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Union, United States Boonespring of Union Full timeWe need *Registered Nurses (RNs) *on *Day &* *Night Shifts *to join our team at *Boonespring Skilled Nursing & Rehabilitation Care* in *Union, KY*.Are you the kind of person that other people rely on to get things done? Do you thrive in fast-paced, challenging environments? Are you a Licensed Registered Nurse? If so, you could be the next Registered Nurse to...
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Union, United States Boonespring of Union Full timeWe need *Registered Nurses (RNs) *on *Day &* *Night Shifts *to join our team at *Boonespring Skilled Nursing & Rehabilitation Care* in *Union, KY*.Are you the kind of person that other people rely on to get things done? Do you thrive in fast-paced, challenging environments? Are you a Licensed Registered Nurse? If so, you could be the next Registered Nurse to...
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Union, United States Carespring Full timeWe need Registered Nurses (RNs) on Day and Night Shifts to join our team at The Atlantes in Cincinnati, OH. re you the kind of person that other people rely on to get things done? Do you thrive in fast-paced, challenging environments? Are you a Licensed Registered Nurse? If so, you could be the next Registered Nurse to join our family. $35 to $41 Per Hour -...
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Union, United States Carespring Full timeWe need Registered Nurses (RNs) on Day and Night Shifts to join our team at The Atlantes in Cincinnati, OH. re you the kind of person that other people rely on to get things done? Do you thrive in fast-paced, challenging environments? Are you a Licensed Registered Nurse? If so, you could be the next Registered Nurse to join our family. $35 to $41 Per Hour -...
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Registered Nurse-RN
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Union, United States Boonespring of Union Full time $32 - $38We need *Registered Nurses (RNs) *on *Day &* *Night Shifts *to join our team at *Boonespring Skilled Nursing & Rehabilitation Care* in *Union, KY*.Submit your CV and any additional required information after you have read this description by clicking on the application button.Are you the kind of person that other people rely on to get things done? Do you...
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Registered Nurse Care Manager
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Union City, Georgia, United States PruittHealth Full timeAbout the RolePruittHealth is seeking a compassionate and skilled Registered Nurse Care Manager to join our Home Health Services team. As a key member of our team, you will be responsible for delivering high-quality patient care in the comfort of their own homes.ResponsibilitiesConduct thorough evaluations, assessments, and treatments in accordance with...
Registered Nurse
3 months ago
VNS Health is seeking a Registered Nurse (RN) Care Manager for a nursing job in Union City, New Jersey. Job Description & Requirements Specialty: Care Manager Discipline: RN Start Date: ASAP Duration: Ongoing Employment Type: Staff Assesses member needs and identifies solutions that promote high quality and cost-effective health care services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical determinations in accordance with healthcare policies as well as applicable state and federal regulations. Delivers timely notification detailing clinical decisions. Coordinates with management, subject matter experts, physicians, member representatives, and discharge planners in utilization tracking, care coordination, and monitoring to ensure care is appropriate, timely and cost effective. Works under general supervision. What We Provide Referral bonus opportunities Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability Employer-matched retirement saving funds Personal and financial wellness programs Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care Generous tuition reimbursement for qualifying degrees Opportunities for professional growth and career advancement Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities What You Will Do Conducts comprehensive review of all components related to requests for services which includes a clinical record review and interviews with members, clinical staff, medical providers, paraprofessional staff, caregivers and other relevant sources as necessary. Examines standards and criteria to ensure medical necessity and appropriateness of admissions, treatment, level of care and lengths of stay. Performs prior authorization and concurrent reviews to ensure extended treatment is medically necessary and being conducted in the right setting. Reviews requests for outpatient and inpatient admission; approves services or consults with medical directors when case does not meet medical necessity criteria. Ensures compliance with state and federal regulatory standards and VNS Health policies and procedures. Participates in case conferences with management. Identifies opportunities for alternative care options and contributes to the development of patient focused plan of care to facilitate a safe discharge and transition back into the community after hospitalization. Reviews covered and coordinated services in accordance with established plan benefits, application of evidenced based medical criteria, and regulatory requirements to ensure appropriate authorization of services and execution of the plans fiduciary responsibilities. Identifies and provides recommendations for improvement regarding department processes and procedures. Maintains current knowledge of organizational or state-wide trends that affect member eligibility and the need for issuance of Determination Notices Improves clinical and cost-effective outcomes such as reduction of hospital admissions and emergency department visits through on-going member education, care management and collaboration with IDT members. Provides input and recommendations for design and development of, processes and procedures for effective member case management, efficient department operations, and excellent customer service. Maintains accurate record of all care management. Maintains written progress notes and verbal communications according to program guidelines. Participates in approval for out-of-network services when member receives services outside of VNS Health network services. Provides case direction and assistance ensuring quality and appropriate service delivery. Keeps current with all health plan changes and updates through on-going training, coaching and educational materials. For Care Management Only: Assesses, plans, facilitates and advocates for options and services to effectively manage an individuals health needs. Promotes quality and cost-effective outcomes at all times. Provides telephonic case management to members, balancing clinical, social, and environmental concerns. Provides analysis of initial health evaluation and comprehensive assessment of the member/family psychosocial status and case management needs. Participates in the development, coordination and implementation of the care plan to address specific needs of the member/family including thorough transitions between settings of care. Coordinates with community providers to ensure efficient and effective transitions and delivery of care in the home and community. Consults with the member, family, and members of the inter-disciplinary team to coordinate the treatment plan, education, self-care techniques and prevention strategies. Verifies that all aspects of the clinical record are in agreement with the members clinical and functional status. Utilizes VNS Health and state approved assessment and documentation as well as interviews with members, family, and care providers in decision-making. Performs annual clinical co-visits for nurses as well as two initial co-visits during the first six months for new hires as follows: one within first three weeks and a second within the first six months. Provides feedback to therapist and management; assists in development of plans to address improvement needs as appropriate. Participates in special projects and performs other duties as assigned. Licenses and Certifications: Current license to practice as a Registered Professional Nurse or an Occupational Therapist in New York State required Certified Case Manager preferred For SelectHealth ETE Only: Nurse Practitioner (NP) certification with background or degree in Public Health preferred Education: Associate's Degree in Nursing or a Masters degree in Occupational Therapy required Bachelor's Degree or Masters degree in nursing preferred Work Experience: Minimum two years of experience with strong cost containment /case management background or two years acute inpatient hospital experience in chronic or complex care required Must have experience and qualifications demonstrating knowledge of working with the LTSS eligible population. preferred Knowledge of Medicare and Medicaid regulations required Excellent organizational and time management skills, interpersonal skills, verbal and written communication skills. Working knowledge of Microsoft Excel, Power-Point, and Word and strong typing skills required Knowledge of Medicaid and/or Medicare regulations required Knowledge of Milliman criteria (MCG) preferred For UM Only: Experience must be with a Managed Care Organization or Health Plan. For SelectHealth ETE Only: Experience in Public Health programming, delivery and evaluation preferred Experience working with community-based organizations in underserved communities preferred VNS Health Job ID R010762. Posted job title: Rn Care Manager About VNS Health VNS Health is one of the nations largest nonprofit home and community-based health care organizations. Innovating in health care for more than 125 years, our commitment to health and well-being is what drives uswe help people live, age and heal where they feel most comfortable, in their own homes, connected to their family and community. On any given day, more than 10,000 VNS Health team members deliver compassionate care, unparalleled expertise and 24/7 solutions and resources to the more than 43,000 neighbors who look to us for care. Powered and informed by data analytics that are unmatched in the home and community-health industry, VNS Health offers a full range of health care services, solutions and health plans designed to simplify the health care experience and meet the diverse and complex needs of those we serve in New York and beyond. Benefits Guaranteed Hours 401k retirement plan Employee assistance programs Dental benefits Vision benefits License and certification reimbursement Life insurance Discount program Holiday Pay Continuing Education Wellness and fitness programs Mileage reimbursement Medical benefits Benefits start day 1
