Momentum Life Sciences

Bilingual (Spanish) Virtual Clinical Educator (Remote)

Posted on:

April 15, 2025

Job Type:

Full-Time

Role Type:

Clinical Operations

License:

RN

State License:

Indiana

**This posting is for future opportunities with Momentum Life Sciences** The Bilingual (Spanish) Virtual Clinical Educator is responsible for utilizing professional clinical skills, including the ability to foster patient relationships through empathy and clinical experience, to provide personalized, high-touch support to patients recently prescribed a complex therapy. The role will engage with patients and providers to provide expert, clinically relevant, individualized counsel in conjunction with product support the new therapy regimen. The VCE will manage a series of touch points as the trusted clinical advocate to a specified patient caseload. The touch points will uncover patient barriers and internal motivators, taking patients from product onboarding to therapy initiation to milestone celebrations, motivation, maintenance, and eventual “graduation” from the program. This role will work collaboratively to enhance the patient start experience and support patient compliance and persistence initiatives by building individual relationships with patients. The educator will provide ongoing education and therapy support to the patient, their caregiver, clinical staff, and/or support network.

Registered Nurse with current, unrestricted license Previous telephonic patient support environment experience, including use of an inbound/outbound call system, with seamless warm transfers HCP and/or Patient education experience, including infusion or injection experience required Compassion, high emotional intelligence, and a passion to be a patient educator Strong communication and written skills to a variety of audiences, and experience working with a treatment team Proven adaptability to changing business demands and problem solving in a fast-paced environment Competent and comfortable utilizing technology Experience working for or contracting with pharmaceutical preferred Experience in motivational interviewing and coaching behavior change Ability to work within established guardrails while maintaining personal rapport with the patient Self-starter with proven adaptability to changing business demands and product relevance in a fast-paced environment Ability to actively listen while multi-tasking High level of comfort with technology, including Microsoft Office products, working on dual monitors, CRM, and strong typing skills are required #LI-Remote

Serves as the single point of contact in the treatment process from start to finish Demonstrates empathy and effectively engages patients, creating a personalized relationship-based connection built on trust and rapport Provide disease education, product overview, device training, and side effect management Proactively reaches out to the patient to provide high-touch support to connect the dots for the patient throughout their program journey Create patient empowerment through a series of “wow” engagements along the patient journey Utilize motivational interviewing tools to quickly and accurately anticipate and address patient barriers; personalize patient messaging concisely, within established time parameters, and in a way that resonates Communicate effectively; understand and influence patient initiation and support processes, encourage patient confidence and accountability to help patients start and stay on therapy Ensure success of program through collaborative partnerships with patients, brand, and operations partners Use intuition and clinical expertise to offer patients appropriate responses to their questions; discern the most beneficial information for the patients; accurately assess patients using provided guidelines outlined in approved messaging Ensure the patient is aware of all the patient services available to them and assisting to connect them to the right resource Connect the patient to local support groups, advocacy groups, and other external resources Provide health coaching throughout the journey to support adherence and compliance to medication Provide assistance and guidance through access and affordability journey Provide HCP feedback to keep them aware of the patient’s participation in the support program Provide education to the care team and proactively reaching out after the clinical decision has been made to start a new patient on regimen Triage and follow-up with Specialty Pharmacy to support patient getting product and knowing where product is in process Provide continuous updates, guidance, and triaging when needed and most importantly ensuring that the patient is driving towards the right health outcomes. Ensure all activities are conducted in a manner that is compliant with all Momentum, client, and industry mandated rules and regulations

Momentum Life Sciences

Full Time Virtual Clinical Educator (11-8p EST) (Remote)

Posted on:

April 15, 2025

Job Type:

Full-Time

Role Type:

Clinical Operations

License:

RN

State License:

Indiana

**This role will be covering the the hours of 11-8p EST, Monday through Friday** The Virtual Clinical Educator is responsible for utilizing professional clinical skills, including the ability to foster patient relationships through empathy and clinical experience, to provide personalized, high-touch support to patients recently prescribed a complex therapy. The role will engage with patients and providers to provide expert, clinically relevant, individualized counsel in conjunction with product support the new therapy regimen. The VCE will manage a series of touch points as the trusted clinical advocate to a specified patient caseload. The touch points will uncover patient barriers and internal motivators, taking patients from product onboarding to therapy initiation to milestone celebrations, motivation, maintenance, and eventual “graduation” from the program. This role will work collaboratively to enhance the patient start experience and support patient compliance and persistence initiatives by building individual relationships with patients. The educator will provide ongoing education and therapy support to the patient, their caregiver, clinical staff, and/or support network.

Registered Nurse with current, unrestricted license Previous telephonic patient support environment experience, including use of an inbound/outbound call system, with seamless warm transfers HCP and/or Patient education experience, including infusion or injection experience required Compassion, high emotional intelligence, and a passion to be a patient educator Strong communication and written skills to a variety of audiences, and experience working with a treatment team Proven adaptability to changing business demands and problem solving in a fast-paced environment Competent and comfortable utilizing technology Experience working for or contracting with pharmaceutical preferred Experience in motivational interviewing and coaching behavior change Ability to work within established guardrails while maintaining personal rapport with the patient Self-starter with proven adaptability to changing business demands and product relevance in a fast-paced environment Ability to actively listen while multi-tasking High level of comfort with technology, including Microsoft Office products, working on dual monitors, CRM, and strong typing skills are required #LI-Remote

Serves as the single point of contact in the treatment process from start to finish Demonstrates empathy and effectively engages patients, creating a personalized relationship-based connection built on trust and rapport Provide disease education, product overview, device training, and side effect management Proactively reaches out to the patient to provide high-touch support to connect the dots for the patient throughout their program journey Create patient empowerment through a series of “wow” engagements along the patient journey Utilize motivational interviewing tools to quickly and accurately anticipate and address patient barriers; personalize patient messaging concisely, within established time parameters, and in a way that resonates Communicate effectively; understand and influence patient initiation and support processes, encourage patient confidence and accountability to help patients start and stay on therapy Ensure success of program through collaborative partnerships with patients, brand, and operations partners Use intuition and clinical expertise to offer patients appropriate responses to their questions; discern the most beneficial information for the patients; accurately assess patients using provided guidelines outlined in approved messaging Ensure the patient is aware of all the patient services available to them and assisting to connect them to the right resource Connect the patient to local support groups, advocacy groups, and other external resources Provide health coaching throughout the journey to support adherence and compliance to medication Provide assistance and guidance through access and affordability journey Provide HCP feedback to keep them aware of the patient’s participation in the support program Provide education to the care team and proactively reaching out after the clinical decision has been made to start a new patient on regimen Triage and follow-up with Specialty Pharmacy to support patient getting product and knowing where product is in process Provide continuous updates, guidance, and triaging when needed and most importantly ensuring that the patient is driving towards the right health outcomes. Ensure all activities are conducted in a manner that is compliant with all Momentum Life Sciences, client, and industry mandated rules and regulations

Momentum Life Sciences

Call Center Nurse Case Manager (Remote)

Posted on:

April 15, 2025

Job Type:

Full-Time

Role Type:

Case Management

License:

RN

State License:

Indiana

**Assigned shift: 12-9p EST** The Nurse Case Manager will provide ongoing contact center and virtual support as an integral part of the patient support services provided for patients prescribed an oral therapy for narcolepsy and idiopathic hypersomnia. The Nurse Case Manager will be responsible for utilizing professional nursing skills, ability to foster patient relationships, strong empathy, and clinical experience to provide ongoing personalized high-touch telephonic support to patients . The role will engage with patients and their caregivers to provide clinically relevant individualized education in conjunction with product support. The Nurse Case Manager will leverage their knowledge while combining technical expertise to deliver best-in-class support, customer service, and ongoing education to these unique patients and their caregivers. The Nurse Case Manager will also partner closely with cross-functional stakeholders, including Field Nurse Educators, to ensure continuity of care and escalation as appropriate across teams

Required Education and/or Experience: Associate’s degree in nursing with patient education experience Experience working for (or contracting with) a pharmaceutical company within a contact center environment, a minimum of 2 years Preferred Education and/ or Experience: Bachelor’s Degree Required License and/or credential(s): Current, unrestricted RN or NP license Required Skills: Background in neurological conditions and/or rare disease Demonstrated ability to collaborate with numerous cross-functional partners/key stakeholders to deliver an optimized patient experience High emotional intelligence and ability to exhibit empathy to meet each patient where they are Strong clinical skills and experience with medication compliance, specialty pharmacy knowledge, and motivational interviewing Desire and ability to create individualized relationships with patients as they progress through their journey Ability to communicate clearly about complex information in a way that resonates with patients Optimistic, upbeat, and enthusiastic in times of challenge and constant change. Ability to deliver outstanding patient experience. Demonstrate experienced competency and ability to independently navigate technology using multiple platforms, computer screens, and other technical components. (Ex: virtual engagement platforms, Telephony Systems, CRM tools, Microsoft Suite) Advanced knowledge of written and verbal communication skills and problem-solving technique Detail-oriented, highly organized, and able to work through ambiguity Able to work independently with minimal supervision, self-motivated Ability to maintain cases and complete calls on time Ability to maintain compliant conversations and documentation in a high-volume role Ability to maintain patient confidentiality by using the headset during all conversations, maintaining a private environment for home office without distraction

Provide telephonic support via inbound and outbound calls, virtual calls, and omnichannel support through email, chat, and text Demonstrate strong empathy and high emotional intelligence to engage patients with complex health conditions effectively, creating an individual relationship-based connection built on trust and rapport Provide instruction and education about treatment/therapy, and connect patients with additional resources when needed while partnering with the Field Nurse Educators, HUB (Certified Pharmacy) and other key stakeholders to ensure the patient feels supported and confident from initiation through any transitions in their therapy journey Collaborate and work cohesively within a POD structure (with VMS Field Nurse Educator team) to identify gaps, barriers, and opportunities to improve process and overall patient experience Communicate complex information effectively and empathetically to patients and their caregivers Accurately complete patient engagements based on provided criteria Identify the root cause for any potential barriers the patients experience in adhering to the therapy through a motivational interviewing model Understand and coach patient initiation and support processes while encouraging patient confidence to help start and stay on therapy Ensure the success of the program through collaborative partnerships with patients, brand, and operational partners Provide your manager constructive patient feedback on the product, patient, and industry insights to enable enhancements. Reporting Adverse Event Product Quality Complaint (AEPQC) reporting per VMS and client policy Ensure all activities are conducted in a manner that complies with all VMS, client, and industry-mandated rules and regulations.

Athletico

Occ Health RN Telephone Triage - Full-Time - Day Shift (Remote)

Posted on:

April 15, 2025

Job Type:

Full-Time

Role Type:

Triage

License:

RN

State License:

Compact / Multi-State

Athletico’s Greater Purpose is to empower people, inspire hope and transform lives. We accomplish this by providing exceptional, progressive, and cost-effective fitness, performance and rehabilitative services through personalized care that emphasizes education and prevention of future injury. This is accomplished through building on our Core Values of one team, understanding our business, recognition, people-focused, accountability, continuous innovation and trust and integrity, which are the foundation for our unique culture.

Pivot Onsite Innovations is now hiring an experienced and passionate Remote Triage Registered Nurse (RN) for our healthcare clinic located at our client's manufacturing plants. This is your opportunity to step out of a traditional nurse setting and make your impact on employee health, wellness and safety! Great schedule: Monday - Friday 6AM to 2PM. Position Summary: The Remote Occupational Health Nurse is responsible for utilizing evidence-based guidelines to employ best practices that require early intervention and setting of realistic expectations for recovery and return to work.

Education: Associate’s Degree in Nursing required, BSN preferred Work Experience: Min 2 years in occupational health preferred Telephonic case management experience preferred Certification/Licensure: Current Compact RN License required Maintain Enhanced Nurse Licensure Compact (eNLC) and reside in a compact state Adhere to the requirements and time frames of licensure in all other states Knowledge and Technical Skills: Strong clinical knowledge in Occupational Health Nursing Positive telephone interaction skills including ability to ask open-ended questions to identify problems and focus conversation for goal directed and time limited conversation Ability to effectively interact with HR, safety staff, local medical providers and other designated personnel for proper initiation and follow-up of possible work-related injuries and illnesses Excellent written and oral communication skills and computer skills Competence with Windows operating system environment, Adobe Professional, Microsoft Office Suite (Outlook, Word, Excel and PowerPoint) and learn other software as needed Language Skills: Ability to read, write and speak English proficiently Bi-lingual (Spanish speaking) beneficial Physical Demands: Ability to fulfill office activities including but not limited to remain stationary for extended periods of time (i.e., while working at a desk), stand/stoop/kneel/crough/stretch, bending and stretching, communicate with others (verbal and written), and use fine motor skills including fine hand manipulation and keyboarding. Working under stress and use of computer/phone required Ability to see at close range, distance vision, peripheral vision, depth perception, and the ability to adjust focus. Work Environment: Fully remote position Mainly indoor, office environment conditions Environment must be free from background noise and distraction, noise level is acceptable, temperature is controlled. A home set-up; must meet all Company IT, privacy and safety requirements

Provide initial injury intake, follow up and case closures in accordance with Policy Procedures Provide initial contact with injured worker, employer, provider and other appropriate stakeholders Obtain history of injury (mechanism and setting) and current job functions Assesses functional status and provide recommendations for first aid, self-care, or medical treatment according to treatment protocols Assess and collect data regarding risk factors for delayed recovery, and generate creative solutions to minimize or eliminate obstacles which prevent, or delay return to work Provide appropriate stakeholders with updates regarding the nature and mechanism of injury as well as suggested level of care Serve as an advocate for the injured/ill worker Counsel’s employees on reduction of risks associated with occupational and environmental hazards, and provides appropriate care plans as needed Request medical records as needed Direct care to preferred providers and negotiates as necessary Ensure appropriate use of medical facilities, early and appropriate referrals, and quality of care at controlled or reduced cost Identify excessive, ineffective or inefficient delivery of health care services and redirect care as needed Perform additional duties and assumes additional responsibilities as identified by supervisor

Athletico

Occ Health RN Telephone Triage - Full-Time - Afternoon Shift (Remote)

Posted on:

April 15, 2025

Job Type:

Full-Time

Role Type:

Triage

License:

RN

State License:

Compact / Multi-State

Athletico’s Greater Purpose is to empower people, inspire hope and transform lives. We accomplish this by providing exceptional, progressive, and cost-effective fitness, performance and rehabilitative services through personalized care that emphasizes education and prevention of future injury. This is accomplished through building on our Core Values of one team, understanding our business, recognition, people-focused, accountability, continuous innovation and trust and integrity, which are the foundation for our unique culture.

Pivot Onsite Innovations is now hiring an experienced and passionate Remote Triage Registered Nurse (RN) for our on-site healthcare clinic located at our client's manufacturing plants. This is your opportunity to step out of a traditional nurse setting and make your impact on employee health, wellness and safety! Must be able to afternoons: Monday - Friday 2PM to 10PM! Position Summary: The Remote Occupational Health Nurse is responsible for utilizing evidence-based guidelines to employ best practices that require early intervention and setting of realistic expectations for recovery and return to work.

Education: Associate’s Degree in Nursing required, BSN preferred Work Experience: Min 2 years in occupational health preferred Telephonic case management experience preferred Certification/Licensure: Current Compact RN License required Maintain Enhanced Nurse Licensure Compact (eNLC) and reside in a compact state Adhere to the requirements and time frames of licensure in all other states Knowledge and Technical Skills: Strong clinical knowledge in Occupational Health Nursing Positive telephone interaction skills including ability to ask open-ended questions to identify problems and focus conversation for goal directed and time limited conversation Ability to effectively interact with HR, safety staff, local medical providers and other designated personnel for proper initiation and follow-up of possible work-related injuries and illnesses Excellent written and oral communication skills and computer skills Competence with Windows operating system environment, Adobe Professional, Microsoft Office Suite (Outlook, Word, Excel and PowerPoint) and learn other software as needed Language Skills: Ability to read, write and speak English proficiently Bi-lingual (Spanish speaking) beneficial Physical Demands: Ability to fulfill office activities including but not limited to remain stationary for extended periods of time (i.e., while working at a desk), stand/stoop/kneel/crough/stretch, bending and stretching, communicate with others (verbal and written), and use fine motor skills including fine hand manipulation and keyboarding. Working under stress and use of computer/phone required Ability to see at close range, distance vision, peripheral vision, depth perception, and the ability to adjust focus. Work Environment: Fully remote position Mainly indoor, office environment conditions Environment must be free from background noise and distraction, noise level is acceptable, temperature is controlled. A home set-up; must meet all Company IT, privacy and safety requirements

Provide initial injury intake, follow up and case closures in accordance with Policy Procedures Provide initial contact with injured worker, employer, provider and other appropriate stakeholders Obtain history of injury (mechanism and setting) and current job functions Assesses functional status and provide recommendations for first aid, self-care, or medical treatment according to treatment protocols Assess and collect data regarding risk factors for delayed recovery, and generate creative solutions to minimize or eliminate obstacles which prevent, or delay return to work Provide appropriate stakeholders with updates regarding the nature and mechanism of injury as well as suggested level of care Serve as an advocate for the injured/ill worker Counsel’s employees on reduction of risks associated with occupational and environmental hazards, and provides appropriate care plans as needed Request medical records as needed Direct care to preferred providers and negotiates as necessary Ensure appropriate use of medical facilities, early and appropriate referrals, and quality of care at controlled or reduced cost Identify excessive, ineffective or inefficient delivery of health care services and redirect care as needed Perform additional duties and assumes additional responsibilities as identified by supervisor

Athletico

Occ Health RN Telephone Triage - Full-Time - Overnights (Remote)

Posted on:

April 15, 2025

Job Type:

Full-Time

Role Type:

Triage

License:

RN

State License:

Compact / Multi-State

Athletico’s Greater Purpose is to empower people, inspire hope and transform lives. We accomplish this by providing exceptional, progressive, and cost-effective fitness, performance and rehabilitative services through personalized care that emphasizes education and prevention of future injury. This is accomplished through building on our Core Values of one team, understanding our business, recognition, people-focused, accountability, continuous innovation and trust and integrity, which are the foundation for our unique culture.

Pivot Onsite Innovations is now hiring an experienced and passionate Remote Triage Registered Nurse (RN) for our on-site healthcare clinic located at our client's manufacturing plants, supporting telephonically. This is your opportunity to step out of a traditional nurse setting and make your impact on employee health, wellness and safety! Must be able to work overnights: Monday - Friday 10PM to 6AM! Position Summary: The Remote Occupational Health Nurse is responsible for utilizing evidence-based guidelines to employ best practices that require early intervention and setting of realistic expectations for recovery and return to work.

Education: Associate’s Degree in Nursing required, BSN preferred Work Experience: Min 2 years in occupational health preferred Telephonic case management experience preferred Certification/Licensure: Current Compact RN License required Maintain Enhanced Nurse Licensure Compact (eNLC) and reside in a compact state Adhere to the requirements and time frames of licensure in all other states Knowledge and Technical Skills: Strong clinical knowledge in Occupational Health Nursing Positive telephone interaction skills including ability to ask open-ended questions to identify problems and focus conversation for goal directed and time limited conversation Ability to effectively interact with HR, safety staff, local medical providers and other designated personnel for proper initiation and follow-up of possible work-related injuries and illnesses Excellent written and oral communication skills and computer skills Competence with Windows operating system environment, Adobe Professional, Microsoft Office Suite (Outlook, Word, Excel and PowerPoint) and learn other software as needed Language Skills: Ability to read, write and speak English proficiently Bi-lingual (Spanish speaking) beneficial Physical Demands: Ability to fulfill office activities including but not limited to remain stationary for extended periods of time (i.e., while working at a desk), stand/stoop/kneel/crough/stretch, bending and stretching, communicate with others (verbal and written), and use fine motor skills including fine hand manipulation and keyboarding. Working under stress and use of computer/phone required Ability to see at close range, distance vision, peripheral vision, depth perception, and the ability to adjust focus. Work Environment: Fully remote position Mainly indoor, office environment conditions Environment must be free from background noise and distraction, noise level is acceptable, temperature is controlled. A home set-up; must meet all Company IT, privacy and safety requirements

Provide initial injury intake, follow up and case closures in accordance with Policy Procedures Provide initial contact with injured worker, employer, provider and other appropriate stakeholders Obtain history of injury (mechanism and setting) and current job functions Assesses functional status and provide recommendations for first aid, self-care, or medical treatment according to treatment protocols Assess and collect data regarding risk factors for delayed recovery, and generate creative solutions to minimize or eliminate obstacles which prevent, or delay return to work Provide appropriate stakeholders with updates regarding the nature and mechanism of injury as well as suggested level of care Serve as an advocate for the injured/ill worker Counsel’s employees on reduction of risks associated with occupational and environmental hazards, and provides appropriate care plans as needed Request medical records as needed Direct care to preferred providers and negotiates as necessary Ensure appropriate use of medical facilities, early and appropriate referrals, and quality of care at controlled or reduced cost Identify excessive, ineffective or inefficient delivery of health care services and redirect care as needed Perform additional duties and assumes additional responsibilities as identified by supervisor

Athletico

Occ Health RN Telephone Triage - Part Time (Weekends) - Day Shift (Remote)

Posted on:

April 15, 2025

Job Type:

Part-Time

Role Type:

Triage

License:

RN

State License:

Compact / Multi-State

Athletico’s Greater Purpose is to empower people, inspire hope and transform lives. We accomplish this by providing exceptional, progressive, and cost-effective fitness, performance and rehabilitative services through personalized care that emphasizes education and prevention of future injury. This is accomplished through building on our Core Values of one team, understanding our business, recognition, people-focused, accountability, continuous innovation and trust and integrity, which are the foundation for our unique culture.

Pivot Onsite Innovations is now hiring an experienced and passionate part-time Remote Triage Registered Nurse (RN) for our on-site healthcare clinic located at our client's manufacturing plants, supporting telephonically. This is your opportunity to step out of a traditional nurse setting and make your impact on employee health, wellness and safety! Must be able to work every weekend remotely: Saturday and Sunday 6A-6P! Position Summary: The Remote Occupational Health Nurse is responsible for utilizing evidence-based guidelines to employ best practices that require early intervention and setting of realistic expectations for recovery and return to work.

Education: Associate’s Degree in Nursing required, BSN preferred Work Experience: Min 2 years in occupational health preferred Telephonic case management experience preferred Certification/Licensure: Current Compact RN License required Maintain Enhanced Nurse Licensure Compact (eNLC) and reside in a compact state Adhere to the requirements and time frames of licensure in all other states Knowledge and Technical Skills: Strong clinical knowledge in Occupational Health Nursing Positive telephone interaction skills including ability to ask open-ended questions to identify problems and focus conversation for goal directed and time limited conversation Ability to effectively interact with HR, safety staff, local medical providers and other designated personnel for proper initiation and follow-up of possible work-related injuries and illnesses Excellent written and oral communication skills and computer skills Competence with Windows operating system environment, Adobe Professional, Microsoft Office Suite (Outlook, Word, Excel and PowerPoint) and learn other software as needed Language Skills: Ability to read, write and speak English proficiently Bi-lingual (Spanish speaking) beneficial Physical Demands: Ability to fulfill office activities including but not limited to remain stationary for extended periods of time (i.e., while working at a desk), stand/stoop/kneel/crough/stretch, bending and stretching, communicate with others (verbal and written), and use fine motor skills including fine hand manipulation and keyboarding. Working under stress and use of computer/phone required Ability to see at close range, distance vision, peripheral vision, depth perception, and the ability to adjust focus. Work Environment: Fully remote position Mainly indoor, office environment conditions Environment must be free from background noise and distraction, noise level is acceptable, temperature is controlled. A home set-up; must meet all Company IT, privacy and safety requirements

Provide initial injury intake, follow up and case closures in accordance with Policy Procedures Provide initial contact with injured worker, employer, provider and other appropriate stakeholders Obtain history of injury (mechanism and setting) and current job functions Assesses functional status and provide recommendations for first aid, self-care, or medical treatment according to treatment protocols Assess and collect data regarding risk factors for delayed recovery, and generate creative solutions to minimize or eliminate obstacles which prevent, or delay return to work Provide appropriate stakeholders with updates regarding the nature and mechanism of injury as well as suggested level of care Serve as an advocate for the injured/ill worker Counsel’s employees on reduction of risks associated with occupational and environmental hazards, and provides appropriate care plans as needed Request medical records as needed Direct care to preferred providers and negotiates as necessary Ensure appropriate use of medical facilities, early and appropriate referrals, and quality of care at controlled or reduced cost Identify excessive, ineffective or inefficient delivery of health care services and redirect care as needed Perform additional duties and assumes additional responsibilities as identified by supervisor

Athletico

Occ Health RN Telephone Triage - Part Time (Weekends) - Overnights (Remote)

Posted on:

April 15, 2025

Job Type:

Part-Time

Role Type:

Triage

License:

RN

State License:

Compact / Multi-State

Athletico’s Greater Purpose is to empower people, inspire hope and transform lives. We accomplish this by providing exceptional, progressive, and cost-effective fitness, performance and rehabilitative services through personalized care that emphasizes education and prevention of future injury. This is accomplished through building on our Core Values of one team, understanding our business, recognition, people-focused, accountability, continuous innovation and trust and integrity, which are the foundation for our unique culture.

Pivot Onsite Innovations is now hiring an experienced and passionate part-time Remote Triage Registered Nurse (RN) for our on-site healthcare clinic located at our client's manufacturing plants, supporting telephonically. This is your opportunity to step out of a traditional nurse setting and make your impact on employee health, wellness and safety! Must be able to work weekend overnights consistently: Saturday and Sunday 6P-6A! Position Summary: The Remote Occupational Health Nurse is responsible for utilizing evidence-based guidelines to employ best practices that require early intervention and setting of realistic expectations for recovery and return to work.

Education: Associate’s Degree in Nursing required, BSN preferred Work Experience: Min 2 years in occupational health preferred Telephonic case management experience preferred Certification/Licensure: Current Compact RN License required Maintain Enhanced Nurse Licensure Compact (eNLC) and reside in a compact state Adhere to the requirements and time frames of licensure in all other states Knowledge and Technical Skills: Strong clinical knowledge in Occupational Health Nursing Positive telephone interaction skills including ability to ask open-ended questions to identify problems and focus conversation for goal directed and time limited conversation Ability to effectively interact with HR, safety staff, local medical providers and other designated personnel for proper initiation and follow-up of possible work-related injuries and illnesses Excellent written and oral communication skills and computer skills Competence with Windows operating system environment, Adobe Professional, Microsoft Office Suite (Outlook, Word, Excel and PowerPoint) and learn other software as needed Language Skills: Ability to read, write and speak English proficiently Bi-lingual (Spanish speaking) beneficial Physical Demands: Ability to fulfill office activities including but not limited to remain stationary for extended periods of time (i.e., while working at a desk), stand/stoop/kneel/crough/stretch, bending and stretching, communicate with others (verbal and written), and use fine motor skills including fine hand manipulation and keyboarding. Working under stress and use of computer/phone required Ability to see at close range, distance vision, peripheral vision, depth perception, and the ability to adjust focus. Work Environment: Fully remote position Mainly indoor, office environment conditions Environment must be free from background noise and distraction, noise level is acceptable, temperature is controlled. A home set-up; must meet all Company IT, privacy and safety requirements

Provide initial injury intake, follow up and case closures in accordance with Policy Procedures Provide initial contact with injured worker, employer, provider and other appropriate stakeholders Obtain history of injury (mechanism and setting) and current job functions Assesses functional status and provide recommendations for first aid, self-care, or medical treatment according to treatment protocols Assess and collect data regarding risk factors for delayed recovery, and generate creative solutions to minimize or eliminate obstacles which prevent, or delay return to work Provide appropriate stakeholders with updates regarding the nature and mechanism of injury as well as suggested level of care Serve as an advocate for the injured/ill worker Counsel’s employees on reduction of risks associated with occupational and environmental hazards, and provides appropriate care plans as needed Request medical records as needed Direct care to preferred providers and negotiates as necessary Ensure appropriate use of medical facilities, early and appropriate referrals, and quality of care at controlled or reduced cost Identify excessive, ineffective or inefficient delivery of health care services and redirect care as needed Perform additional duties and assumes additional responsibilities as identified by supervisor

Amcord Care Inc.

Nursing Facility Service Coordinator - Kutztown area - Remote

Posted on:

April 15, 2025

Job Type:

Full-Time

Role Type:

License:

None Required

State License:

Pennsylvania

The Nursing Facility Service Coordinator will be responsible for identifying, coordinating, and facilitating all necessary support and services for residents of nursing facilities. This role requires an individual with excellent communication and interpersonal skills, the ability to manage multiple tasks and priorities, and a strong understanding of nursing facility operations.

Must have a Bachelor’s degree in social work, psychology, or other related fields with practicum experience, or in lieu of a Bachelor’s degree have at least three (3) or more years’ experience in a social service or healthcare related setting. Excellent communication and interpersonal skills. Ability to work collaboratively with staff, program participants, and community organizations. Strong organizational and problem-solving skills. *Must be willing and able to travel regularly through these areas and surrounding counties* Pottsville, PA 17901 Bethlehem, PA 18017 Allentown, PA 18103-18104 Shenandoah, PA 17976 Easton, PA 18042 Reading, PA 19611

Manage an active caseload which involves monitoring and evaluating options and services to meet an individual's health needs. Develop and modify care plans at least annually or on an as needed basis in collaboration with the resident, their family, and facility staff. Ensure that nursing facility residents receive appropriate healthcare services and that their medical needs are being met. Notify the member of their right to choose any willing and qualified provider to provide a service on the members service plan. Serve as a liaison between nursing facility residents, their families, and healthcare providers. Coordinate and participate in interdisciplinary care conferences with nursing facility staff and healthcare providers as needed. Ensure compliance with all legal and regulatory requirements related to nursing facility services. Required to complete forty (40) hours orientation training and ongoing twenty (20) hour annual training. Responsible for following Amcord Care Inc. policies and procedures for document maintenance, confidentiality or records and employees' rights. Willingness and ability to work in the field while also having the ability to work independently with integrity in a virtual setting.

The Cigna Group

RN Utilization Management Clinical Reviewer Senior Analyst - Work from Home, Anywhere, USA

Posted on:

April 15, 2025

Job Type:

Full-Time

Role Type:

Utilization Review

License:

RN

State License:

Conneticut

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.

Provides advanced professional input to complex Nurse Case Management assignments/projects. Plans, implements, and evaluates appropriate health care services in conjunction with the physician treatment plan. Handles more complex, high acuity cases, and/or account sensitive cases involving largest reserves. Utilizes clinical skills to assess, plan, implement, coordinate, monitor and evaluate options and services in order to facilitate appropriate healthcare outcomes for members. Ensures that case management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained. Performs prospective, concurrent, and retrospective reviews for inpatient acute care, rehabilitation, referrals, and select outpatient services. May review initial liability disability claims to determine extent and impact of insured's medical condition, medical restrictions and limitations and expected duration. Performs leadership role on team when implementing new tools or case management programs/initiatives. Manages own caseload and coordinates all assigned cases. Supports and provides direction to more junior professionals. Works autonomously, only requiring “expert” level technical support from others. Exercises judgment in the evaluation, selection, and adaptation of both standard and complex techniques and procedures. Utilizes in-depth professional knowledge and acumen to develop models and procedures, and monitor trends, within Nurse Case Management. RN and current unrestricted nursing license required.

Minimum requirements: Active unrestricted Registered Nurse (RN) license in state or territory of the United States. Preferred requirements: Bachelors degree a plus 3 years clinical experience in inpatient or managed care setting Demonstrated ability to anticipate, plan, coordinate and organize. Knowledge of community, state and federal resources. Possession of a valid driver’s license, proof of insurance, good driving record and reliable transportation. Strong skills in teamwork, negotiation, conflict management, problem solving, and effective decision making. Experience in medical management and case management in a managed care setting or hospital is highly desirable. Ability to assess complex issues, recommend changes and resolve problems. Strong computer knowledge and abilities. Knowledge of managed care products and strategies. Ability to work within changing business environment and balance business needs with patient advocacy. Experience managing multiple projects in a fast paced matrix driven environment. Effective at negotiation, teamwork and cooperative relations with diverse internal and external stakeholders. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

Position Scope: Manages/Coordinates an active caseload of inpatient case management cases for Cigna. Uses clinical knowledge to assess inpatient admission level of care, treatment plan and goals, identified gasps or risk for readmission or complications and any barriers to discharge. Establishes patient centric goals and interventions to meet the member’s needs while inpatient and post inpatient stay. Interfaces with facility, member, family, and other healthcare team members as well as internal matrix partners. Balances business needs with patient advocacy. Builds solid working relationships with internal staff, matrix partners, key functional areas, customers, and providers. Summary description of position: Plans, implements and evaluates appropriate health care services in conjunction with the physician treatment plan. Handles more complex, high acuity cases and /or account sensitive cases. Performs prospective, concurrent and retrospective reviews for inpatient acute care, rehabilitation, referrals and select outpatient services including DME (durable medical equipment). Ensures that inpatient case management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained. Excellent time management, organization and negotiation skills. Strong research and analytical skills. Ability to assess complex issues, recommend changes and resolve problems. Knowledge of managed care preferred. Works independently, receiving direction from manager or team leader for new or unprecedented situations. Manages own caseload and coordinates all assigned cases. Acts as a resource to others. Utilizes Cigna's approved guidelines and tools to rigorously assess the clinical status of the member, the level of care and the services the member is receiving as clinically appropriate covered services. Anticipates care needs along the continuum of inpatient and outpatient services and facilitates coordination across the network of providers, participants and caregivers to assure timely discharge/transfer to an alternate level of care. Consults with manager and medical director to resolve any issues related to delay of services or barriers to discharge in a timely manner. Major responsibilities and desired results: Develops and defines a structured working relationship with key partners in inpatient facilities to support regular, effective communication and exchange of information in order to manage the member’s needs in compliance with all Federal/State/Facility contract and internal Cigna requirements. Retrieves active daily census each morning and prioritizes cases for impact. Access the approved Cigna guidelines for inpatient review and directs communication with the facility to elicit clinical information and facilitate discharge planning. Identified all cases appropriate for inpatient case management interventions, initiates and discusses options for discharge planning with the facility, provider, vendor, member and/or family and documents interactions and outcomes related to those actions. Identify and build effective relationships with a network of community, government, and knowledge resources. Maintain information on those resources and share with peers as appropriate. Act as liaison and patient advocate between account, participant, family, physician(s) and facilities/agencies. Take appropriate action to ensure participant and practitioner satisfaction within benefit constraints. Develop a participant centered plan for short term and long term objectives, including time frames for follow up. Utilize available internal and community resources in development of plan. Involve all appropriate parties (member, physician, providers, employers, etc) to determine case results/outcomes. Provide information and resources as appropriate to empower participants to take an active role in care, treatment and cost decisions. Implement, coordinate, monitor and evaluate the plan on a systematic, ongoing, appropriate basis. Negotiate price and quality care levels, intensity and durations of services. Document findings and continue to anticipate needs, determine benefit coverage status and communicate proactively to participant and members of treatment team. Identifies new referrals for complex and specialty CM programs and coordinates transition to appropriate CM when necessary. Identifies and elevates potential quality of care issues to Cigna's Quality representatives for follow up determination. Works to identify gaps in care and resolution of those identified and prevention of future gaps in care. May be required to participate in customer and auditor visits. Participates in special projects as deemed necessary. Other duties as required and related to this role.

Solace

Case Manager - Healthcare Advocate (Remote 1099)

Posted on:

April 15, 2025

Job Type:

Full-Time

Role Type:

Care Management

License:

None Required

State License:

California

By harnessing the power of human connection through technology, Solace is transforming healthcare in the U.S. Healthcare in the U.S. is fundamentally broken. The system is so complex that 88% of U.S. adults do not have the health literacy necessary to navigate the system without help. By helping people work with professional health advocates, Solace serves as an integral, personal support layer for health issues in a way that the health system can’t. Using proprietary technology to match patients with experienced advocates, Solace cuts through the red tape of healthcare and helps individuals and families make informed decisions that result in better outcomes. Solace is a Series B startup founded in 2022 and backed by Inspired Capital, Craft Ventures, Torch Capital, Menlo Ventures and Signalfire. We have a lean, fully-remote U.S. team distributed coast-to-coast.

As a Healthcare Advocate for Solace, you will work with Medicare patients throughout their healthcare journey. In this role, you will navigate patients through difficult and complex health concerns to help them achieve their health and wellness goals while addressing Social Determinants of Health (SDOH). You’ll be an empathetic listening ear and an action-oriented guide who knows what to do to solve patient problems—and actually does it. Please note that this is a 1099 role. You can choose to work part time or full time. The role is remote.

Demonstrated experience in care management, patient advocacy, or healthcare navigation. Deep understanding of Social Determinants of Health and experience working with diverse patient populations. Endless empathy for people, and a strong ability to fight for those who cannot. Strong clinical skills paired with exceptional organizational abilities. You can balance multiple tasks and work under pressure without sacrificing clarity in your communications and documentation. Pride in your technical savvy; you can quickly and fluently learn new systems and software. An extreme bias toward action and execution. A willingness to provide fearless feedback. You care about forging a system that empowers better patients outcomes, and are not shy about sharing your thoughts.

Learn the Solace systems, tools, technology, partners, and expectations, while also providing your unique expertise in every interaction. Build strong, trusting relationships with Medicare patients, where listening and empathy are the foundation for every interaction. Be able to identify and prioritize Medicare patients’ needs and assist them to maintain a streamlined care continuum. Develop comprehensive patient care plans that holistically address social determinants of health, i.e. food resources, transportation access, and support at home. Build the systems of the future in working with Medicare patients.

Solace

RN Healthcare Advocate (Remote 1099)

Posted on:

April 15, 2025

Job Type:

Full-Time

Role Type:

License:

RN

State License:

California

By harnessing the power of human connection through technology, Solace is transforming healthcare in the U.S. Healthcare in the U.S. is fundamentally broken. The system is so complex that 88% of U.S. adults do not have the health literacy necessary to navigate the system without help. By helping people work with professional health advocates, Solace serves as an integral, personal support layer for health issues in a way that the health system can’t. Using proprietary technology to match patients with experienced advocates, Solace cuts through the red tape of healthcare and helps individuals and families make informed decisions that result in better outcomes. Solace is a Series B startup founded in 2022 and backed by Inspired Capital, Craft Ventures, Torch Capital, Menlo Ventures and Signalfire. We have a lean, fully-remote U.S. team distributed coast-to-coast.

As an RN Healthcare Advocate for Solace, you will work with Medicare patients throughout their healthcare journey. In this role, you will navigate patients through difficult and complex health concerns to help them achieve their health and wellness goals while addressing Social Determinants of Health (SDOH). You’ll be an empathetic listening ear and an action-oriented guide who knows what to do to solve patient problems—and actually does it. Please note that this is a 1099 role. You can choose to work part time or full time. The role is remote.

RN license in good standing. Deep understanding of Social Determinants of Health and experience working with diverse patient populations. Endless empathy for people, and a strong ability to fight for those who cannot. Strong clinical skills paired with exceptional organizational abilities. You can balance multiple tasks and work under pressure without sacrificing clarity in your communications and documentation. Pride in your technical savvy; you can quickly and fluently learn new systems and software. An extreme bias toward action and execution. A willingness to provide fearless feedback. You care about forging a system that empowers better patients outcomes, and are not shy about sharing your thoughts.

Learn the Solace systems, tools, technology, partners, and expectations, while also providing your unique expertise in every interaction. Build strong, trusting relationships with Medicare patients, where listening and empathy are the foundation for every interaction. Be able to identify and prioritize Medicare patients’ needs and assist them to maintain a streamlined care continuum. Develop comprehensive patient care plans that holistically address social determinants of health, i.e. food resources, transportation access, and support at home. Build the systems of the future in working with Medicare patients.

Wellbox Health

Virtual Nurse Coordinator: LPN

Posted on:

April 15, 2025

Job Type:

Full-Time

Role Type:

Telehealth

License:

LPN/LVN

State License:

Compact / Multi-State

Wellbox is a rapidly growing healthcare company focused on empowering people to live healthier lives through comprehensive preventative care solutions delivered by an elite team of experienced nurses. We are currently seeking tech-savvy LPN Patient Care Coordinators to conduct monthly telephonic outreach to chronically ill patients, developing personalized care plans that address their health challenges.

Position Type And Expected Hours Of Work We are seeking full-time LPN team members who can work 40 hours per week, between the hours of 8 am – 6 pm in the patient’s time zone, Monday – Friday. Pay Structure Orientation + Training (First two months): $20 hourly. Post-Orientation: $22 hourly, plus bonus incentive. Monthly Bonuses up to $525 monthly. Referral Bonuses up to $1000.

Active Compact LPN License. Minimum two years of clinical experience; care coordination experience preferred. Proficient with Electronic Medical Records and Microsoft Office. Excellent communication and problem-solving skills.

Manage patients’ healthcare needs via virtual phone conversations. Document visits using technology platforms and EHRs. Develop personalized care plans addressing physical, mental, and preventative health. Coach patients on treatment plans, including nutrition and wellness. Connect patients with resources and prepare them for medical appointments.

NaphCare, Inc.

PRN Utilization Managment Registered Nurse

Posted on:

April 14, 2025

Job Type:

Role Type:

Utilization Review

License:

RN

State License:

Alabama

NaphCare is a family owned, medical technology company that has been delivering high quality healthcare to correctional facilities across the nation for over 30 years. Come join our team of over 4000 employees and growing! NaphCare pays well, offers outstanding benefits, and has an incredibly engaged corporate support team to make sure you have what you need to be truly excellent at what you do. NaphCare partners with correctional facilities to provide proactive, patient-focused healthcare. We recognize that we serve a unique and diverse patient population, and our onsite teams take pride in bringing excellence in care to a population in great need. Be part of a world-class team of professionals who are revolutionizing correctional healthcare as you use our cutting-edge resources, including our award-winning electronic operating system NaphCare has a partnership with NetCE that provides CEU/CME for our staff. NetCE uses a rigorous peer review process to ensure that all activities and content are up-to-date. This service streamlines continuing education for all NaphCare Employees to meet state specific requirements for maintaining licensing. With NaphCare, you'll play a critical role in our continuing mission to be the leading provider of quality healthcare in the correctional industry. If you want a career that will make a difference, choose the company that is different. We support your growth and internal promotion. Once hired, we encourage our employees to continue to seek opportunities for advancement and leadership.

NaphCare is hiring experienced PRN-Utilization Management Registered Nurse just like you at the Corporate Headquarters located in Birmingham, Alabama.

A current and unrestricted RN license in Alabama A minimum of 3 years’ experience in an acute care setting and 2 years’ experience in utilization review and/or case management Valid cpr card Excellent communication and interpersonal skills attention to detail and decision-making skills are essential BSN or ADN required. Some travel required.

Develop, implement, and administer the quality assurance and utilization review processes Monitor and report on the quality of all facets of the medical care provided to patients Perform utilization and concurrent review of patient cases Conduct detailed clinical chart assessments Gather clinical information to assess and expedite care needs Determine need, if any, for intervention, and discussing with physicians Reviews requests from providers regarding medical necessity of requested services for patients Reviews and audits patients' medical records as indicated to determine medical necessity Utilizes nationally recognized criteria to determine medical necessity of requested services Refers provider requests to Medical Director or designee when medical necessity of requested services does not meet recognized criteria

Tuesday Health

Complex Care Navigator (RN)

Posted on:

April 14, 2025

Job Type:

Full-Time

Role Type:

Clinical Operations

License:

RN

State License:

Ohio

Tuesday Health launched in 2023 to deliver compassionate, supportive care for patients and caregivers navigating serious illness. We believe that each patient's journey is unique. As such, we deliver member-directed, whole-person care to seriously ill patients in our program, using leading edge supportive care models, including appropriate transitions to hospice when the time is right. This results in drastically improved quality of life for members and their caregivers, and a meaningful reduction in unproductive medical spend. Our overall mission is to transform serious illness and end of life care; our team believes deeply in this mission and puts our members first in all that we do.

Location: Canton, OH This is a full-time position, traveling within the community. Monday-Friday with hours of 8:00am-5:00pm Tuesday Health is looking for a creative and experienced Registered Nurse to join our team as a Complex Care Navigator. You will work alongside other members of the Tuesday Health clinical teams, providing a multi-disciplinary approach to care for our members with serious illness and ensuring the delivery of high-quality supportive care services to our patients and their families. The RN will conduct home visits and work remotely on occasion.

Active and unrestricted Registered Nurse license in the State of Ohio without any board action Experience in clinical/medical setting preferred Experience in a multi- disciplinary care model working across network providers, health plan care management support, and employed clinicians Strong communication and organization skills Ability to multitask and work under pressure without sacrificing a positive member experience Ability to know when to escalate and potentially act professionally in an emergent situation Strong technical skills to navigate different documentation systems and tools; as well as ability to learn new systems as the company grows and evolves Strong written skills Ability to drive during daytime, nighttime, or inclement weather Valid driver's license with safe driving record State minimum automobile insurance coverage Comfort with change and ambiguity; you understand that rapid changes to the business, strategy, organization, and priorities will come with rapid evolution of our business

Administer multiple assessments and screening tools within the clinical model at different times throughout the care timeline Interpret responses to assessments and screening tools and support prioritization of need based on responses Be accountable for care plan development within the multidisciplinary care team Lead in internal and joint rounds to ensure the member experience is optimal and coordinated Learn the Tuesday Health electronic systems, tools, technology, to deliver a coordinated approach to ensure the members have a unique experience Build a strong, trusting relationship with every member, where listening and empathy are the foundation of every interaction Serve as the quarterback of the multidisciplinary team transforming care for members with serious illness

HV Health and Safety

Occupational Health Nurse Case Manager (LVN)

Posted on:

April 14, 2025

Job Type:

Full-Time

Role Type:

Case Management

License:

LPN/LVN

State License:

Compact / Multi-State

At HV Occupational Health and Safety, we are passionate about fostering growth, embracing change to create thriving, and encouraging safe work environments. As a double minority-owned company, we bring a unique perspective to workplace safety, offering exceptional services that help businesses achieve the best outcomes. Our commitment to honesty, integrity, and respect defines everything we do. We take pride in our ability to be problem solvers, finding practical solutions to complex challenges, and maintaining a positive outlook in every situation. Our team members are not only professionals—they are family-oriented individuals who understand the importance of safety and well-being for both the workforce and their loved ones. Our mission is to empower employees with confidence, providing tailored solutions and expert knowledge to cultivate a culture of safety and success. Together, we aim to build a safer future, one job site at a time.

**We are looking for compassionate and caring LVNs with a compact state license to join our remote team.** You’re a dedicated medical professional who cares deeply about helping people stay healthy, safe, and informed—especially in the workplace. You recognize that supporting employees’ health goes beyond just responding to incidents; it’s about early intervention, clear communication, and being a trusted clinical presence from wherever you are. Whether you’re triaging an injury, guiding someone through a return-to-work process, or educating a patient on preventative care, you approach each interaction with empathy, professionalism, and a strong sense of purpose. You work well with teams, think on your feet, and bring calm to high-pressure situations. If you have a background in nursing and a heart for service—even if you don’t check every box—we’d love to hear from you. At HV Health and Safety, integrity, teamwork, and excellence are core to everything we do. Join us and help make a meaningful difference in the lives of working people every day.

EDUCATION AND EXPERIENCE QUALIFICATIONS: Licensed Vocational Nurse (LVN) license in good standing (multi-state/compact license preferred). Minimum of 2 years of clinical experience, ideally with exposure to occupational health, urgent care, or telehealth. Familiarity with workplace health standards, OSHA reporting, and/or workers’ compensation procedures. Strong clinical judgment and ability to make confident decisions remotely. Comfortable using telehealth platforms, electronic health records (EHR), and communication tools. PREFERRED: COHN/COHN-S, CAOHC, or occupational health experience a plus. Bilingual (English/Spanish or other languages) a plus. Experience in case management or injury triage.

Conduct virtual patient assessments, reviewing symptoms, medical history, and current concerns, including both personal and workplace-related issues. Triage injuries and illnesses to determine next steps, including appropriate care level, time off recommendations, or emergency referrals. Provide clear nursing advice, care instructions, and health education tailored to the employee population. Support return-to-work evaluations and recovery monitoring in coordination with workplace policies. Collaborate with safety, HR, and other internal teams to ensure coordinated care and support. Maintain accurate, confidential documentation in accordance with HIPAA, OSHA, and company standards. Promote preventative care, chronic condition management, and overall employee wellness. Stay up to date with best practices in occupational and virtual care.

HV Health and Safety

Telehealth Nurse (LVN)

Posted on:

April 14, 2025

Job Type:

Full-Time

Role Type:

Telehealth

License:

LPN/LVN

State License:

Compact / Multi-State

At HV Occupational Health and Safety, we are passionate about fostering growth, embracing change to create thriving, and encouraging safe work environments. As a double minority-owned company, we bring a unique perspective to workplace safety, offering exceptional services that help businesses achieve the best outcomes. Our commitment to honesty, integrity, and respect defines everything we do. We take pride in our ability to be problem solvers, finding practical solutions to complex challenges, and maintaining a positive outlook in every situation. Our team members are not only professionals—they are family-oriented individuals who understand the importance of safety and well-being for both the workforce and their loved ones. Our mission is to empower employees with confidence, providing tailored solutions and expert knowledge to cultivate a culture of safety and success. Together, we aim to build a safer future, one job site at a time.

**We are looking for compassionate and caring LVNs with a compact state license to join our remote team.** You’re a dedicated medical professional who cares deeply about helping people stay healthy, safe, and informed—especially in the workplace. You recognize that supporting employees’ health goes beyond just responding to incidents; it’s about early intervention, clear communication, and being a trusted clinical presence from wherever you are. Whether you’re triaging an injury, guiding someone through a return-to-work process, or educating a patient on preventative care, you approach each interaction with empathy, professionalism, and a strong sense of purpose. You work well with teams, think on your feet, and bring calm to high-pressure situations. If you have a background in nursing and a heart for service—even if you don’t check every box—we’d love to hear from you. At HV Health and Safety, integrity, teamwork, and excellence are core to everything we do. Join us and help make a meaningful difference in the lives of working people every day.

EDUCATION AND EXPERIENCE QUALIFICATIONS: Licensed Vocational Nurse (LVN) license in good standing (multi-state/compact license preferred). Minimum of 2 years of clinical experience, ideally with exposure to occupational health, urgent care, or telehealth. Familiarity with workplace health standards, OSHA reporting, and/or workers’ compensation procedures. Strong clinical judgment and ability to make confident decisions remotely. Comfortable using telehealth platforms, electronic health records (EHR), and communication tools. PREFERRED: COHN/COHN-S, CAOHC, or occupational health experience a plus. Bilingual (English/Spanish or other languages) a plus. Experience in case management or injury triage.

Conduct virtual patient assessments, reviewing symptoms, medical history, and current concerns, including both personal and workplace-related issues. Triage injuries and illnesses to determine next steps, including appropriate care level, time off recommendations, or emergency referrals. Provide clear nursing advice, care instructions, and health education tailored to the employee population. Support return-to-work evaluations and recovery monitoring in coordination with workplace policies. Collaborate with safety, HR, and other internal teams to ensure coordinated care and support. Maintain accurate, confidential documentation in accordance with HIPAA, OSHA, and company standards. Promote preventative care, chronic condition management, and overall employee wellness. Stay up to date with best practices in occupational and virtual care.

Blue Cross and Blue Shield of Louisiana

Medical Review Nurse

Posted on:

April 14, 2025

Job Type:

Contract

Role Type:

Clinical Operations

License:

LPN/LVN

State License:

Louisiana

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.

Residency in or relocation to Louisiana is preferred for all positions. POSITION PURPOSE: Responsible for coordinating, processing and managing all in-patient and out-patient claims from a medical standpoint to ensure proper administration of contractual limitations and exclusions to include medical necessity, while maintaining compliance with regulatory guidelines. NATURE AND SCOPE: This role does not manage people This job reports to: Departmental Leadership Necessary Contacts: In order to effectively fulfill this position, the incumbent must be in contcact with: Healthcare providers and subscribers to obtain medical information. Obtains request for reviews from and notifies determinations to BAD, ITS, NASCO, FEP, BMS, and legal.

Education: High School Diploma or equivalent is required Work Experience: 4 years of recent LPN experience providing direct patient care with one year of authorization, medical review experience and case management is required Skills and Abilities: Knowledge of standardized code sets and medical terminology is required Proficiency in the use of standardized code sets is required Must demonstrate excellent interpersonal, administrative, and telephone skills. Working knowledge of MS Office is required Demonstrated ability to handle multiple tasks in customer friendly manner while maintaining performance standards is required Knowledge of health insurance contracts/benefits is preferred Licenses and Certifications: Current, unrestricted LPN license in the state of Louisiana and/or in the required jurisdictions, or where services are provided required CPUR or CPC certification is preferred upon hire; required within 24 months in position. A comparable professional medical review or case management certification is preferred

Reviews medical claims and requests for services and applies medical judgment and/or criteria in determining the benefits for pre-services and post-services according to contractual benefits and limitations, (i.e., contractual exclusions, cosmetic procedures, medical necessity, and administrative discrepancies) to ensure the proper administration of contractual and medical limitations/exclusions. Prepares documentation of medical information, completes research, makes recommendations, and refers potential denials to the Medical Directors and Management, when necessary, to ensure compliance with URAC standards, MNRO and DOL laws and regulations. Completes correspondence correctly when necessary to providers and subscribers to ensure that customers are aware of the determinations and appeal processes/rights meeting all regulatory standards. Meets targeted expectations for staff and unit performances as required by BCBSLA and department management. Collaborates with team members and communicates to the supervisor suggestions for improvement to ensure adherence to the corporate initiative of diversity. Additional Accountabilities and Essential Functions The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions Perform other job-related duties as assigned, within your scope of responsibilities. Job duties are performed in a normal and clean office environment with normal noise levels. Work is predominately done while standing or sitting. The ability to comprehend, document, calculate, visualize, and analyze are required. #LI_CB1 #LI-Remote

Optum

LPN Case Manager Remote

Posted on:

April 14, 2025

Job Type:

Full-Time

Role Type:

Case Management

License:

LPN/LVN

State License:

New York

Optum NY, (formerly Optum Tri-State NY) is seeking a LPN Case Manager to join our team in Middletown, NY. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you’ll be an integral part of our vision to make healthcare better for everyone. At Optum, you’ll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you’ll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

Join Our Team as an LPN Case Manager! Why Optum? At Optum, you’ll have access to the clinical resources, data, and support of a global organization, empowering you to help patients live healthier lives. Work alongside talented peers in a collaborative environment that values diversity and inclusion, driving towards the Quadruple Aim. We believe in providing an exceptional career experience, enabling you to thrive both at work and at home. Make a Difference: Are you ready to make a meaningful impact in the lives of our patients? As an LPN Discharge Coordinator, you’ll ensure smooth transitions for patients without the hassle of nights, weekends, or holidays. This full-time position offers excellent hourly compensation and benefits within 30 days, including generous PTO, paid holidays, annual bonus potential, annual reviews, tuition reimbursement, and opportunities for continued career progression. Plus, all clinical licensure costs are covered! Your Role: As a Case Manager, you’ll be an integral member of the direct delivery care team, serving as a gateway to information and support. Your daily communication with the acute care team, Embedded Care Coordination RN, PCP office care team, patients, and caregivers will ensure optimal communication and care during and after the acute care episode. Your goal is to facilitate understanding of the hospitalization, discharge care plan, and assess patient literacy.

Required Qualifications: Active and unrestricted LPN license in the state of New York Experience in caring for chronic disease patients Experience with navigation of local medical and social support systems Preferred Qualifications: Experience in clinical or community health settings Care Coordination, Case Management or Home Health experience Experience with Electronic Medical Records and Microsoft Excel

Assess patient and family’s unmet health and social needs Provide effective communications to improve health literacy Develop a care plan based on mutual goals with patient, family, and provider’s emergency plan, medical summary, and ongoing action plan Monitor patient’s adherence to plan of care and progress toward goals, facilitating changes as needed Facilitate patient access to appropriate medical and specialty providers and other care coordination team support specialists Ensure effective tracking of test results, medication management, and adherence to follow-up appointments Facilitate communication between specialists and Primary Care Physician post-discharge for cohesive care plan development Attend and actively participate in care coordinator-related training and meeting activities Perform regular visits to provide patient and family support and education

Optum

Telephonic Care Navigator – Remote in NC

Posted on:

April 14, 2025

Job Type:

Full-Time

Role Type:

Telehealth

License:

None Required

State License:

North Carolina

Optum Home & Community Care, part of the UnitedHealth Group 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 At Home product, together with an interdisciplinary care team 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 care settings. Join us to start Caring. Connecting. Growing together.

Our Care Navigators have a serious responsibility to make every contact informative, productive, positive, and memorable for what it says about how much we care. Care Navigators will carry a case load and will work with clinical staff. Coordinate care with providers, schedule appts, arrange transportation, make sure members are aware of all their benefits, check for upcoming appts and schedule & identify gaps for members. Mostly outbound calling but blended with a few incoming callings using auto dialer and manual dialing. This position is full time Monday – Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 9am – 5:30pm EST. It may be necessary, given the business need, to work occasional overtime. We offer 3 weeks of on-the-job training. The hours during training will be 9:00 am to 5:30 pm local time. If you are located within the State of North Carolina, you will have the flexibility to work remotely* as you take on some tough challenges.

Required Qualifications: High School Diploma / GED Must be 18 years of age or older 1+ years of call center and / or telephonic customer service experience 1+ years of professional experience in an office setting using the telephone and computer as the primary instruments to perform the job duties 1+ years of Healthcare/ insurance experience and/or Social work/community outreach/advocacy experience 1+ years of experience analyzing and solving customer problems Work experience using Microsoft Word (edit, create & save documents), Microsoft Excel (sorting & filtering data), and Microsoft Outlook (email, folders, attachments and calendaring) Ability to work Monday – Friday 9:00am-5:30pm EST Preferred Qualifications: Social Work, Public Health or related field Bilingual fluency in English and Spanish OR other language Medicaid and / or Medicare experience Experience working with medical terminology Telecommuting Requirements: Reside within the state of North Carolina Ability to keep all company sensitive documents secure (if applicable) Required to have a dedicated work area established that is separated from other living areas and provides information privacy. Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service. Soft Skills: Must be able and comfortable with maintaining metrics and goals within the department Must be comfortable working on the phone and multiple systems on the computer simultaneously while assisting members Must be comfortable making outreach to members without prior engagement Excellent Organizational Skills Telephone etiquette

Completes telephonic outreach to DSNP/CSNP members utilizing multiple outreach modes: including auto-dialer, manual and inbound calls Educates member on gaps in care and assists with closure of gaps, including scheduling provider appointments Assists members with social determinants of health and links to community resources Ensures member has access to PCP Outreaches members on caseload consistent with program guidelines Consistently meets metrics, both quality & performance Provides excellent customer service to both members and providers Constantly maintains schedule adherence and good attendance Maintains confidential health information according to state and federal regulations including HIPAA.

Optum

Virtual Health RN

Posted on:

April 14, 2025

Job Type:

Full-Time

Role Type:

Primary Care

License:

RN

State License:

Compact / Multi-State

MedExpress, part of the Optum family of businesses, is seeking a RN to join our team. Optum is a clinician-led care organization that is changing the way clinicians work and live. As a member of the Optum Care Delivery team, you’ll be an integral part of our vision to make healthcare better for everyone. At Optum, you’ll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. Here, you’ll work alongside talented peers in a collaborative environment that is guided by diversity and inclusion while driving towards the Quadruple Aim. We believe you deserve an exceptional career, and will empower you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice ideas and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to make health care better for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together.

The Virtual Registered Nurse (RN) works in conjunction with medical weight loss providers and support staff who provide healthcare solutions and clinical excellence to patients through virtual health using real-time audio-visual engagement. All duties and responsibilities are to be performed in compliance with state and federal laws and regulations governing the legal scope of nursing practice and practicing standard of evidence-based nursing to each patient. You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Required Qualifications: Graduate of an accredited School of Nursing with current and unrestricted RN licensure in a Nurse Licensure Compact State Maintain CEU/CNE’s as applicable for licensure 2+ years of dedicated nursing experience in primary care, urgent care, and or condition management program Experience using audio/visual technology or video conferencing platforms Knowledge of principles and processes for providing patient and personal services. This includes patient needs assessment, meeting quality standards for services, and evaluation of patient satisfaction. Applicable federal, state, and local laws and regulations including the requirements of the HIPAA and OSHA and applicable state rules and regulations pertinent to nursing practices Knowledge of computerized information systems used in business applications and clinical management systems (EMR) Demonstrated ability to perform duties in accordance with the customary rules of ethics and conduct of the applicable State Board of Nursing and other such regulating bodies Proven solid commitment to customer service and excellence in healthcare Proven ability to communicate effectively both orally and in writing Proven ability to work efficiently and effectively in fast paced, innovative environment Proven ability to effectively manage multiple, competing priorities Proven ability to work independently and as part of a high performing team Respectful of and sensitive to cultural/ethnic/religious healthcare needs, practices, backgrounds and competencies Preferred Qualifications: Remote experience Experience with weight loss management Experience with health and nutrition

Patient Care: Complete detailed and comprehensive data collection upon clinical intake, including appropriate evaluation of chief complaint, medication Hx, PMH, allergies, social Hx, etc. Review charts and records for completeness Facilitate telehealth services by completing virtual pre-intake with patients in preparation for appointments. Notify provider when patient is ready for visit Accommodate the patient’s needs, preferences, and potential cultural, social, physical, cognitive, and linguistic and communication barriers to technology use Process requests and referrals, providing efficient follow up with the patient, pharmacy, or other entity, as needed Prepares drug refill, lab order, and imaging order requests for review by the provider as directed by department protocols and established standing orders Oversee and coordinate the daily patient care flow, assisting and participating in all aspects of patient care for all patients within the center Apply the use of logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions and approaches to problems Provide patient education at virtual visit appointments including anticipatory guidance, information about chronic care, disease prevention and the promotion of health maintenance Clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating) Providing health education, coaching and treatment decision support for patients Engage patient with meaningful interaction that will motivate commitment and increase level of activation Identify possible challenges to patient success and provide continued support for goal attainment Collaborate with Interdisciplinary team on case management and health coaching support needs identified Participate in interdisciplinary team care conferences Complete and/or track clinical orders and results daily Assist the provider with calling patients and informing them of normal lab results reviewed by the provider. Proper, concise and complete documentation in EMR, other computer-based applications, and/or paper-based forms for all assessments and procedures Use best practices in telepresence skills to create a positive patient-clinician rapport and a meaningful encounter through technology Provide clinical oversight and guidance for unlicensed assistive personnel Comply with OSHA and HIPAA requirements, and follow policies and procedures Other duties as assigned such as new models of care, new types of procedures, use of new technology, etc. Learning and Ongoing Education: Obtain and maintain RN compact state licensure and other state licenses in virtual service areas Maintain clinical skills and competency for all procedures and participate in training and mentoring of other clinical staff patients Completes clinical competency evaluation/review as determined by leadership Maintain technical skills and apply new knowledge to position according to clinic policy Maintain knowledge of Medical Terminology and standards of nursing care Read and keep up to date on all department communications Complete all assigned training Documentation of competency is required for all role appropriate procedures, in addition to State specific licensure or certification as applicable Maintain knowledge of common safety hazards and precautions to establish a safe work environment Participate in quality improvement projects as applicable

IntellaTriage

Remote Hospice Triage RN- PT 2 shift 6p-12a rotating Sat & Sun 3:30-12 CST

Posted on:

April 13, 2025

Job Type:

Part-Time

Role Type:

Triage

License:

RN

State License:

Compact / Multi-State

Built around a mission to improve the lives of nurses and patients, IntellaTriage has been providing after-hours nurse triage for hospice and home health providers since 2008. Utilizing best-in-class technology, IntellaTriage provides round-the-clock direct access to licensed, registered nurses using client-customized protocols for patient-centered, compassionate care. We are growing rapidly and excited to support our clients’ nursing staff in the field by leveraging our outsourced team of nurses to manage after-hours care delivery. Our triage nurses become an extension of our clients’ care team, and they trust us to support them and their patients during their non-core hours. Learn more at www.intellatriage.com.

We invite you to join our growing team! IntellaTriage Nurses enjoy the benefits of working from home, providing care, without the stress and expense of commuting each day! **MUST have or be willing to obtain a Compact RN license **MUST live in/work from a Compact US state **Experience with end-of-life care is required **Must have high speed internet **Must be tech savvy, enjoy a fast-paced environment, and have keyboard competence **Part-time nurses only work 6 days out of a 14-day pay period Part- time schedule: Work a minimum 2 evening shift weekly 6p-12a CST (shift times are set/ week day flexes) Work every other weekend, both Saturday and Sunday 3:30p-12a CST

MUST have or be willing to obtain a Compact RN license (states with pending or future implementation dates are not considered current compact states until the implementation date) You must remain in good standing and ensure your home state license remains active. IntellaTriage will cover the cost of non-compact state licensure if necessary for client support. Hospice, palliative, end-of-life care is strongly preferred Experience in a fast-paced environment: ED, surgical services, or critical care, etc. Must be comfortable accessing multiple technology applications to document during calls Ability and comfort with typing in a fast-paced environment Fluency in English is required, additional languages are a bonus Must physically reside in the U.S. and be legally eligible to work for any employer Must be able to complete three weeks of remote paid training that is conducted during days and evenings Must be available to work every other Saturday & Sunday Must be available to work some Holidays as required Must be able to handle stress and multitask when receiving calls (minimum of 5 calls per hour on weekdays, and up to 8 per hour on weekends) Must be able to communicate empathically with patients while adhering to protocols Must maintain CEU’s as designated by the states in which you are answering calls Must attend any in-services, and additional training on an as needed basis Must pass background check and nurse licensing check

Our Hospice Triage Nurses: Have experience in hospice, palliative, end-of-life care and in fast-paced environments: ED, critical care, surgical services, etc. Part-time nurses work a minimum of 1 week day shift & every other weekend both Saturday & Sunday Receive three weeks of remote paid training. The training schedule varies based on availability You can pick up additional shifts, if available, for the clients’ you are trained to support. We will provide you with a laptop and headset. You’re required to use your own high-speed internet You’ll need a quiet space, away from noise and distraction, while you work (privacy/HIPAA compliant space is required). You’ll access EMRs for charting and utilize our internal applications to perform job functions You MUST be able to follow instructions, read directions, and be confident using technology A minimum of 30 minutes paid shift prep is required prior to taking calls You’ll spend 30 minutes to 2 hours, at the end of your shift, completing remaining charting before clocking out

Morgan Stephens

Utilization Review Nurse – Outpatient (Remote)

Posted on:

April 13, 2025

Job Type:

Full-Time

Role Type:

Utilization Review

License:

RN

State License:

Compact / Multi-State

We are seeking an experienced Utilization Review Nurse (Outpatient) to join our remote Utilization Management team. This role focuses on reviewing medical necessity for outpatient services, including DME, therapy, surgery, and imaging. The ideal candidate has experience with Virginia Medicaid (preferred) or other state Medicaid programs and is highly organized, self-motivated, and comfortable working independently to meet productivity and turnaround time (TAT) requirements. You will assess services for members to ensure appropriate care, optimal outcomes, cost effectiveness, and compliance with state and federal guidelines.

Required: Active, unrestricted RN license in Virginia or a Compact State 2+ years of clinical experience in hospital nursing, case management, or utilization review Outpatient utilization management experience including DME and therapy Strong understanding of Medicaid (Virginia preferred), Medicare, and Commercial LOBs Proficiency with InterQual, MCG, and familiarity with CMS and NCQA standards Tech-savvy with experience using Microsoft Office and EMR systems (EPIC, Allscripts, Athena, Cerner, etc.) Ability to work in EST hours (8:00 AM–4:30 PM or 8:00 AM–5:00 PM EST) Preferred: Direct experience working with Virginia Medicaid Strong knowledge of outpatient medical review practices Familiarity with TruCare, Point Click Care, or EZ-Cap a plus Bilingual in English and Spanish is a plus

Perform medical necessity reviews for outpatient services such as DME, physical/occupational therapy, surgical procedures, imaging, and other related requests Self-pull cases from queue and process efficiently while meeting turnaround time and quality expectations Apply evidence-based criteria (e.g., InterQual, MCG, CMS LCD/NCD) to determine authorization outcomes Collaborate with Medical Directors for secondary reviews when needed Identify eligibility, benefits, and expected length of stay for outpatient services Ensure timely and appropriate documentation of all clinical decisions Support discharge planning and coordinate with internal teams for transition of care when applicable Maintain compliance with Virginia Medicaid or other state Medicaid guidelines and policies Work independently in a structured remote environment using Microsoft Teams, Excel, Outlook, and clinical systems Participate in regular team meetings, audits, and staff development initiatives Demonstrate a professional, approachable, and collaborative demeanor

LanceSoft Inc.,

Family Nurse Practitioner Virtual Care Weekends and Holidays - MC#25-209219

Posted on:

April 13, 2025

Job Type:

Contract

Role Type:

Telehealth

License:

NP/APP

State License:

Florida

LanceSoft’s mission is to establish global cross-culture human connections that further the careers of our employees and strengthen the businesses of our clients. We are driven to use the power of our global network to connect businesses with the right people, and people with the right businesses without bias. We provide Global Workforce Solutions with a human touch.

Position Type: Full time Location: Fully remote (never coming onsite) Work Type: Remote Est. Pay Range: $70.00/hr. to $75.00/hr. The Telehealth Nurse Practitioner delivers patient care services through a remote technology platform. You will work in collaboration with a dedicated team of professionals as you independently provide holistic, evidenced based care inclusive of accurate assessment, diagnosis, treatment, management of health problems, health counseling, and disposition planning for our patients ranging in age 18 months and above. Encounters are documented utilizing an electronic health record (EHR). Telehealth providers report directly to the Enterprise Initiative Lead.

Must hold a FL license and have Independent Practice (3000 hours of overall experience (100 weeks or 2.5 yrs) Must also be licensed in at least three of these states: OH, MA, MD, ME, DC, RI Must be willing/available to work two weekends per six-week cycle Must be willing/available to work one major holiday and one minor holiday per year. Minimum of two years of medical relevant experience Basic Life Support (BLS) certification A minimum of high speed/broadband internet connectivity with a download speed of at least 25 download and 3 upload speed. Speed test not required on resume, but please ensure candidate is aware of this requirement. Must hold an unrestricted license and have the ability to obtain multi state/ compact privileges and licensure in noncompact states as required by the business. Effective verbal, written, and electronic communication skills Outstanding organizational skills and ability to multi-task Initiative, problem solving ability, adaptability, and flexibility Ability to work without direct supervision and practice autonomously Is proficient with information management and technology Capacity to collaborate with professional colleagues as necessary to provide quality care. Education: Completion of a Master’s Degree level Family Nurse Practitioner program with current National Board Certification and State of Employment license to practice in the Advanced Practice Nurse role required.

Patient-Centered Quality and Safety: Evaluate primary care, acute, chronically ill, and transitional care patients, in addition to providing healthcare education and counseling, and disposition planning for our patients ranging in age 18 months and above Provide patient counseling; inclusive of pregnancy prevention, STI Prevention/safer sex practices, contraceptive care counseling and medication management Educate patients on health maintenance and respond to patient care inquiries Document all patient care within an EHR according to policies and procedures Provide care and coordination of our patients with internal and external colleagues, including the broader patient centered medical home, ensuring the highest standard of care is provided for all patients and at all times Effectively work within a patient care team, including fellow Providers, Collaborative Physicians, paraprofessionals, Pharmacists and other members of the health care team Customer Service Excellence: Deliver excellent customer service Seek to increase patient engagement and satisfaction through integration of feedback from patients, management, and professional colleagues Focuses consistently on the patient to create a warm and welcoming environment Tailor communication style to effectively influence quality outcomes and patient needs Collaborate with pharmacy and front store colleagues to provide a complete patient experience Maintain patient confidentiality in accordance with PHI and HIPAA standards Healthcare Environment Management: Resolve conflict using appropriate management techniques Cultivate and maintain positive relationships among practice employees, colleagues and external partners Reprioritizes continually throughout the day to fulfill patient and business needs Support the overall patient experience, by effectively managing clinical and non-clinical duties as well as patient expectations Quickly adopt new service offerings and patient care models Adhere to the core values of in all communications and interactions Assist with hiring, development, and evaluation of Practice employees Complete necessary tasks for clinic operations, including but not limited to taking inventory, following up on lab results, receiving incoming phone calls, ordering supplies and maintaining clinic cleanliness Business Acumen: Remain accountable to managing business needs including, but not limited to, budget, payroll, inventory, billing insurance, and payment collection Own the success of your practice through implementation of the clinic level business plan designed to meet identified business goals Assure complete and accurate payment for services through comprehensive documentation in the patient chart, verification of payment method (insurance, cash or combination) for each visit, and collection of payment as directed by the EMR Complete revenue cycle managements tasks including collecting payment at time of service for all visits and preparing nightly deposits. Autonomy: Work independently , prioritize and solve problems, take initiative, and advocate for their patients and their practice Actively participate in professional development thru professional groups, committees within the organization and/or additional external experiences Maintain self-awareness and professionalism of individual actions and how they impact the clinic, practice, and healthcare industry Continuing education, including what is required to maintain employment, is the responsibility of the provider.

HealthCare Support

Remote Utilization Review LVN - California License Required

Posted on:

April 13, 2025

Job Type:

Contract

Role Type:

Utilization Review

License:

LPN/LVN

State License:

California

HealthCare Support is actively seeking a Remote Utilization Review LVN - California License Required to fill an opening. Pay Details: $34 per hour Shift Details: Monday – Friday 8am to 5pm HI (Hawaii)

High School Diploma or GED Active and unrestricted LVN/LPN license in CA (can sit in another state PST or MST but need to be able to work PST hours) 1+ year of inpatient/concurrent review

Concurrent review for inpatient charts using MCG (Milliman Care Guidelines) and Medicare guidelines for inpatient case management Work directly with the provider(s) and Medical Director to facilitate quality service to the member and provider Identifies and refers members to the appropriate healthcare program (e.g. case management, disease management)

HealthCare Support

Licensed Behavioral Health Clinician – Remote

Posted on:

April 13, 2025

Job Type:

Full-Time

Role Type:

Behavioral Health

License:

RN

State License:

Michigan

Healthcare Support is actively seeking a Licensed Behavioral Health Clinician to fill an opportunity with an Outpatient Collaborative Care company as a 100% Remote Telehealth Behavioral Health Clinician in the state of Michigan. Shift: Monday – Friday | 8-hour shift | Days

LPCC, LMHC, LMSW, LPC, LCSW or RN licensure within the state of Michigan 3+ years of experience in behavioral health intervention as an independently licensed clinician/therapist

Screen and assess patients for mental health and substance abuse disorders, and develop personalized treatment plans with appropriate follow-up care Provide evidence-based behavioral interventions (e.g., motivational interviewing, behavioral activation) and support psychotropic medication management, ensuring adherence and monitoring for side effects Track treatment responses, monitor clinical symptoms, and facilitate patient education, referrals, and care coordination through EHR and other clinical tools Actively participate in team consultations, process improvement initiatives, and meet performance metrics while maintaining collaboration with medical providers and psychiatric consultants

HealthCare Support

Bilingual Licensed Behavioral Health Clinician – Remote

Posted on:

April 13, 2025

Job Type:

Full-Time

Role Type:

Behavioral Health

License:

RN

State License:

Florida

Shift: Monday-Friday, flexible 8-hr day shift | 100% remote HealthCare Support is actively seeking a Bilingual Licensed Behavioral Health Clinician to join a Psychiatric Collaborative Care company remotely.

Must have LPCC, LMHC, LMSW, LPC, LCSW, RN or Psychologist in the designated state (Florida) Must be fluent in English & Spanish Minimum of 3+ years of experience in behavioral health intervention clinical work, case management, and/or community care coordination. Experience working with various populations A license in the state to be independently billable is required. Current enrollment in the state’s Medicaid & Medicare is preferred but eligibility for such at a minimum is required Proficiency with MS Office Suite and ability to navigate web applications

Screen and assess patients for mental health and substance abuse disorders. Facilitate patient engagement, treatment plans, and follow-up care. Provide brief behavioral interventions using evidence-based techniques such as behavioral activation, problem-solving treatment, motivational interviewing, or other treatments as appropriate supported by the clinical technology software. Support psychotropic medication management as prescribed by medical providers, focusing on treatment adherence monitoring, side effects, and effectiveness of treatment. Provide health behavior and social determinants of health interventions to improve functioning and improvements in medical outcomes. Systematically track treatment response and monitor patients (in person, video or by telephone) for changes in clinical symptoms and treatment side effects or complications.

HealthCare Support

RN/ LPN Prior Authorization Nurse

Posted on:

April 13, 2025

Job Type:

Contract

Role Type:

Utilization Review

License:

RN

State License:

Arizona

HealthCare Support is actively seeking an RN/ LPN Prior Authorization Nurse to fill an opening with a fortune 25 Healthcare company. Shift: M/F 8:30-5pm Location: Remote in AZ

Graduate from an Accredited School of Nursing. BSN preferred LPN or RN license in Arizona, RN strongly preferred 2+ years of Prior Authorization, Utilization Management, Utilization Review experience with reviewing outpatient services such as DME, Home health, nutrition, pain, hospice, sleep studies Milliman or IQ computer experience

Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care.

HealthCare Support

Remote RN Certified Coder

Posted on:

April 13, 2025

Job Type:

Contract

Role Type:

Clinical Operations

License:

RN

State License:

California

HealthCare Support is actively seeking a Remote RN Certified Coder to fill a job opening. This role is fully remote, but you must be able to work EST hours.

Bachelor’s degree Certified Professional Coder (AAPC or AHIMA) Active unrestricted RN license 3+ years of experience with coding and reimbursement methodologies (e.g. CPT, HCPCS, ICD-10, CMS, etc.) 3+ years of RN experience Prior managed care experience Proficient in the use of MS Word, Excel, Access, and PowerPoint. Excellent written and verbal communication skills

This position will be working on a COC/ SPD project full time to help build out the coding for our benefit plans Determine which codes belong to the language in the benefit plans Review what peers have designated as correct coding Facilitate any discussions needed to get to a coding document Review audit results and make adjustments as necessary Participate in project meetings This individual will be working on a team with other certified coders and a few business analyst roles The shifts for the position: Monday to Friday, 8am to 5pm EST This is a contract position, through the end of 2025

Inhouse Recruiting Solutions

RN OASIS Reviewer/Coder

Posted on:

April 13, 2025

Job Type:

Full-Time

Role Type:

Clinical Operations

License:

RN

State License:

Texas

RN OASIS Reviewer/Coder (Remote) Location: Remote Company: Empower Empower is currently hiring a remote RN OASIS Reviewer/Coder.

Current RN license Minimum of 2 years of experience in OASIS review and ICD-10 coding Strong attention to detail and familiarity with Medicare documentation standards Prior experience with coding software and EMR systems Excellent time management and communication skills

This position is responsible for reviewing and coding OASIS assessments to ensure accuracy, compliance, and alignment with CMS guidelines. The reviewer will provide feedback to field staff and collaborate with internal departments to ensure high standards of documentation and reimbursement practices.

Athens Administrators

Telephonic Nurse Case Manager

Posted on:

April 13, 2025

Job Type:

Full-Time

Role Type:

Case Management

License:

RN

State License:

California

Explore the Athens Administrators difference: We have been dynamic, innovative leaders in claims administration since our founding in 1976. We foster an environment where employees not only thrive but consistently recognize Athens as a “Best Place to Work.” Immerse yourself in our engaging, supportive, and inclusive culture, offering opportunities for continuous professional growth. Join our nationwide family-owned company in Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the Athens Administrators family today!

Athens Administrators has an immediate need for a full-time Telephonic Nurse Case Manager to support our Managed Care Department. The position can be located remotely from California, Colorado, Nevada, Texas, Oregon, Idaho, Arizona, or Oklahoma if technical requirements are met. This position will work M-F from 9am to 5pm Pacific time schedule regardless of time zone. Athens offices are open for business Monday-Friday from 7:30 a.m. to 5:30 p.m. The Telephonic Nurse Case Manager researches and recommends resources and creates flexible, cost-effective options for injured, catastrophically, or chronically ill individuals on a case-by-case basis to facilitate quality individualized treatment goals, including timely return to work if appropriate. This position will assist the unit in maintaining a successful program which may include helping develop workflows, reporting, staff recruitment and training.

A Master's or Bachelor's degree in nursing or an Associate's Degree in Nursing from an accredited school, along with equivalent work experience, is required CCM, CIRS, CRRN, COHN or other related designation preferred Master’s or Bachelor’s degree in related field with a CCM, CDMS, or CRC or other related designation preferred Active RN license from any US state required at time of hire Current RN licensure in CA required within one year of hire (if not already obtained) California RN application submitted within the first two weeks of hire. Athens reimburses licensing fees 3+ years’ workers’ compensation case management experience or related field required Strong clinical background in orthopedics, neurology, or rehabilitation useful Strong cost containment background, such as utilization review or managed care also useful Extensive clear and tactful communications required via writing, reading, telephone calls, note taking, letter writing, memoranda, etc. Strong negotiation skills The ability to work effectively with minimal direct supervision Well-developed verbal and written communication skills with strong attention to detail Excellent organizational skills and ability to multi-task Ability to type quickly, accurately and for prolonged periods Proficient in Microsoft Office Suite Ability to learn additional computer programs Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization Seeks to include innovative strategies and methods to provide a high level of commitment to service and results Ability to be demonstrate care and concern for fellow team members and clients in a professional and friendly manner Acts with integrity in difficult or challenging situations and is a trustworthy, dependable contributor. Athens’ operations involve handling confidential, proprietary, and highly sensitive information, such as health records, client financials, and other personal data. Therefore, maintaining honesty and integrity is essential for all roles within the company.

Organizes and review medical records to identify specific medical issues; Provides information and recommendations to appropriate parties. Maintains regular contact with all parties involved to facilitate communication and to provide medical and vocational management and coordination services. Arranges for prompt and appropriate medical treatment of an injured worker by qualified providers (choice of providers as per regulations). Schedules appointments to avoid delays in treatment by primary care physicians, specialists, or ancillary services. Assists the treating physician in developing a written treatment plan for the injured worker, including the identity and scope of treatment by any other providers to which referrals have been made. May be requested to attend doctor and/or attorney visits, hospital and/or long-term facility discharge planning conferences, et cetera for the purpose of determining appropriateness of care and developing an effective long-term care strategy as deemed necessary. Work with the medical providers to track progress and to modify the treatment plan as necessary until maximum medical improvement is achieved. Obtains medical reports and required work status forms. Ensures all parties receive appropriate reports. Develops Independent Medical Evaluation Plan. Provides assessment, planning, implementation, and evaluation of patient's progress Facilitate authorization/certification of procedures, diagnostic testing, physical therapy/occupational therapy and durable medical equipment as per regulations to ensure appropriate treatment is not delayed. Cooperates with the treating physician to obtain a full or conditional release to return to work before injury becomes a lost time claim. Work with the treating physician to update any conditions as medical treatment progresses Assesses the injured worker and his/her support system and family. Makes appropriate referrals throughout the continuum of care including educational, financial, and psychological or other human services as indicated Coordinates with the employer to develop a modified duty job for the injured worker who cannot immediately return to his/her full pre-injury employment, ensuring the job is consistent with any physical restrictions assigned by the treating doctor. Educates the employer on the tangible and intangible benefits of accommodating the injured worker to keep him in the work force. Where a return to work with the same employer is not possible, provide vocational services to the injured worker to identify vocational goals and develop an early return to work plan. Research medical and community resources for patients with catastrophic or chronic diagnoses, such as but not limited to, AIDS, cancer, spinal cord injury, diabetes, head injury, back injury, hand injury, burns, et cetera. Maintains constant contact with the adjuster assigned to the file through telephone calls, email, and written reports. For each customer be aware of the limits of decision-making authority delegated by the adjuster to the case manager and respect these limits. Satisfy the documentation and reporting requirements of each customer. Maintains continuing education requirements per state license requirements. Maintains an updated and working knowledge of workers’ compensation and federal laws that impact the delivery of health care and return to work May be requested to attend doctor and/or attorney visits, hospital and/or long-term facility discharge planning conferences, et cetera for the purpose of determining appropriateness of care and developing an effective long-term care strategy as deemed necessary. Assist the overall unit with development of workflows, best practices, reporting templates, and training needs as deemed necessary. Requires regular and consistent attendance May be asked to travel to other branches for training or file reviews as needed. Comply with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP)

Healthcare Shares

Registered Nurse Advisor at Healthcare Venture Capital Fund - Healthcare Shares

Posted on:

April 12, 2025

Job Type:

Part-Time

Role Type:

Primary Care

License:

RN

State License:

New York

We are a Healthcare Venture Capital fund focused on investing in social impact healthcare startups.We seek a Registered Nurse Advisor to provide clinical expertise, strategic insights, and guidance on evaluating healthcare investments.

As a Registered Nurse Advisor, you will play a key role in evaluating healthcare startups, engaging with founders, providing clinical expertise, and helping us connect with other healthcare professionals interested in venture capital and entrepreneurship. The Registered Nurse Advisor will work alongside physicians, dietitians, and other healthcare advisors to ensure that startups bring clinically sound, patient-centered innovations to market.

Registered Nurse (RN) with clinical, telehealth, or startup experience in hospital care, outpatient care, telemedicine, or patient advocacy. Passion for healthcare innovation, digital health, and entrepreneurship. Strong understanding of clinical workflows, patient engagement, and healthcare technology from a Registered Nurse perspective. Ability to critically evaluate startups, assess business models, and identify real-world clinical challenges in nursing and patient care. Interest in networking with founders, investors, and other healthcare professionals. Previous experience in healthcare startups, consulting, or advisory roles is a plus but not required.

Startup Evaluation: Assess healthcare startups in digital health, telemedicine, medical devices, patient engagement, and chronic disease management, providing insights from a Registered Nurse perspective. Founder & Investor Engagement: Advise healthcare entrepreneurs, investors, and executives on nursing-related startups, business models, and patient care innovations. Community & Network Growth: Connect with Registered Nurses, physicians, and healthcare leaders who may be interested in joining our investment network or supporting early-stage healthcare startups. Due Diligence & Market Research: Provide input on nursing industry trends, regulatory challenges (Medicare reimbursement, insurance, clinical workflows), and patient adoption hurdles for potential investments. Advisory Board Participation: Join investment discussions and offer strategic guidance on portfolio companies requiring nursing expertise, clinical validation, and workflow integration. Collaboration with Healthcare Advisors: Work closely with physicians, Registered Dietitians, and other healthcare professionals to ensure that investments align with nursing best practices and patient care standards.

Naven Health

Quality Assurance Chart Review Nurse - Naven Health (Remote - National)

Posted on:

April 12, 2025

Job Type:

Full-Time

Role Type:

Clinical Operations

License:

RN

State License:

Tennessee

Delivering an exceptional infusion experience, everywhere. Delivering on our unyielding commitment, always. Naven Health is a nationwide home infusion nursing network and clinical platform focused on delivering specialized, truly exceptional infusion care. With over 1,600 team members, including over 1,500 nurses, we are a company aligned to the values of the nurses at our center – to provide an exceptional infusion experience, everywhere. Naven Health delivers home infusion services for a broad range of specialized therapies, as well as clinical trial services and special programs for pharmaceutical manufacturers. Joining the Naven Health team means being a part of a dynamic and growing organization that is dedicated to our customers, our teammates, and the patients we serve.

The Quality Assurance Chart Review Nurse is responsible for the review of assigned clinical records. The Quality Assurance Chart Review Nurse works closely with the Quality Assurance Team to identify documentation discrepancies and deficiencies in the patient’s clinical records. The Quality Assurance Chart Review Nurse utilizes audit tools and systems to collect data for the Quality Department under the direction of the Senior Manager of Quality, Regulatory, & education.

Basic Education and/or Experience Requirements: Nursing degree or certificate Active and unrestricted license as an LPN/LVN or RN IV certified for LPN/LVN candidates 3 years of clinical nursing experience 1 year of home infusion experience Basic Qualifications: Ability to work remotely and achieve target goals. Proficiency in electronic medical records and computer systems (Microsoft Excel, Teams, Forms, etc.) Proven strong Communication Skills – verbal, written, presentation Strong clinical background with direct knowledge of care in the home Physical Demand Requirements: Ability to work on a personal or laptop computer for extended periods of time Travel Requirements: (if required): N/A Preferred Qualifications & Interests (PQIs): Previous experience as a Quality Assurance Nurse or Chart Review Auditor Knowledge and understanding of TJC Accrediting Standards for Home Health Knowledge and understanding of Clinical Practice Guidelines for infusion therapy.

Conducts chart reviews to ensure compliance with regulatory, accreditation, policy, and standard operating procedures and standards. Reviews clinical documentation for accuracy, completeness, and adherence with clinical best practice guidelines. Provides feedback to clinical leadership regarding documentation discrepancies, deficiencies, and areas of improvement. Participates in Quality Improvement Activities by conducting Focused Reviews and Compliance Monitoring Audits for Performance Improvement Projects. Supervisory Responsibilities Does this position have supervisory responsibilities? (i.e. hiring, recommending/approving promotions and pay increases, scheduling, performance reviews, discipline, etc.) No X

Optum

Clinical Quality LPN - Remote in EST

Posted on:

April 12, 2025

Job Type:

Full-Time

Role Type:

Telehealth

License:

LPN/LVN

State License:

Minnesota

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The Patient Navigator will be responsible for conducting outbound calls and answer inbound calls, off-season survey follow-up, provide patients with community resources, close gaps on HOS, etc. for all markets as needed. The Patient Navigator will support a variety of strategic activities, based on Member Experience data and performance metrics throughout the OptumCare enterprise. This individual will maintain the highest standards to ensure the members have the best healthcare experience by facilitating the process every step of the way, and will complete daily activities reports. Schedule: Monday – Friday (No weekends, no holidays). Must be flexible to work hours in different times zones as needed for a nationwide account. You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Required Qualifications: Current, unrestricted LVN/LPN license 3+ years of clinical experience as a LVN or LPN 3+ years of experience in the health industry and/or in a large complex matrixed organization Intermediate level of proficiency with MS Excel, Word, and PowerPoint– Project scope documents, project presentations, etc. Intermediate level of proficiency with SharePoint Preferred Qualifications: Experience in a call center HEDIS/STAR experience or participation with similar regulatory reporting

Conduct a high volume of outbound calls to assist members, evaluate current health status, discuss non-compliance to medication(s), schedule pharmacy telephonic appointments, and/or obtain important follow up information from providers. Calls are made primarily using an auto dialer requiring precision to detail and adaptability to type of response needed Answer inbound calls from members and assists them with their inquiries Identifies patients with the missing measures and works to close the measures through education/counseling, appointment setting, and other means as appropriate Follows system scripting and validates member demographic information Documents the provider or member’s record with accurate information obtained on the call Maintains education/knowledge base of HEDIS/STARs standards and guidelines Uphold UHG Cultural Values Ability to multitask and performs all other related duties as assigned

The Judge Group

RN - In-home Assessments

Posted on:

April 12, 2025

Job Type:

Contract

Role Type:

License:

RN

State License:

Compact / Multi-State

Our client is currently seeking a Remote Field RN to do In-Home Assessments in North New Jersey! Position Title: Remote Field Nurse (RN Ongoing Contract (W2, Weekly Pay, Temp to Hire potential) Location: North New Jersey (Hudson, Union, Bergen counties) Role Type: Remote Field Role – travel required for member assessments; not office-based. Hours: 8:00 AM-5:00 PM or 9:00 AM-6:00 PM, with 3-4 member assessments daily. Job Overview: We are seeking a highly motivated and detail-oriented Registered Nurse (RN) for a field-based position that involves conducting member assessments within the North New Jersey area. This is a remote role with travel requirements, offering autonomy and independence for organized self-starters with strong technical and computer proficiency.

Training & Compensation: Training for the first two weeks will take place onsite at the Hopewell location. Mileage reimbursement provided for travel. Qualifications: Active NJ RN license or Compact NJ license required. Valid driver's license and reliable transportation. Experience in Home Health or Med Surg preferred. Proficient in computer systems and technology. Exceptional organizational and note-taking skills. Strong ability to work independently.

Conduct assessments for PCA (Personal Care Assistant) and MDC (Major Diagnostic Category) services using established guidelines to ensure appropriate care and services are authorized. Evaluate the necessity, appropriateness, and efficiency of services provided. Collaborate with patients, families, physicians, hospitals, and other stakeholders to ensure services align with diagnoses and outcomes. Coordinate high-quality, cost-effective care across the continuum using clinical practice guidelines. Monitor medical care activities and outcomes for effectiveness and appropriateness. Advocate for members and families, ensuring resource utilization meets their needs. Refer members to MLTSS (Managed Long-Term Services and Supports) and educate them on SNP (Special Needs Plan) when appropriate. Accurately and comprehensively document assessments in compliance with organizational standards. Facilitate communication with multidisciplinary teams, ensuring efficient care management. Contribute to quality improvement initiatives to enhance member outcomes. Perform other duties and assigned tasks as directed by management.

The Judge Group

Remote Medical Policy Review RN

Posted on:

April 12, 2025

Job Type:

Contract

Role Type:

Clinical Operations

License:

RN

State License:

Compact / Multi-State

The Judge Group is currently seeking a remote Medical Policy Review RN for a fantastic client of ours! Are you passionate about ensuring appropriate and efficient utilization of medical benefits? Join our team as a Medical Policy Review Specialist, where you'll play a crucial role in the medical policy determination of claims and cases consistent with Plan Medical Policy. You'll also be responsible for researching and analyzing medical techniques, procedures, and products, and making recommendations for draft medical policy. Job Title: Medical Policy Determination Specialist Location: Remote but must reside in NJ, PA, NY, DE, or CT and have an active RN license in the state of NJ

Candidates must live in NJ, PA, NY, DE, or CT. Active NJ or NJ Compact RN license. Minimum 3 years RN experience in a clinical setting. Comfortable working with Claims systems - Horizon uses Nasco. Must have coding experience; certification not required. Demonstrated ability to work in a production-focused environment. Must be tech-savvy with strong Microsoft experience and knowledge of intranet and internet applications.

Provide timely and accurate responses to inquiries from the claim policy teams in relation to courtesy pre-d requests, claims pending for medical review, and appeal inquiries. Prepare cases for Medical Director Review and/or outside consultant review and response where appropriate. Process pends for which the Medical Policy Inquiry Resolution team has authority to do so. Identify opportunities for development of or revisions to Horizon Medical Policy based on case review. Identify areas and pursue solutions where medical policy is not being applied correctly in claim payment outcomes. Manage inventory assigned, document production in RMRS, and follow through on all assigned inquiries. Stay abreast of all mandates, policy changes, and workflow changes impacting outcomes. Perform special projects as assigned by management. Demonstrate knowledge and understanding of the laws, regulations, and policies that pertain to the organization unit's business and conform to these laws, regulations, and policies in carrying out the accountabilities of the job.

Assembly Health

MatrixCare Experienced Skilled Nursing Tracking Specialist

Posted on:

April 12, 2025

Job Type:

Full-Time

Role Type:

License:

RN

State License:

Illinois

Become a part of the Quality Healthcare Team! Quality Healthcare, a member of the Assembly Health family of companies is looking for a Skilled Nursing Tracking Specialist. If you are looking for a company that is focused on being the best in the industry, love being challenged, and make a direct impact on our business, then look no further! We are adding to our motivated team that pride themselves on being client-focused, biased to action, improving together, and insistent on excellence and integrity.

Prior experience using MatrixCare. Experience working with nursing home facilities and Medicaid applications. Strong written and verbal skills with the ability to adjust the message to fit the audience. Possess strong organizational and time management skills. Ability to analyze and synthesize information to understand issues and identify options. Engage with a wide base of clients across the organization. Collaborate with interdepartmental team members to complete projects. Quality requires employees working from home, or otherwise remote, maintain broadband internet access at the address where remote work is being performed. Quality will require a valid speed test report. If you are unable to meet these requirements, please discuss with your recruiter.

Provide a viable payer source beginning from date of entry throughout the resident's stay. Process Medical Assistance applications and re-determinations. Utilize uTrack to enter all data. Interact with client and facility staff with professionalism in all facets of customer service. Prioritize and adjust workload based on the urgency and importance of issues. Escalate growing balances and/or unresolved time sensitive issues. Ensure facilities are operating according to procedure and compliance. Maintain timely communication with directors, administrators, and staff regarding potential issues at the facilities. Participate in team meetings, committees, and/or conference calls. Other responsibilities may include training of new Tracking Specialists.

Rightway

Bilingual Case Manager, RN

Posted on:

April 12, 2025

Job Type:

Full-Time

Role Type:

Case Management

License:

RN

State License:

Compact / Multi-State

Rightway is on a mission to harmonize healthcare for everyone, everywhere. Our products guide members to the best care and medications by inserting clinicians and pharmacists into a member’s care journey through a modern, mobile app. Rightway is a front door to healthcare, giving members the tools they need along with on-demand access to Rightway health guides, human experts that answer their questions and manage the frustrating parts of healthcare for them. Since its founding in 2017, Rightway has raised over $130mm from investors including Khosla Ventures, Thrive Capital, and Tiger Global at a valuation of $1 billion. We’re headquartered in New York City, with a satellite office in Denver. Our clients rely on us to transform the healthcare experience, improve outcomes for their teams, and decrease their healthcare costs.

Under the general supervision of the Sr. Clinical Manager, the Case Manager RN performs clinical triage, high-risk outreach, condition support, care planning, clinical education, and care coordination functions in supporting Rightway members with navigating, accessing, and best supporting their care needs. The Case Manager RN also serves as a trusted advisor for providing clinical guidance and directing to the most appropriate high-quality care providers with the objective of improving clinical outcomes while also reducing healthcare costs e.g. minimizing ED or other unnecessary care visits while increasing utilization of more appropriate care settings, such as primary care doctors.

RN, ADN, or BSN degree Must be fluent in Spanish Holds an active and in good standing RN license in a compact state 5+ years of direct patient care experience required, preferably in family medicine Triage nursing experience desired Population health, disease management, or similar experience required Care management or chronic condition support experience desired

Clinical triage to assess the severity of the member’s health concerns using evidence-based protocols and algorithms in directing care to the right healthcare resource in a timely manner without compromising quality or safety Leveraging data-driven analytics in conducting proactive outreach to engage members of clinical interest, e.g. e high-risk, high-spend, rising risk, and evidence of care gaps with the objective of engaging and assisting members in making more informed care decisions, supporting across their continuum of care and well-being journey with lifestyle and behavior changes. Engage members in clinical conversations to best understand their care needs, assess risks, preferences, and care barriers, and then guide and recommend appropriate next steps to improve health outcomes Identify and address barriers preventing members from accessing preventative care or establishing ongoing relationships with primary care providers Assist in scheduling appointments, referrals, and follow-up care to close gaps in preventative care and chronic disease support Clinical navigation support includes but is not limited to personalized condition education, care options, and planning, care compliance, medication adherence, shared decision support, and care coordination Leverages appropriate input and direction from the Rightway clinical lead to determine the best clinical options for more complex member healthcare needs. Accurately documents symptoms/complaints, nursing assessment, the guidance provided, and member/caller response. Acts in the best interest of the member by being a health advocate and supporter in the member’s healthcare journey. Coordinates the completion of screening services for high-risk members by providing care support, adherence follow-up, and care coordination support. Member’s trusted healthcare advisor, member experience, and retention focus e.g. longitudinal care education, guidance, and support Develops effective collaboration and working relationships across the Navigation team and organization. Maintains a member-centric, customer-driven professional attitude. Stay within the RN scope of practice by strictly following our care navigation protocols unless directed to do otherwise by a provider on the clinical team and documenting appropriately when a change occurs.

Summit Medical Consultants LLC

Triage Nurse (LPN) Remote - must reside in Colorado

Posted on:

April 12, 2025

Job Type:

Full-Time

Role Type:

Triage

License:

LPN/LVN

State License:

Colorado

Summit Medical Consultants is actively recruiting for a full-time Triage Nurse to join our Clinical Triage Team. Summit Medical Consultants is a rapidly growing Physician Practice. Founded in 2015, we have expanded to approximately 100 employees and are continuing to grow. Our mission is to provide patients and their families with robust clinical services throughout their Acute Inpatient Rehab, Skilled Nursing, Long Term Care and Assisted and Independent Living stays. We coordinate with the Hospitalists and Specialist physicians and surgeons, Physical, Occupational, Speech Therapists, Case Management and Psychiatry at the facility level to provide compassionate and coordinated care. Work Location: Remote - must reside in Colorado along the I-25 corridor from Ft. Collins to Pueblo.

Active LPN Colorado nursing license 2 years clinical nursing experience in the post-acute care setting preferred Proficient in utilizing Google Docs, Google Sheets, and electronic medical records (EMRs). Familiarity with messaging platforms and phone systems is highly desirable.

Prioritize and handle clinical phone calls within the LPN scope of practice in alignment with standing orders. Serve as a bridge between pharmacies and mid-levels/Physicians to resolve pharmacy-related concerns. Communicate with providers regarding questions or issues, recording detail in the EHR system. Monitor the message threads closely and promptly follow up according to established protocols. Process incoming paperwork and forward it to the designated provider for signature. Act as a liaison between patient families and providers, addressing messages, resolving issues, and offering support within the LPN scope of practice. Maintain professionalism and courtesy during phone interactions, adhering to outlined timeframes for returning calls. Participate in monthly Team Meetings, Triage Meetings and other instructed gatherings. Adapt to evolving workflows in a growing practice, recognizing that duties may change periodically to meet practice needs. Maintain frequent and prompt communication with the Triage Manager and all providers throughout the day. Conduct Chronic Care Management patient chart reviews, telephone calls, and related documentation. Immediately escalate any issues to the managers. Fulfill any additional duties and tasks as assigned and required. Provide a precise and detailed daily account of time allocation. Assist in various administrative tasks, as instructed and as necessary Rotate holiday coverage with the Triage Team. Department expectations: Serving as a central communication hub among providers, facility partners, patients, patient families and outside vendors. Address practice protocol appropriately and meticulously documents all interactions with patients, families, and facilities. Ensuring accurate documentation for prescriptions, verbal orders, and clinical telephone calls is a key responsibility for all Nursing team members. Assessing the quality of patient care delivered by the Nursing team and coordinating patient care services with patients, staff, physicians, and other departments is crucial. Work schedule is FT days 40 hr/week and at least two weekends a month. This description is intended to serve as an outline. Please note the above responsibilities are not an exclusive list. You will be given additional duties, tasks, and responsibilities in your employment. It will be your responsibility to complete all other tasks assigned.

Revive Mobile IV LLC

Mobile IV RN

Posted on:

April 12, 2025

Job Type:

Contract

Role Type:

License:

RN

State License:

Pennsylvania

THIS JOB IS FULLY MOBILE. **YOU MUST BE WILLING TO DRIVE AND ENTER CLIENTS HOMES,WORKPLACES, HOTELS, ETC. BENEFITS ARE NOT PROVIDED AS THIS IS A CONTRACT POSITION.

Looking for nurses who live within the city of York, PA Must be highly skilled in IV placement, comfortable working as a triage nurse Must have a minimum of 2 years of recent experience in daily IV placement Unrestricted licensure as a Registered Nurse (RN) in the State of Pennsylvania Two years of RN experience (ED, Critical Care or L&D experience preferred) Unrestricted Driver’s License Must follow directions well and be good at multi-tasking Access to reliable transportation and willingness to drive up to 45 minutes for appointments. Able to send/receive text messages, work with smartphone apps, and use GPS navigation Able to work collaboratively with co-workers and clients Able to work independently in all care settings BLS certification required Required to provider 15-20 hours of availability a week

https://www.indeed.com/viewjob?jk=5f30aef1ed2450e1&tk=1iojq6quvgqlg85m&from=serp&vjs=3

Elara Caring

Hospice Triage Registered Nurse (RN)

Posted on:

April 12, 2025

Job Type:

Part-Time

Role Type:

Triage

License:

RN

State License:

Compact / Multi-State

At Elara Caring, we have a unique opportunity to play a huge role in the growth of an entire home care industry. Here, each employee has the chance to make a real difference by carrying out our mission every day. Join our elite team of healthcare professionals, providing the Right Care, at the Right Time, in the Right Place.

Remote Hospice Triage RN Saturday & Sunday, 9:00 AM – 9:00 PM EST Must Have a Compact RN License and Reside in an Approved State Elara Caring is growing and currently seeking an experienced Hospice Triage Registered Nurse to join our remote team. This is a critical weekend role supporting patients and families during some of their most vulnerable moments, delivering compassionate, timely care over the phone. As a Remote Hospice Triage RN, you will serve as the first point of contact for patients and caregivers, providing clinical guidance, emotional reassurance, and care coordination — all from the comfort of your home. This position plays a vital part in our ability to deliver continuous, high-quality care beyond standard business hours.

Graduate of an accredited nursing program (Certificate, Diploma, Associate, or Bachelor’s degree) Active Compact RN License Must reside in one of the following states: Oklahoma, Texas, Louisiana, Illinois, Massachusetts, Ohio, Michigan, Indiana, Missouri, or Kansas Willingness to obtain licensure in non-compact states (MI, IL, MA); Elara will cover the cost Minimum of 1 year of hospice experience Minimum of 1 year of triage nursing experience Reliable high-speed internet HIPAA-compliant home office setup

Provide remote triage services to hospice patients in Oklahoma, Texas, Louisiana, Illinois, Massachusetts, Ohio, Michigan, Indiana, Missouri, and Kansas Maintain strict patient confidentiality in accordance with HIPAA Plan, direct, and participate in delivering professional services to hospice clients Identify changes in patient condition and coordinate appropriate care with physicians and team members Initiate and manage patient safety plans in collaboration with patients, families, and community resources Verify and implement the plan of care in line with physician orders and clinical standards Serve as the primary point of contact and supervisor for after-hours hospice services Manage incoming referrals, staff assignments, re-certifications, and communication between patients and care teams Complete required documentation related to patient death notifications Assess needs and coordinate spiritual and social work services Educate staff on hospice admission criteria and confirm patient eligibility Ensure compliance with Medicare, Medicaid, and other regulatory requirements Promote a respectful, supportive environment for patients and families Take on additional duties and projects as needed

Octiva

Telehealth Support Specialist

Posted on:

April 12, 2025

Job Type:

Full-Time

Role Type:

Telehealth

License:

None Required

State License:

Texas

Octiva Healthcare provides a 24/7 extension of clinics with three tiers of services: support specialists for general inquiries, message-taking, and appointment scheduling; nurses for medical concerns; and clinicians for advanced medical care.

We are seeking a dedicated Healthcare Support Specialist to join our remote team. This role is pivotal in managing inbound patient calls, ensuring seamless communication, and providing exceptional service to our patients.

Skills and Qualifications: Excellent communication skills, both verbal and written, with a focus on patient interaction. Proficient in computer use, including experience with healthcare software and electronic health records. Strong problem-solving skills and the ability to troubleshoot technical issues. Ability to handle sensitive information with discretion and confidentiality. Experience in a customer service role, preferably within healthcare or a similar high-touch environment. Empathy and patience when dealing with sick or stressed patients. Comfortable working remotely with the discipline to manage time and tasks effectively. Additional Information: This position is fully remote, requiring a reliable internet connection and a quiet workspace. Must be available to work during standard business hours, with potential for some early or late shifts to accommodate patient needs. This role is essential in enhancing our patient experience by ensuring they have access to the care they need when they need it, all while maintaining the highest standards of customer service in a healthcare setting.

Patient Interaction: Manage and respond to inbound patient calls with professionalism and empathy. Address patient inquiries regarding appointments, medical procedures, and general health concerns. Appointment Management: Schedule, reschedule, or cancel patient appointments using our electronic health record system. Ensure all appointments are accurately recorded and patients are informed of their appointment details. Call Routing: Efficiently route calls to the appropriate members of our clinical care team, including doctors, nurses, or specialists, based on the patient's needs. Technical Support: Provide basic technical assistance to patients using telehealth services or accessing patient portals. Troubleshoot common issues to ensure patients can utilize our digital health platforms effectively. Documentation: Maintain accurate and confidential patient records. Ensure all interactions are logged correctly in compliance with HIPAA regulations. Customer Service: Deliver high-quality customer service, aiming to resolve patient concerns in one call when possible. Follow up on unresolved issues to ensure patient satisfaction. Team Collaboration: Work closely with clinical staff to relay critical information and ensure continuity of care. Participate in team meetings to discuss patient care improvements and operational efficiencies.

Octiva

24/7 Telemedicine Triage Nurse

Posted on:

April 12, 2025

Job Type:

Full-Time

Role Type:

Triage

License:

RN

State License:

Compact / Multi-State

Octiva Healthcare is a telemedicine company that provides 24/7/365 clinical support to patients in need of timely care and advice. Our mission at Octiva is to provide around-the-clock healthcare that meets the highest standards of clinical excellence and patient experience. We ensure our services are accessible from any location and in any language, embracing a culture of compassion, clear communication, and strict compliance to security. Our goal is to be a constant in our patients' lives, available 24/7, delivering care with a personal touch.

**Please see pay range before applying** Octiva Triage Nurse – Fluent Spanish Speaking Required Active Califonia RN license Required at time of Application Compact License Required Triage Nurse The ideal candidate has a strong background in clinical nursing and outstanding patient communication skills. The Triage Nurse is a part of the clinical care team which includes nurses, advanced practice providers, and physicians. This position practices nursing via the telephone, utilizing your nursing skills and training , input from physicians, and approved telephone nursing guidelines and protocols. The functions of this position include electronic prescription refill, triage to the most appropriate level of care, providing nursing advice and self-care treatments, identifying resources, and performing nurse follow-up activities. All duties and responsibilities fall within departmental and organizational guidelines and are within the scope of practice as defined by the Board of Registered Nursing and in compliance with state laws and medical nursing standards of care.

Education: Graduate of accredited school of nursing required. BSN preferred. On-the-job training in triage Experience: Two to five years of practical RN experience; outpatient experience preferred. One to two years of practical experience in a physician’s office or medical office setting preferred. Telehealth experience strongly preferred. Performance Requirements: Knowledge: Knowledge of telephone-based clinical assessment techniques Knowledge of medical practice telephone triage Knowledge of medical symptomology and what constitutes urgent/emergent care Knowledge of medical terminology and abbreviations Professional knowledge of clinical nursing protocols Skills: Skill in using a variety of EMRs Skill in using computerized medical information database during evaluation as guide to appropriate decision Skill in making triage decisions and responding quickly and calmly in emergency situations Other Requirements: Fluent in Spanish and English, written and verbal Compact RN License

Evaluate patients on the telephone, offer nursing advice, and triage to the appropriate level of care, including referral to an emergency room or local urgent care, transfer to our own telemedicine provider, or scheduling an appointment with their regular physician. Perform telephonic evaluation of each patient with symptoms to determine the risk of serious illness or injury, and the appropriate next step in care. Follow clinical protocols and guidelines implemented by Octiva Healthcare and/or our partner clinics. Access patient’s medical chart through each clinic’s Electronic Medical Record in order to review needed information and to document treatment plan and advice provided. Perform all other duties as required or assigned.

Blue Cross Blue Shield of Michigan

Care Manager RN - Multi State License

Posted on:

April 12, 2025

Job Type:

Full-Time

Role Type:

Care Management

License:

RN

State License:

Compact / Multi-State

This opportunity is also available for individuals that reside in the following areas with a compact license: Colorado, Georgia, Indiana, Kentucky, Massachusetts, Minnesota, Mississippi, Ohio, Pennsylvania, Virginia, Washington, Louisiana, and Iowa. 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 BCBSM 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. Fully remote telephonic position. This position requires outbound calls to members to engage them into the program with continuous telephonic outbound calls for ongoing care plan goals. Members may also request to interact via our digital app, instead of telephonically. As a care manager you will need to use motivational interviewing skills to engage members into the free program. Currently Care Managers are calling members that do not know they have been identified for the program and we are looking at opportunities for other team members to make these outreaches in the future. Note: All specialties are needed including Pediatrics, also working hours up to 8pm EST may be expected. This position is fully remote. To work remote your internet speed must be 25mbps or higher, please check with your Internet provider to confirm that you have enough speed.

Licenses and Certifications • RN - Registered Nurse - Multi-State-Licensure, RN - Must reside and be licensed in the same state that is part of the Nurse Compact Department Preference Must have exemplary computer skills and be able to utilize multiple systems when interacting with members/providers – Strongly Preferred QUALIFICATIONS: Nursing Diploma or associate 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. Certification in Case Management (CCM) required or to be obtained within 18 months of hire Certification in Chronic Care Professional (CCP) preferred Ability to think critically, be decisive, and problem solve a variety of topics that can impact a member’s outcomes. Must have intermediate computer knowledge, typing capability and proficiency in Microsoft programs (Excel, OneNote, Outlook, Teams, Word, etc.).

Lead the coordination of a regionally aligned, multidisciplinary team to provide holistic care to meet member needs telephonic and/or digitally. The multidisciplinary team is inclusive of Medical and Behavioral Health Social Workers, Registered Dietitians, Pharmacists, Clinical Support Staff and Medical Directors. 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 Continue professional development by completing relevant continuing education and maintaining Certified Case Manager (CCM).

Commonwealth Care Alliance

Per DIEM, RN instED

Posted on:

April 12, 2025

Job Type:

Role Type:

Triage

License:

RN

State License:

Massachusetts

instED provides on-demand, urgent care in the home for medically complex patients. The RN, instED Clinical Resource Center will receive referrals for services, conduct intake assessments, provide triage to ensure referrals are clinically appropriate, and respond clinical questions related to referrals and services. The InstED RN will engage telephonically with patients, clinicians, and care partners who call with urgent clinical needs for a medically diverse group of patients across the continuum of care. Supervision Exercised: No, this position does not have direct reports.

Working Conditions -Remote work environment Must be able to work a flexible schedule. RN coverage is Monday thru Sunday 0800-2200. The shifts can be full shifts or half-shift. Weekends and Holidays are required (instED provides services 365 days per year) Required Education: Bachelor’s degree in Nursing Required Licensing: Current, active MA RN license; will need CT, licenses also (at instED expense) Required Experience: 5+ years of relevant nursing experience Triaging patients with complex medical histories across the lifespan Desired Experience: Experience in urgent care,primary care, or emergency department preferred Call center triage experience preferred Quality and process improvement experience preferred Required Language(s): English Desired Language(s) Fluency in Spanish a plus

Intake: Receive referrals for an instED visit, both electronically and telephonically, from patients, clinicians, and care partners Ensure complete and accurate information for the visit request Obtain comprehensive data collection electronically and/or via telephone from referring provider or patient directly Triage per instED triage guidelines and protocols, assessing patients and applying solid decision-making to achieve highest patient outcomes Deliver competent, safe, compassionate and individualized telephonic nursing/triage care for patients with complex medical histories Triage: Make clinically-appropriate recommendations for action/interventions Triage and prioritize referrals for acuity and sequencing of visits Identify emergent situations and provide clinical advice appropriately Analyze data to identify and determine expected outcomes Develop a plan with instED team to identify strategies to attain expected outcomes Exercise sound clinical judgment, along with excellent working knowledge of instED, to appropriately disperse accurate level of resources needed for achieving the best patient outcomes Follow-up: Communicate with patients and care partners to provide education and instructions regarding any recommended follow-up care. Follow-up services may include, but are not limited to, follow-up call by Provider, Tele-health re-visit, PCP evaluation, re-deployment of paramedic or other clinical provider, and phone teaching with teach-back to ensure understanding Ensure appropriate teaching has occurred with patient and or family Provide follow-up and encounter summary with referring provider and Primary Care Provider Complete accurate and appropriate documentation in real time Demonstrate strong focus on patient experience, with commitment to service excellence from intake through discharge Secondary responsibilities: Quality Assurance Work with the instED team to develop metrics and standards for Quality Assurance within the Clinical Resource Center Participate in Quality Assurance activities in other areas within the instED delivery model Ongoing Program Support: Participate in the development and design of the instED Now platform offering feedback and suggestions for improvement

MPF Federal

Call Center Nurse (RN-BSN) - Remote

Posted on:

April 12, 2025

Job Type:

Full-Time

Role Type:

Telehealth

License:

RN

State License:

Compact / Multi-State

Ready to Bring Your Acute Care Skills Home? Join Our Remote RN Team Supporting Our Military Communities! Are you a seasoned ER or Med-Surg nurse looking for a meaningful, mission-driven role that lets you care for others without the scrubs and long drives to the hospital? MPF Federal is hiring Remote Telehealth Triage Nurses (RNs) to join our 24/7 Nurse Advice Line—supporting veterans and their families—all from the comfort of your home. This isn’t just a job; it’s your chance to use your clinical expertise, empathy, and critical thinking skills to guide patients through their toughest moments—all while achieving better work-life balance. Pay & Perks $35.00/hr base rate Evening, night, weekend, and holiday differentials may apply 100% Remote – Work From Home All schedules include Saturday and Sunday and do not rotate Shifts Available (Choose Your Schedule!) Day Shifts: 8:00 AM – 6:30 PM (10-Hour) Evening Shifts: 3:30 PM – 12:00 AM (8-Hour) Night Shifts: 12:00 AM – 8:30 AM (8-Hour) Split Shift: 6:00 AM–10:00 AM & 5:00 PM–9:00 PM Next Start Date: May 19th 6 Weeks Paid Training | Monday–Friday, 8:00 AM – 4:30 PM

5+ Years of Recent Hands-On Acute Care RN Experience ER or Med-Surg strongly preferred Current Compact RN License in good standing from the state you are physically in BSN Degree from an accredited American university Confidence with phone-based care and multi-screen computer systems Strong clinical judgment, emotional intelligence, and documentation skills A mission-first mindset and passion for serving military-connected communities Bonus Points If You Also Have: Experience with behavioral health, mother-baby, and/or peds Past work in telehealth, triage, or call center nursing Familiarity with military healthcare systems or VA patients Tech & Work Environment: Must have a hard-wired Ethernet internet connection (Wi-Fi only, satellite, or radio internet is not acceptable) Quiet, distraction-free home office space with a door for HIPAA compliance Metrics-driven environment – you’ll need to meet quality, handle time, and documentation goals Federal Requirements: Must be a U.S. Citizen Ability to pass a Public Trust Background Check & Drug Screening per federal guidelines Must be willing and able to obtain licenses in all 50 states (we support you here!)

Triage Symptoms: Assess callers using evidence-based protocols Deliver Immediate Care Advice: Recommend next steps, from self-care to urgent care, calmly and confidently Offer Health Education: Counsel patients on medications, test results, and chronic condition management Crisis Triage: Handle behavioral health, emergency, and complex calls with empathy and grace Document Interactions: Accurately chart calls in our EHR and follow compliance protocols Team Collaboration: Work closely with a supportive leadership team and fellow remote RNs

Ohio State University Physicians, Inc.

RN Triage - OBGYN

Posted on:

April 12, 2025

Job Type:

Full-Time

Role Type:

Triage

License:

RN

State License:

Ohio

Looking to join our dynamic team at Ohio State University Physicians where excellence meets compassion!? With over 100 cutting-edge outpatient center locations, dedicated to providing exceptional patient care while fostering a collaborative work environment, our buckeye team includes more than 1,800 nurses, medical assistants, physicians, advanced practice providers, administrative support staff, IT specialists, financial specialists and leaders that all play an important part. As an employee of OSUP, you'll be an integral part of a team committed to advancing healthcare, education, and professional growth. Our culture At OSUP, we foster a culture grounded in the values of inclusion, empathy, sincerity, and determination. We meet our teams where they are, coming together to serve each other and our community.

Associate Degree in Nursing and current Ohio Registered Nurse license. CPR/BLS certified. Knowledge of triage procedures along with clinic, physician office and/or urgent care experience. Preferences: Bachelor’s Degree in Nursing. Two or more years of nursing experience. Phone triage experience. Experience in clinical specialty where assigned. ACLS certified.

The Registered Nurse (RN) provides telephonic triage skilled nursing services and advice to patients, and assists in clinic when needed, under the direction of a physician or midlevel provider, and provides a variety of related services to maintain a safe, therapeutic environment. The functions of the Registered Nurse are to collect patient health data, analyze the data to determine diagnoses, develop a plan of care that prescribes interventions to attain the expected outcomes, identify expected outcomes individualized to the patient, and routes patient accordingly while working collaboratively with the healthcare team. Performs professional nursing work of considerable difficulty including the care of patients as outlined by physicians and the objectives and policies of the organization. Provides patient and family health education and health assessment.

Monogram Health Inc

Bilingual MH First Triage RN - Weekend Day Shift

Posted on:

April 11, 2025

Job Type:

Full-Time

Role Type:

Triage

License:

RN

State License:

Compact / Multi-State

Monogram Health is a next-generation, value-based chronic condition risk provider serving patients with chronic kidney and end-stage renal disease and related metabolic disorders. Monogram seeks to fill systemic gaps and transform how nephrology, primary care and chronic condition treatment are delivered. Monogram’s innovative, in-home approach utilizes a national nephrology practice powered by a suite of technology-enabled clinical services, including case and disease management, utilization management and review, and medication therapy management services that improve health outcomes while lowering medical costs across the healthcare continuum. Monogram has emerged as an industry leader in championing more significant health equity and improving health outcomes for individuals with chronic kidney and end-stage renal disease by increasing access to evidence-based care pathways and addressing social determinants of health. Monogram Health believes in fostering an inclusive environment where employees feel encouraged to share their unique perspectives, leverage their strengths, and act authentically. We know that diverse teams are strong teams and welcome those from all backgrounds and varying experiences.

The MH FIRST RN is pivotal in providing critical support to field teams facing urgent and complex patient concerns. The Registered Nurse has expertise that will ensure patients receive the care, resources, and support they need, especially during high-stress situations and environmental crises. SHIFT: Weekend Day Shift 7A-7P with 4 additional hours during the week.

Maintain a current and valid compact RN license, allowing you to practice across state lines. Availability for Weekend Day Shift: 7:00 AM – 7:00 PM (Saturday and Sunday), plus 4 additional hours during the week Minimum of 3 years of clinical nursing experience, with a preference for emergency care, critical care, or triage backgrounds. Availability to adjust shift flexibly in response to peak coverage or staffing needs. Demonstrate the ability to communicate calmly and confidently during high-stress situations. Build strong relationships with team members and patients through effective rapport-building. Exhibit meticulous attention to detail and outstanding organizational skills. Show unwavering dedication to patient safety and delivering high-quality care.

Utilize licensing and crisis management skills to assess and address urgent needs. Assess care plan requirements and assist in their implementation. Utilize proficiency in documentation and technology to streamline member care. Offer valuable support and guidance to patients and their families in critical situations. Primary point of contact for patients, Monogram field staff, and care center personnel needing immediate support. Provide seamless transitions by providing comprehensive handoffs to incoming staff. Conduct chart auditing during non-peak call volumes. Emergency/disaster outreach as events occur. Support service level agreement (SLA) compliance for annual assessments and care plans. Assist in post-hospital outreach to ensure patient needs are met, with no outstanding needs that could result in readmissions.

Accompany Health

RN Case Manager, Transitions of Care

Posted on:

April 11, 2025

Job Type:

Full-Time

Role Type:

Case Management

License:

RN

State License:

Michigan

Transitions of Care (TOC) RNs are a key part of our Accompany Health care model which also includes Physicians, Advanced Practice Clinicians, Community Health Workers, Patient Experience Navigators, RNs, Social Workers, Behavioral Health Clinicians, Psychiatrists, and Pharmacists. Together this team is responsible for providing and coordinating holistic, patient-centered care for an intimate panel of patients with complex medical, behavioral health, and social needs. As a TOC RN, you will help ensure our patients have the care they need after a vulnerable time period post-discharge from the Emergency Department or hospital. As a TOC RN, you will care for patients virtually via video, telephone, or text. As part of the central nursing team, you will help provide transitional care for patients in various cities. You will contact patients who have recently been discharged and conduct a clinical assessment and medication reconciliation, and will help patients who require additional care with scheduling follow up appointments as needed. You will also occasionally contact local hospitals when needed to collaborate with the inpatient team to coordinate safe discharge planning. As part of the TOC role, you may also help provide proactive outreach virtually for some of our complex patients who have frequent admissions. You will support the local care team responding with compassion and empathy, uncovering barriers and connecting patients with appropriate care and resources that can keep them safely at home and out of the hospital when possible.

What makes you a fit for the team: Passionate about caring for complex, historically underserved patients with co-occurring chronic and behavioral health conditions in an integrated, multi-disciplinary model anchored in home-based and tech-enabled virtual care. Committed to providing the highest quality, outstanding clinical care to all patients, regardless of their needs. Strong proficiency in using technology and delivering a high caliber of care virtually. Excellent communicator, collaborator and team player who enjoys working in an integrated, multi-disciplinary model. Committed to providing the highest quality, outstanding clinical care and willing to go the extra mile for all patients. Possess high attention to detail as well as adaptability, and is excited to be a part of and contribute to the development of a rapidly evolving, innovative care model. Enjoys continuously learning and adapting workflows to improve patient care. Desired skills and experience Required: Active, unrestricted Registered Nurse license in home state and willingness and certification in good standing and the ability to get licensed in requested states such as Michigan, Colorado or Massachusetts within 90 days of hire date. 3+ years of experience providing clinical services to Adult and/or Geriatric individuals with co-occurring chronic medical and behavioral health conditions, particularly in virtual settings. Demonstrated ability to help a patient adapt new habits, change behaviors, and motivate towards achieving health goals. Comfort with electronic medical record documentation and excited about how technology can support your work and drive ongoing improvement towards new and better care Experience and comfort working within an interdisciplinary care team, and specifically communicating with clinical and non-clinical team members. Preferred: Experience in adult internal medicine, family medicine, geriatrics, palliative care, and virtual care. Experience in transitions of care management for patients being discharged from hospitals, skilled nursing facilities, and behavioral health facilities, including performing detailed medication reconciliation, patient education, and connection/navigation to appropriate services. Experience in behavioral health settings and/or caring for patients with serious mental illness and/or substance use disorder. Experience in trauma-informed care and practices. Experience as an active participant in continuous quality improvement projects. Experience in value-based care organizations

Providing post-discharge follow up care for patients virtually via video, telephone, or text Providing patients with education on their care plans and medications. Effectively interpreting and utilizing electronic data tools and analysis to organize daily activities and provide high quality of care Collaborating closely with local Accompany Health teams to ensure continuity of care Establishing and fostering trusting relationships with your patients and ensuring that care is appropriately aligned with their goals and values Collaborating with external hospitals when necessary to collaborate on discharge planning and advocate for patient care aligned with their goals Providing feedback on program design and workflows to ensure we are providing the best patient care possible. Timely and appropriate documentation. Roles and responsibilities may evolve as our care model develops. Occasional in person team building time

Accompany Health

Clinical (Telephonic) Behavioral Health Triage RN

Posted on:

April 11, 2025

Job Type:

Full-Time

Role Type:

Behavioral Health

License:

RN

State License:

Michigan

Triage RNs are a key part of our care model which also include Physicians, Advanced Practice Clinicians, Community Health Workers, Patient Experience Navigators, RNs, Social Workers, Behavioral Health Clinicians, Psychiatrists, and Pharmacists. Together this team is responsible for providing and coordinating holistic, patient-centered care for an intimate panel of patients with complex medical, behavioral health, and social needs. As a Triage RN, you will be part of the central urgent care team, supporting patients across multiple markets. You will provide care primarily through virtual modalities—video, phone, and text—and serve as the first line of clinical support for patients reaching out with urgent medical or behavioral health concerns. You’ll respond with empathy, clinical expertise, and a trauma-informed approach to deliver both physical and behavioral health care support in real time. This role plays a critical part in helping patients remain safely at home by avoiding unnecessary emergency visits and ensuring timely, appropriate care. As our behavioral health RN, you will collaborate closely with Medical Directors, fellow triage RNs, Behavioral Health Clinicians, and other members of the interdisciplinary team to support safe, coordinated, and holistic care for our patients. The shift for this role will be Monday-Friday 10:00 am-7:00 pm EST, or 3:00 pm-11:30 pm EST. To ensure sufficient clinical coverage, our expectation is that our care team will cover shifts up to 3 holidays per year.

What makes you a fit for the team: Passionate about caring for complex, historically underserved patients with co-occurring chronic and behavioral health conditions in an integrated, multi-disciplinary model anchored in home-based and tech-enabled virtual care. Experienced in both clinical triage and behavioral health support, with a calm and compassionate approach to high-pressure situations. Demonstrated ability to assess and manage patients experiencing behavioral health crises, including active suicidality, aggression, severe mood instability, psychosis, and acute substance use episodes—while maintaining clinical focus and ensuring appropriate triage and escalation. Strong understanding of Trauma-informed care principles and ability to apply them in high pressure situations. Strong communicator and collaborator who thrives in an interdisciplinary, tech-enabled care model. Flexible, solutions-focused, and motivated to improve care delivery through innovation and teamwork. Committed to providing equitable, dignified, and person-centered care in all interactions. Possess high attention to detail, and is excited to be a part of and contribute to the development of a rapidly evolving, innovative care model. Enjoys continuously learning and adapting workflows to improve patient care. Desired skills and experience Required: Active, unrestricted Registered Nurse license in home state in good standing, with the ability to get licensed in requested states such as Michigan, Colorado & Massachusetts within 90 days of hire date 3+ years of clinical experience, including experience with patients who have behavioral health conditions or co-occurring diagnoses particularly in virtual settings Strong triage, assessment, and critical thinking skills across both medical and behavioral presentations. Experience in crisis response, de-escalation, and trauma-informed care, preferably in a community mental health setting, integrated behavioral health setting serving a high volume of severe mental illness, psychiatric emergency room or crisis center, or other high acuity mental health clinical setting Demonstrated ability to help a patient adapt new habits, change behaviors, and motivate towards achieving health goals Comfort with electronic medical record documentation and excited about how technology can support your work and drive ongoing improvement towards new and better care Experience and comfort working within an interdisciplinary care team, and specifically communicating with clinical and non-clinical team members Preferred: Experience in urgent care, emergency medicine, and clinical triage. Familiarity with substance use recovery models and social determinants of health. Board certification in Psychiatric-Mental Health Nursing (PMH-BC) Experience providing care in virtual settings Prior work in value-based care or integrated care teams. Comfort supporting individuals with untreated or symptomatic mental illness and/or addiction. Experience as an active participant in continuous quality improvement projects. Experience in value-based care organizations

Provide inbound telephonic clinical triage and virtual care to patients experiencing both medical and behavioral health symptoms or concerns. Deliver high-quality assessments via phone, video, and text—escalating to appropriate providers or team members when necessary. Serve as primary triage support for behavioral health crisis and complex cases including: Conducting risk assessments using tools such as the Columbia Suicide Severity Rating Scale (C-SSRS) to evaluate suicide risk. Assessing for homicidal ideation, including intent, plan, and access to mean. Evaluating for mania and psychosis, including hallucinations, delusions, and disorganized thinking. Provide immediate de-escalation, crisis counseling, and safety planning for patients in distress. Coordinate with crisis response teams, law enforcement, and emergency departments when necessary. Triaging patients who are intoxicated or under the influence of substances, with appropriate escalation and coordination for care and safety. Setting and maintaining firm, clear, and professional boundaries with patients exhibiting traits of personality disorders, including those with repeated urgent outreach or inappropriate behavior, while ensuring clinical safety and adherence to team protocols. Support patients in behavioral health distress using trauma-informed care, crisis de-escalation, and recovery-oriented communication. Coordinate care and collaborate with Accompany Health Medical Directors, APCs, triage RNs, Behavioral Health Clinicians, and interdisciplinary team members to ensure appropriate resolution for patient triage concern. Use sound clinical judgment to determine appropriate levels of care and help divert unnecessary ER utilization when safe. Support and education, in collaboration with the Behavioral Health team, of the interdisciplinary team on management of patients with acute behavioral health issues. Document all patient encounters accurately and timely in the EMR and other care tracking systems. Build therapeutic rapport with patients and contribute to ongoing care planning in alignment with their goals and values. Collaborate with the team to improve workflows and best practices across both clinical and behavioral triage services. Providing post-discharge follow up care for behavioral health patients virtually via video, telephone, or text. Attending relevant RN conferences, complex care conferences, multidisciplinary case conferences, and behavioral health case conferences to provide integrated care to our patients. Participate in occasional in-person team-building or training activities. Roles and responsibilities may evolve as our care model develops.