setting Self-motivated, organized, and comfortable working remotely Proficient with virtual tools such as Zoom, Google Meet, and online scheduling platforms

Educate clients on life insurance solutions, including Term, Whole Life, and Indexed Universal Life (IUL)policies Provide personalized strategies for college planning and education funding options Assist clients with 401(k) rollovers into IRAs or other retirement vehicles while ensuring regulatory compliance Conduct financial needs analyses to match clients with appropriate protection and planning solutions Build and maintain long-term client relationships through ongoing reviews and communication Host virtual consultations, educational webinars, and remote workshops Work collaboratively with a supportive, mentorship-driven team

Molina Healthcare

Care Manager, LTSS (RN) Central OH

Posted on:

March 14, 2026

Job Type:

Full-Time

Role Type:

Care Management

License:

RN

State License:

Ohio

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need potential. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.

Required Qualifications: At least 2 years experience in health care, including at least 1 year experience in care management, managed care, and/or experience in a medical or behavioral health setting, and at least 1 year of experience working with persons with disabilities, chronic conditions, substance abuse disorders, and long-term services and supports (LTSS), or equivalent combination of relevant education and experience. Registered Nurse (RN). License must be active and unrestricted in state of practice. Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. Ability to operate proactively and demonstrate detail-oriented work. Demonstrated knowledge of community resources. Ability to work within a variety of settings and adjust style as needed - working with diverse populations and various personalities and personal situations. Ability to work independently, with minimal supervision and demonstrate self-motivation. Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. Ability to develop and maintain professional relationships. Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. Excellent problem-solving and critical-thinking skills. Strong verbal and written communication skills. Microsoft Office suite/applicable software program(s) proficiency. In some states, must have at least one year of experience working directly with individuals with substance use disorders. Preferred Qualifications: Certified Case Manager (CCM). Experience working with populations that receive waiver services.

Completes comprehensive member assessments within regulated timelines, including in-person home visits as required. Facilitates comprehensive waiver enrollment and disenrollment processes. Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals. Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. Promotes integration of services for members including behavioral health care and long-term services and supports (LTSS) and home and community resources to enhance continuity of care. Assesses for medical necessity and authorizes all appropriate waiver services. Evaluates covered benefits and advises appropriately regarding funding sources. Facilitates interdisciplinary care team (ICT) meetings for approval or denial of services and informal ICT collaboration. Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. Assesses for barriers to care and provides care coordination and assistance to members to address psycho/social, financial, and medical obstacles concerns. Identifies critical incidents and develops prevention plans to assure member health and welfare. May provide consultation, resources and recommendations to peers as needed. Care manager RNs may be assigned complex member cases and medication regimens. Care manager RNs may conduct medication reconciliation as needed. 25-40% estimated local travel may be required (based upon state/contractual requirements).

CVS Health

A1A Case Manager RN - Registered Nurse - NC

Posted on:

March 14, 2026

Job Type:

Full-Time

Role Type:

Case Management

License:

RN

State License:

Compact / Multi-State

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.

This RN Case Manager role is part of Aetna One Advocacy (A1A) and requires in office training and ongoing work in High Point, Nc. There is a requirement to live within a commutable distance of High Point, Nc (typically within 45 minutes maximum). The expected start date for the cohort is May 11, 2026. The initial in office training will last for approximately 4 months. Once office training is complete, the role is work from home with occasional in office workdays scheduled in advance with the employee. There will be an expectation that the Case Manager works in the office at least one time per quarter for further training but it may be more often and notice will be provided. Normal Working Hours: 8am-4:30pm EST. Once training is completed, the Case Manager will work occasional later shifts per month on a team rotation. There are no weekend shifts. Flexibility is required for onsite work shifts per the need of the business. What is A1A? Aetna One Advocate is Aetna’s premier service and clinical offering for Aetna nation-wide and creates industry-leading solutions for our customers and members. The model is a fully integrated population health and customer service solution for large plan sponsors. The high-touch, high-tech member advocacy service combines data-driven processes with the expertise of highly trained clinical and concierge member services. Our mission is to meet each member at every aspect of their health care journey. Our embedded customer-dedicated service and clinical pods allow maximization of inbound and outbound touchpoints to solve members’ needs and create behavior change. Our data analytics, white-glove service and end-to-end ownership of member support creates a trusted partner in health. This is an exciting time to join Aetna, a CVS Health company, in our journey to change the way healthcare is delivered today. We are health care innovators. The RN Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness.

Required: A Registered Nurse that must hold an unrestricted license in their state of residence, preferably with multi-state/compact privileges and be willing and able to be licensed in all non-compact states Upon hire, it will be required to obtain all 50 state licenses. 3+ years of clinical practice experience required as an RN There is a requirement to live within a commutable distance of High Point, Nc (typically within 45 minutes maximum). Preferred: Case Management in an integrated model Certified Case Manager (CCM) certification Oncology Experience Bilingual in English and a 2nd language Education: Associates Degree in Nursing required. BSN preferred.

Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. Through the use of clinical tools and information/data review, conducts an evaluation of member’s needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. Assessments consider information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. Reviews prior claims to address potential impact on current case management and eligibility. Assessments include the member’s level of work capacity and related restrictions/limitations. Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality. Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management. Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.

Centene Corporation

Care Manager (RN)

Posted on:

March 14, 2026

Job Type:

Full-Time

Role Type:

Care Management

License:

RN

State License:

Compact / Multi-State

Centene Corporation is a leading healthcare enterprise committed to helping people live healthier lives. Centene offers affordable and high-quality products to more than 1 in 15 individuals across the nation, including Medicaid and Medicare members (including Medicare Prescription Drug Plans) as well as individuals and families served by the Health Insurance Marketplace. Centene believes healthcare is best delivered locally. Our local health plans provide fully integrated, high-quality, and cost-effective services to government-sponsored and commercial healthcare programs, focusing on under-insured and uninsured individuals. Centene’s hiring practices reflect the composition of the members and communities we serve, allowing us to deliver quality, culturally sensitive healthcare to millions of members. Centene employees help change the world of healthcare and transform our communities. To learn more about career opportunities with Centene, visit: https://jobs.centene.com/

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Location Requirement: Candidates must reside in Middlesex or Union County, New Jersey to be eligible for consideration. This position requires up to 50% local travel within the designated region. Work Schedule: Monday–Friday, 8:00 AM – 5:00 PM Position Purpose: Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families.

Education/Experience: Requires a Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing and 2 – 4 years of related experience. License/Certification: RN - Registered Nurse - State Licensure and/or Compact State Licensure required

Evaluates the needs of the member, barriers to accessing the appropriate care, social determinants of health needs, focusing on what the member identifies as priority and recommends and/or facilitates the plan for the best outcome Develops ongoing care plans / service plans and collaborates with providers to identify providers, specialists, and/or community resources to address member's unmet needs Identifies problems/barriers to care and provide appropriate care management interventions Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and appropriate person-centered care or services Provides ongoing follow up and monitoring of member status, change in condition, and progress towards care plan / service plan goals; collaborate with member, caregivers, and appropriate providers to revise or update care plan / service plan as necessary to meet the member's goals / unmet needs Provides resource support to members and care managers for local resources for various services (e.g., employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans, as appropriate Facilitate care management and collaborate with appropriate providers or specialists to ensure member has timely access to needed care or services May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators Provides and/or facilitates education to members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner Other duties or responsibilities as assigned by people leader to meet business needs Performs other duties as assigned. Complies with all policies and standards.

CVS Health

A1A Case Manager RN - Registered Nurse - OH

Posted on:

March 14, 2026

Job Type:

Full-Time

Role Type:

Case Management

License:

RN

State License:

Compact / Multi-State

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.

This RN Case Manager role is part of Aetna One Advocacy (A1A) and requires in office training and ongoing work in New Albany, Ohio. There is a requirement to live within a commutable distance of New Albany, Ohio (typically within 45 minutes maximum). The expected start date for the cohort is May 11, 2026. The initial in office training will last for approximately 4 months. Once office training is complete, the role is work from home with occasional in office workdays scheduled in advance with the employee. There will be an expectation that the Case Manager works in the office at least one time per quarter for further training but it may be more often and notice will be provided. Normal Working Hours: 8am-4:30pm EST. Once training is completed, the Case Manager will work occasional later shifts per month on a team rotation. There are no weekend shifts. Flexibility is required for onsite work shifts per the need of the business. What is A1A? Aetna One Advocate is Aetna’s premier service and clinical offering for Aetna nation-wide and creates industry-leading solutions for our customers and members. The model is a fully integrated population health and customer service solution for large plan sponsors. The high-touch, high-tech member advocacy service combines data-driven processes with the expertise of highly trained clinical and concierge member services. Our mission is to meet each member at every aspect of their health care journey. Our embedded customer-dedicated service and clinical pods allow maximization of inbound and outbound touchpoints to solve members’ needs and create behavior change. Our data analytics, white-glove service and end-to-end ownership of member support creates a trusted partner in health. This is an exciting time to join Aetna, a CVS Health company, in our journey to change the way healthcare is delivered today. We are health care innovators. The RN Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness.

Required: A Registered Nurse that must hold an unrestricted license in their state of residence, preferably with multi-state/compact privileges and be willing and able to be licensed in all non-compact states Upon hire, it will be required to obtain all 50 state licenses. 3+ years of clinical practice experience required as an RN There is a requirement to live within a commutable distance of New Albany, Ohio (typically within 45 minutes maximum). Preferred: Case Management in an integrated model Certified Case Manager (CCM) certification Oncology Experience Bilingual in English and a 2nd language Education: Associates Degree in Nursing required. BSN preferred.

Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. Through the use of clinical tools and information/data review, conducts an evaluation of member’s needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. Assessments consider information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. Reviews prior claims to address potential impact on current case management and eligibility. Assessments include the member’s level of work capacity and related restrictions/limitations. Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality. Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management. Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.

Motion Recruitment

Virtual Care Nurse Practitioner (APRN)

Posted on:

March 14, 2026

Job Type:

Full-Time

Role Type:

Telehealth

License:

NP/APP

State License:

Compact / Multi-State

Job Title: Virtual Care Nurse Practitioner (APRN) Location: Remote (United States) *Must be located/authorized to work in the US without visa sponsorship or transfer now or in the future. No C2C inquiries, please* This emerging health tech startup is dedicated to reshaping how patients with chronic inflammatory and environmentally triggered illnesses are diagnosed and supported. By integrating advanced diagnostic tools with empathetic, technology-enabled care, the company is creating a patient-centered platform that delivers meaningful relief for individuals facing complicated and often unseen health challenges. They are seeking an innovative, technology-driven Nurse Practitioner (APRN) to become part of the clinical team and contribute to the evolution of care for chronic inflammatory illnesses. As a key contributor, you will provide specialized treatment to patients during initial launch stages and then nationwide. Your clinical expertise will be instrumental in enhancing care protocols and driving innovation across telehealth products and digital platforms.

APRN certification from an accredited program Current APRN license in good standing across at least 15 states Background working in fast-moving environments Ability to effectively manage a large volume of patient interactions Skilled in telehealth systems and digital care platforms Adaptable and comfortable integrating new technologies in a scaling organization At least 3,600 hours of supervised, in-person clinical practice under a physician Demonstrated confidence in delivering remote care and coordinating digital follow-up Bonus points for: NLC (Nurse Licensure Compact) licensure APRN licensure across all 50 states Prescriptive authority in your licensed states

Deliver remote care during video consultations and asynchronous messaging, in alignment with the company’s evidence-based standards and clinical protocols Perform thorough evaluations, including detailed symptom assessment and medical history review Order diagnostic testing and initiate prescriptions as appropriate Support the refinement and expansion of clinical guidelines and digital health solutions

w3r Consulting

LPN Care Coordinator

Posted on:

March 14, 2026

Job Type:

Contract

Role Type:

Care Management

License:

LPN/LVN

State License:

Compact / Multi-State

w3r Consulting is an award-winning, best-in-class IT consulting and management company that delivers enterprise solutions at the intersection of innovation and ingenuity. Organizations throughout the healthcare payor, financial services, and professionals and business services sectors turn to w3r for a strategic, IT-fueled advantage that elevates their stature and capabilities in competitive global markets. As a minority-owned business, w3r brings diverse and multifaceted people from across different backgrounds and life experiences to the table, unlocking the power of unique perspectives and inventive ideas to help clients achieve their evolving goals.

This position is responsible for conducting home health assessment, contacting identified members to inform and educate them on health care programs to address their personal health plan needs, engaging the member in discussion of adherence to personal health plans, responding to inquiries from members, and supporting the clinicians in the Medical Management department with their provider and member activities.

Bachelor of Social Work or Psychology OR LVN, LPN with 1 year experience in managed care systems OR RN OR 3 years care coordination for a state managed or waiver program OR 3 years managed care systems experience. Knowledge of medical terminology Experience coordinating member medical related needs, providing assistance to members, and analyzing member needs PC proficiency including Microsoft Office applications Customer service skills Verbal and written communications skills including developing written correspondence to members and to other department personnel and coaching skills, including motivational interviewing, to educate members on medical issues Current state driver license, transportation, and applicable insurance Ability and willingness to travel

Responsible for home health assessments and system updates. Perform outreach and follow up attempts to members on their health care plan. Build relationships with members to encourage compliance with care plans and to alert the Case Manager quickly when issues arise Inform and educate members on their program, may use supplied scripts. Complete records in system by performing data entry. Encourage member usage of our programs, including arranging appointments and additional member services (e.g., transportation). Generate appropriate correspondence and send to member manually, electronically, or telephonically. Conduct check-ins with members to review individual care plan goals. Maintain production requirements based on established department business needs. Provide support to the clinical team by performing the non-clinical functions (as identified by the business process) necessary to generate, manage, and close a case within the platform. Receive, analyze, conduct research and respond to telephone and/or written inquiries. Process information from member or provider to determine needs/wants and ensure customer questions have been addressed. Respond to customer or send to appropriate internal party. Notify help desk of system issues. Perform data entry function to update customer or provider information. Obtain required or missing information via correspondence or telephone. May serve as contact for the various groups regarding claims which involves conducting research, obtaining medical records/letters of medical necessity from TMG, reopen or initiate new cases as needed and refer case to clinicians. Support and maintain communications with various in-house areas regarding groups? concerns, i.e.: Marketing, Provider Affairs, and SSD. Communicate and interact effectively and professionally with co-workers, management, customers, etc. Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies. Maintain complete confidentiality of company business. Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.

Northwestern Memorial Hospital

Remote Triage RN - Clinical Contact Center, Part-time, Rotating (Must reside in IL, IN, IA, WI, OH, MO, MI, or FL)

Posted on:

March 14, 2026

Job Type:

Part-Time

Role Type:

Triage

License:

RN

State License:

Compact / Multi-State

Northwestern Medicine is the collaboration between Northwestern Memorial HealthCare and Northwestern University Feinberg School of Medicine around a strategic vision to transform the future of healthcare. It encompasses the research, teaching, and patient care activities of the academic medical center. Sharing a commitment to superior quality, academic excellence and patient safety, the organizations within Northwestern Medicine comprise a combined workforce of more than 30,000 among clinical and administrative staff, medical and science faculty and medical students. Northwestern Medicine is comprised of more than 100 locations throughout the region, anchored by the #1 hospital in Illinois as ranked by U.S. News & World Report. What makes us better, makes you better.

The Triage RN, Access reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. The Triage RN, Access provides clinically expert virtual triage service. In their role, the triage nurses serve as a liaison between the patient and their physician by assessing the presenting problem or chief complaint, utilizing targeted evidence based triage protocols to identify acuity and develop appropriate care advice and next-step recommendations. Remote work from Illinois, Wisconsin, Indiana, Missouri, Iowa, or Ohio

Required: Graduate of accredited RN program 2 years of ambulatory care experience Registered Nurse License issued by State of Illinois Current AHA BLS Provider certification Preferred: BSN Specialty certification upon eligibility

Triage nurses must demonstrate excellent customer service and communication skills and the ability to function as part of a highly effective team that consistently puts Patients First. Establish positive first impressions with patients and customers, establishing a role as patient advocate Triage all incoming telephone calls and electronic messages, prioritizing and resolving, involving the provider as appropriate, successfully completing the communication cycle. Incorporates critical thinking to develop, implement and update an individualized plan of care based on identified patient care and learning and needs Asks key questions to gain insight into the patient’s clinical condition and able to adjust approach as needed to get necessarily information Document all communications in the electronic medical record Schedules patient for visit with provider as appropriate based upon protocols Follows triage protocols in place for the department Assist in scheduling appointments for patients with providers within NM. Assist in orientation of new staff members. Assist in specific process improvement projects Participates in departmental quality improvement activities Uses effective service recovery skills to solve problems or service breakdowns when they occur

Humana

Vendor Management Lead (Registered Nurse)

Posted on:

March 13, 2026

Job Type:

Full-Time

Role Type:

Leadership / Management

License:

RN

State License:

Compact / Multi-State

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

The Vendor Management Lead (RN) oversees vendor management operations from a market perspective, ensuring alignment with Humana’s clinical and operational standards. This role directs a team of RN professionals, fosters effective vendor and provider relationships, and drives resolution of clinical and operational issues to support quality care and compliance. The Vendor Management Lead (RN) is responsible for overseeing the vendor management functions from a market perspective, ensuring alignment between Humana’s business and clinical operations, vendor partners, and providers. This role provides strategic direction, leadership, and support to a team of Senior Vendor Management Professionals (RN), facilitating effective issue resolution, gap identification, and process optimization to advance quality care and operational excellence. This leader will build positive strategic partnerships with Contracting to align on Institutional Special Needs Plan providers and have oversight of SNF provider network and optimization from the clinical perspective. This role will also work with Provider Engagement to monitor outcomes for Value Based and Delegated Services Providers.

Use your skills to make an impact: Active and unrestricted Compact license (RN) license required Prior experience in a healthcare or insurance setting 5 + years of Utilization Management experience 3 + years of vendor management and/or process or project management experience Demonstrated ability to define and track KPIs and/or service level agreement metrics and other measurable success criteria Proven verbal and written communication skills with the ability to interact effectively across all organizational levels Ability to break down complex problems into actionable steps Demonstrated critical thinking and analytical problem-solving skills Exceptional relationship management skills Demonstrates accuracy and thoroughness, identifies process improvements Proficient in Microsoft Office applications including Word, Excel and PowerPoint Advanced facilitation skills with experience leading cross-functional discussions Preferred Qualifications: Master's Degree Knowledge of claims processes Knowledge of Stars and HEDIS Knowledge of clinical quality benchmarks and reporting requirements for value base providers Certification with Six Sigma and/or the Project Management Institute Knowledge of Medicare Advantage Grievance and Appeals experience Additional Information This position will require 5-15% travel within the market. Work-At-Home Requirements WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. Satellite and Wireless Internet service is NOT allowed for this role. A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Provide strategic leadership and guidance to the Senior Vendor Management Professional (RN) team, ensuring effective execution of vendor management initiatives in accordance with Humana’s policies and regulatory requirements. Oversee and optimize vendor relationships, including performance monitoring, compliance management, and the resolution of complex operational and clinical issues. Facilitate collaboration between Humana, vendor partners, and providers, ensuring clear communication channels and the successful implementation of market-based strategies. Support the review of clinical authorizations and ensure consistency with established guidelines for various levels of care, leveraging clinical expertise and best practices. Identify systemic gaps and process improvement opportunities across vendor partnerships, developing and implementing action plans to close gaps and enhance service delivery. Analyze market trends, operational data, and vendor performance metrics to inform decision-making and drive continuous quality improvement. Ensure adherence to privacy, security, and enterprise information protection protocols, escalating issues as appropriate and maintaining compliance with internal procedures. Mentor and develop team members, fostering a culture of accountability, collaboration, and professional growth. Participate in strategic planning, vendor selection, and contract negotiations as needed, ensuring alignment with organizational objectives and clinical standards. Represent the vendor management function in cross-functional meetings, audits, and enterprise initiatives.

ARCHER

1099 Legal Nurse Consultant

Posted on:

March 13, 2026

Job Type:

Part-Time

Role Type:

Clinical Operations

License:

RN

State License:

Texas

ARCHER Systems is a leading technology enabled legal services company that provides pre-settlement and post-settlement administration services for single event, mass tort, and class action cases with the goal of helping claimants access their settlement proceeds more efficiently and quickly. The company plans to continue leveraging technology and top tier talent to enhance customer service and offer new product lines and services. ARCHER’s core offering is post-settlement Healthcare Lien Resolution Administration and QSF (Qualified Settlement Fund) Administration and payments processing for multi-claimant (mass tort and class action) litigation. Other services include claims administration, single event lien resolution, probate and bankruptcy coordination, release administration, medical records review, and plaintiff fact sheet and other intake/census preparation and management. ARCHER enables law firms to focus on their litigation while ensuring that critical pre-settlement and post-settlement administration documents, services, business analytics and reporting are handled efficiently and effectively.

The Legal Nurse Consultant works collaboratively with the Pre‑settlement and Claims Administration teams to perform clinical reviews of medical information based on case‑specific methodologies. Responsibilities may include preparing chronologies and timelines, developing medical summaries, applying mass‑tort‑specific medical matrix criteria, and offering clinical opinions relevant to case validity and valuation. Location: Remote

SKILLS & QUALIFICATIONS: Proficiency in Microsoft Word, Adobe, and Excel Strong ability to analyze, prioritize, and evaluate complex medical information Effective team collaborator with the ability to work across all levels of staff to meet business goals Ability to manage multiple priorities, work under pressure, and meet strict deadlines Working knowledge of healthcare data analysis and clinical review principles Detail oriented, organized, and capable of managing multiple tasks simultaneously 1–3 years of medical review experience required Strong computer skills across multiple software platforms, including (but not limited to) healthcare charting systems REQUIRED CERTIFICATION: Active Registered Nurse License (RN) or other applicable medical license MINIMUM EDUCATION: Associate Degree in Nursing (ADN) or nursing diploma required Bachelor’s degree in nursing (BSN) preferred REQUIRED EQUIPMENT: Windows PC running Windows 11 with 16GB RAM and 5GB available hard drive space or Apple MacBook (Pro or Air) running Tahoe or newer with 16GB RAM and 5GB available hard drive space. Cell phone with Microsoft Authenticator installed. Secure high speed internet connection

Analyze and summarize medical records for both pre settlement and post settlement projects Apply knowledge of pharmaceutical, mass tort, and product liability cases (experience preferred) Assist with the transcription, editing, and formatting of physician reviews Ensure all work is completed within contractual deadlines and that deliverables meet all required components Deliver final work product in accordance with client specific guidelines Communicate effectively with internal teams and external stakeholders regarding case reviews Evaluate, identify, and report on medical care issues and other relevant findings Participate in project data analysis, reporting processes, and continuous feedback cycles

Hope Hospice

LVN Triage - REMOTE

Posted on:

March 13, 2026

Job Type:

Full-Time

Role Type:

Triage

License:

LPN/LVN

State License:

California

We have been a trusted community resource since 1980. Our reputation has been built on consistency, responsiveness, and quality. As a non-profit, community-led agency, we are able to focus on providing quality care to patients and families when they need it most, rather than being driven by profit or financial demand.

The LVN Triage Nurse is responsible for triaging patients, families, physicians and other calls related to the delivery of care and services. They are also responsible for processing and coordinating inquiries for referrals. The LVN Triage Nurse will receive phone calls from Hospice patients and families and coordinate the care needed and/or schedule home visits as needed. The triage nurse will collaborate with the interdisciplinary team (IDT) members and facilitate communication among the IDT, Hospice, and the patient’s Attending Physician as needed. Schedule: Tuesday - Saturday; 9:30am - 6:00pm Location: Remote

Education/Experience: Completion of a Licensed Vocational Nursing Education Program from an accredited school Minimum of one year of LVN experience preferably in an acute care setting. Hospice or palliative care experience preferred Computer proficiency in Microsoft Office, preferred Experience working effectively with an interdisciplinary group Certificates, Licenses, Registrations: Current license as a licensed vocational nurse in the State of California

Receives patient-related calls or communication and provides appropriate patient teaching, assistance and instruction on symptom management Collaborate and report to hospice field clinical staff or CTM or AOC about patient needs Provide information regarding services to referral sources as needed Serve as a member of the hospice clinical team to address problems associated with the delivery of patient care Schedule patient visits as needed

Molina Healthcare

RN Care Manager (Telephonic Case Management) - Remote in Nebraska

Posted on:

March 13, 2026

Job Type:

Full-Time

Role Type:

Telehealth

License:

RN

State License:

Nebraska

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.

At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience. Registered Nurse (RN). License must be active and unrestricted in state of practice. Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law. Understanding of the electronic medical record (EMR) and Health Insurance Portability and Accountability Act (HIPAA). Demonstrated knowledge of community resources. Ability to operate proactively and demonstrate detail-oriented work. Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations. Ability to work independently, with minimal supervision and self-motivation. Responsiveness in all forms of communication, and ability to remain calm in high-pressure situations. Ability to develop and maintain professional relationships. Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change. Excellent problem-solving, and critical-thinking skills. Strong verbal and written communication skills. Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases. Preferred Qualifications: Certified Case Manager (CCM).

Completes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals. Conducts telephonic, face-to-face or home visits as required. Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. Maintains ongoing member caseload for regular outreach and management. Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care. Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration. Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts. Assesses for barriers to care, provides care coordination and assistance to member to address concerns. May provide consultation, resources and recommendations to peers as needed. Care manager RNs may be assigned complex member cases and medication regimens. Care manager RNs may conduct medication reconciliation as needed. 15% estimated local travel may be required (based upon state/contractual requirements).

TEKsystems

Registered Nurse - SIU Experience REQUIRED

Posted on:

March 13, 2026

Job Type:

Contract

Role Type:

Clinical Operations

License:

RN

State License:

Illinois

We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

Clinical Quality Assurance Coordinator – SIU Division Location: Remote Experience Level: Intermediate Overview We are seeking detail‑oriented and clinically strong Registered Nurses (RNs) or Licensed Vocational/Practical Nurses (LVNs/LPNs) to join our client’s Special Investigative Unit (SIU) as Clinical Quality Assurance Coordinators . In this role, you will support the review of medical services, validate accuracy, and ensure compliance with policies, criteria, and fraud‑waste‑abuse (FWA) standards. You will partner closely with Client Coordinators who process applications and referrals, then rely on you to complete the clinical quality review and communicate findings back to clients.

SIU Division Requirements: Experience in Group Health SIU or similar investigative environments. Strong understanding of Fraud, Waste, and Abuse (FWA) detection and investigative methods. Solid working knowledge of CPT, HCPCS, ICD‑10 codes and billing/payment policies. Ability to identify clinical and billing irregularities with precision. Required Skills: Quality assurance and clinical analysis Nursing documentation software Understanding of insurance policies and clinical documentation Strong written and verbal communication Ability to interpret clinical information and apply criteria accurately

Conduct detailed quality assurance reviews of processed referrals and applications. Verify accuracy of surgeon selection, specialty alignment, and State Insurance usage. Confirm that requested services were completed exactly as ordered—no more, no less. Assess whether services met clinical policies, criteria, and medical necessity. Identify irregularities such as upcoding, unbundling, incorrect modifier usage, or unusual billing patterns. Prepare clear, grammatically accurate reports summarizing findings and clinical rationale. Communicate results to clients via phone and email with professionalism and clarity. Manage quick‑turnaround cases and prioritize workload effectively.

Thyme Care

Complex Oncology Nurse Navigator (11:30AM - 8:00PM EST)

Posted on:

March 13, 2026

Job Type:

Full-Time

Role Type:

Care Management

License:

RN

State License:

Compact / Multi-State

We exist to create a more connected, compassionate, and confident experience for people with cancer and those who care for them. We make it easier to get answers, access high-quality care quickly, and feel supported throughout treatment and beyond. Today, Thyme Care is a market-leading value-based oncology care enabler, partnering with national and regional health plans, providers, and employers to deliver better outcomes and lower costs for thousands of people across the country. Our model combines high-touch human support with powerful technology and AI to bring together everyone involved in a person's cancer journey: caregivers, oncologists, health plans, and employers.As a tech-native organization, we believe technology should strengthen the human connection at the center of care. Through data science, automation, and AI, we simplify complexity, improve collaboration, and help care teams focus on what matters most: supporting people through cancer. Looking ahead, our vision is bold: to become a household name in cancer care, where every person diagnosed asks for Thyme Care by name. If you're inspired to make cancer care more human and to help reimagine what's possible, we'd love to meet you. Together, we can build a future where every person with cancer feels truly cared for, in every moment that matters.

Thyme Care Inc., the management company to Thyme Care Medical PLLC, is the employing entity with your duties to be performed for Thyme Care Medical PLLC, a medical practice, and its patients. As a Complex Oncology Nurse Navigator, you will be on the frontlines serving our members diagnosed with cancer. This role reports to our RN Care Team Lead. In it, you will conduct clinical assessments, monitor for changes in health, coordinate care, including transitions, and educate members and caregivers about their diagnosis and treatment over the phone to support our higher-acuity members as they move through the oncology care continuum. You will demonstrate a strong clinical focus that supports the need for culturally competent care. Additionally, you will help improve Thyme Care's service offerings by communicating member and provider feedback to our clinical leadership. You will also assist with other administrative projects as needed. This role can be remote or hybrid-based in our Nashville office. Most of your day will be dedicated to speaking with members and handling clinical escalations and tasks. We maintain a schedule that includes your lunch and breaks to ensure sufficient clinical coverage.

A member-first approach. You're personally motivated by our mission and by what we are building. You seek to understand problems and help people solve them, especially this one. A BSN. You have a Bachelor of Science Degree in Nursing, a compact unrestricted Registered Nurse (RN) license, and a willingness to obtain additional state licenses as needed. Experience. You have at least 5 years of nursing experience with 3 years of high-acuity, adult oncology experience. Additionally, you are certified as an Oncology Certified Nurse (OCN), Advanced Oncology Certified Nurse (AOCN), Advanced Oncology Certified Nurse Specialist (AOCNS), or Certified Case Manager (CCM). Organized. You're skilled in juggling multiple tasks and working under pressure without sacrificing organization in your communications and documentation. Effective listener and communicator. You are winsome and articulate, but you always start with listening and hearing what may not be voiced because you listen intently to others. You build rapport and great working relationships with members and colleagues. Comfort with ambiguity. Start-ups are fast-paced environments, and you understand that rapid changes to the business, strategy, organization, and priorities are par for the course… and part of the adventure. A desire to learn how to use new technologies. We are a technology company focused on interacting with folks during the season when they need it most. Experience with video chatting, Google Suite, Slack, electronic health records, or comfort in learning new technology is important. Experience with working remotely and a willingness to learn new technology are required. Identify priorities and take action. You know how to identify and prioritize a member's needs and do what it takes to address urgent and important needs immediately.

Have completed training and are up to speed on Thyme Care systems, tools, technology, partners, and expectations. Have built strong, trusting relationships with your members, where listening and empathy are the foundation for every interaction. Be comfortable following Care Team policies and procedures, escalation pathways, communications best practices, and documentation standards. Your ability to effectively engage and support our members is reflected in our efficiency metrics and quality standards. Identify and prioritize a member's needs and help them remain safe in the community. Assist members with care coordination and care management following admissions. Coordinate discharge plans with hospital case managers and follow-up care with providers. Monitor member progress, provide regular updates, and establish targeted support plans with the healthcare team in case conferences. Build strong, trusting relationships with payers and providers to optimize care and prevent readmissions for our members. Partner with non-clinical Care Team members to support the member's social determinants of health needs, such as food resources, transportation access, and support at home. Conducting telephonic assessments, including pain assessments and medication reconciliation. Ensure members have access to medications and appointments, providing referrals and support as appropriate. Perform virtual home safety evaluations and assess the need for DME/supplies. Provide referrals to PT, OT, skilled nursing, palliative care, hospice care, etc., as appropriate. Be available for urgent clinical escalations and clinical consult support.