Nursing Jobs

Job Title: Nurse Case Manager Company: Reinhard-Madison Approach Staffing, Inc. Location: White Plains, NY Description: Case Manager POSITION SUMMARY The nurse in this position is responsible for performing concurrent review for acute and/or sub-acute inpatient stays, inclusive of the admission review, as well as the ongoing inpatient stay. This review is conducted using Milliman Guidelines, with physician referral and review as appropriate. The nurse is also responsible for facilitating the implementation of discharge plans in conjunction with hospital discharge planners. ESSENTIAL RESPONSIBILITIES (1)Monitors medical necessity of length of stay and quality of care of all hospitalized members (2)Performs prior authorization of elective procedures/services with medical necessity review as required (3)Monitors medical necessity and length of service for outpatient and home care services (4)Identifies and refers cases to the chronic care improvement program (5)Directs services in-plan whenever possible (6)Initial review of all emergent admissions for medical necessity and appropriateness, using clinical guidelines for review (7)Review of ongoing acute and sub-acute stays for appropriateness, using clinical guidelines (8)Referral to and/or discussion with physician advisors on complex cases, or those cases which do not appear to meet clinical guidelines (9)Works with facility discharge planners to facilitate discharge planning (10)Builds and develops relationships with facilities to assure/promote positive changes and the appropriate use of resources (11)Works in conjunction with the CMO and the VP of Health Services for the appropriate resolution of problematic cases (12)Documents appropriately in order to ensure compliance with accrediting institutions related to turn-around times: NCQA, DOH, State, and Federal regulatory requirements according to HMO contract agreements (13)Establishes and maintains an environment that fosters teamwork, accountability, empowerment and excellence (14)Effectively prepares and presents case information during inpatient rounds EDUCATION, EXPERIENCE AND SKILLS REQUIRED (A)New York State RN license, Bachelors degree preferred (B)Strong clinical background (C)Minimum 2 years managed care utilization/case manager experience (D)Knowledge of Medicare Regulations (E)Previous experience with Medicare risk population preferred (F)Previous experience with PC based systems is required (G)Strong interpersonal skills (H)Strong written and verbal communications skills (I)Demonstrates ability to work effectively with Physicians (J)Ability to work in a dynamic and changing environment while effectively handling multiple competing priorities (K)Ability to promote positive behavioral changes (L)Bilingual preferred

Job Title: Registered Nurse Company: PDI Group Location: San Antonio, TX Description: We are working with a large hospital group in San Antonio hiring various RN positions. * We are looking for a number of ICU RNs for the day and night shifts. * ER RNs specifically for the night shift * Cardio CICU Nurses. 2 days (7a-7p) and 2 nights (7p-7a). As they are opening an open heart program. * ICU Nurses with transplant experience, liver, pancreas, kidney transplant exp. 2 days (7a-7p) and 2 nights (7p-7a). * Night Charge Nurse and Night Staff Nurse for Boerne, TX – suburb of San Antonio They offer a great compensation package, benefits, relocation, and a sign on bonus. Please let me know if you would like to learn more about any of the opportunities – or if you know of another RN that might be looking please let them know.

Job Title: Appeals & Grievances Nurse Mgr Company: Reinhard-Madison Approach Staffing, Inc. Location: White Plains, NY Description: Appeals & Grievances Nurse Manager SPECIFIC JOB FUNCTIONS: 1. Supervises the Appeals and Grievance Unit Coordinators, manages the work allocation and ensures full compliance with Medicare Part C and Part D Appeals and Grievance Standards 2. Ensures incoming cases are accurately categorized and triaged appropriately. Assigned work and tracks completion.. Coordinates investigations with other departments. 3. Reviews pre-service appeal cases as well as post service appeals based on denials for lack of medical necessity. 4. Responds to DOI, DOH and CMS complaints, as well as to external appeal entities including the IRE. 5. Audits files and prepares reports, including aggregate statistics and trend analyses. Identifies and helps to address opportunities for process improvement in the organization 6. Responsible for handling escalated member and provider concerns with the dual goal of ensuing satisfaction and retention. 7. Serves as the primary liaison with other departments to resolve complex appeals, grievances and/or legal issues. Determines appeal and grievance outcomes that result in plan payment for services. ESSENTIAL SKILLS & QUALIFICATIONS 1. Registered Nurse preferred. 2. Minimum of 2 years supervisory experience of Appeals and Grievance functions in a managed care organization 3. Experience with Medicare complaints and extensive knowledge of regulatory issues relating to appeals and grievances strongly preferred. 4. Experience performing Utilization review preferred 5. Experience with Claims analysis also preferred. 6. Strong verbal and written communication skills, analytical ability. 7. Knowledge of industry coding systems and claims submission forms and formats. 8. Solid working knowledge of claims and medical management operations. 9. Must be able to use with ease Micro-soft office applications including Word and Excel, as well as to learn and easily use the health plan's core information systems 10. Must be able to work with a high case volume under time pressures to ensure high level of compliance in this heavily regulated and visible arena 11. Some weekend cover required

Job Title: LPN Company: Kathleen A. MacIsaac, M.D. Inc. Location: Tampa, FL Description: Need a change? LPN for full or part-time employment in a progressive Integrative Medicine practice.Preventive medicine methods are employed to enhance the baseline wellness of the patient population. Not a primary care practice. Get involved with the new face of Medicine. Features of this practice are nutrition, health education, metabolic and allergy assessment, bio-identical hormone therapy,lifestyle modification, stress management,wholistic approach. The prospective employee must be motivated and interested in promotion of wellness. Training will be provided as needed.Prior experience in related field is not essential.Current skill in IV therapy important.Small practice,low stress,no weekends or evenings. One physician.

Job Title: Med. Assistant Adjunct Instruc Company: Brown Mackie College Akron Location: Akron, OH Description: Brown Mackie College Akron Adjunct Part Time Instructors (classes taught on a month-to-month delivery system) Brown Mackie College Akron is currently seeking instructors in the following areas: Medical Assisting Program Position Summary Instruct and facilitate meaningful learning of the course competencies in the curriculum and proactively support all facets of the learning environment. Provide education through learning centered instruction that will enable graduates to fulfill the evolving needs of the marketplace. Encourage a culture of learning that values mutual responsibility and respect, life long learning and ethics as well as personal and professional development. Key Job Elements Provides competency based education Designs/delivers class instruction Enables student exit competencies Delivers learning centered instruction Promotes student success Manages the learning environment Contributes to a culture of learning Relates professional, life, industry experience to learning Requirements Associate of Applied Science Medical Assisting Certified or Registered Medical Assistant Bachelor in an related field Join our team! Brown Mackie College is a highly regarded provider of associate degree programs in applied business and science. Education Management Corporation (EDMC), the parent company of Brown Mackie College, is one of the world’s largest dynamic leaders in providing premier quality private, for profit post secondary education, and currently operates over 74 colleges and universities located across the U.S. and Canada.

Job Title: RN Case Manager Company: Professional Resource Network Location: Bloomington, MN Description: PRN is looking to hire 1 RN Case Manager in our office location in Bloomington! Days/Hours are Monday-Friday 8am-4:30pm. Hours can be somewhat flexible! NO weekends, NO holidays! Laid back friendly office environment. 65% office time, 35% field time. DESCRIPTION: Provides leadership in the provision of nursing care to the Professional Resource Network Home Health client. Admits clients and coordinates their home care course of treatment. Confers and collaborates with physicians in implementation of the home care treatment plan. QUALIFICATIONS: 1. Currently licensed as a Registered Nurse in Minnesota. 2. Holds a valid Drivers License. 3. U.S. citizenship or evidence of a valid alien work permit. 4. Minimum of three years of adult medical-surgical experience. 5. Minimum of one year home health care experience. 6. Excellent organizational and management skills. 7. Knowledge of generally accepted principles of accounting.

Job Title: RN/LVN Admissions Coordinator Company: LA Jewish Home for the Aging Location: Reseda, CA Description: Today's Jewish Home is a complete multi-level senior living facility, providing seven distinctive levels of care that include Independent Living, Residential Care, Assisted Living Care, Skilled Nursing, Geriatric Psychiatry, Alzheimer's Care, and Skirball Hospice. A pioneer and national leader in life-enhancing senior care, the Jewish Home emphasizes the complete needs of the individual — body, mind, and spirit. With a focus on the needs of the "whole person," the Home's programs, protocols, and services incorporate the very latest senior care research and findings, resident feedback, and a culturally-based tradition of respect and compassion for seniors and families. We are currently looking for an RN or LVN with recent acute hospital experience and sharp assessment skills to determine appropriate admissions to the Home as well as manage the care and readmission of residents in the hospital.

Job Title: Director of Nursing Company: MaximaCare Location: Carrollton, TX Description: Director of Nursing - Home Health Registered Nurse for "Director of Nursing" position: At MaximaCare Home Health, we are revolutionizing home care with exceptional clinical care, innovative solutions and uncompromising patient service.  Are you ready to put your experience to work in directing patient care? We are seeking a dynamic and compassionate Registered Nurse to take a leadership role in our progressive company for our full-time Director of Nursing position. We are in search of a high-energy person with the desire and ambition to be an integral part of our team of professional individuals dedicated to providing quality home health care throughout the Dallas/Denton/Fort-Worth areas. If you are looking for a fun and challenging opportunity with a rapidly growing company we would like to talk with you. RN Home Health Director of Nursing supervises, coordinates and ensures patient care activities with the home health setting. Responsibilities include, but are not limited to: Direct and manage office and clinical activities Implement, coordinate, maintain and evaluate all levels of patient care Monitor patient care to ensure quality and appropriateness of services. Ensure proper communication between clinical staff, patients, referral sources and payers Discuss operational issues; update staff on new or changed regulations and review records and documentation to ensure regulatory and in-house compliance Direct and participate in agency objectives to improve relations with patients, community and referral sources (participating in health fairs, conventions and sales calls to referral sources when needed) Provide backup support for all staff which may include:  start of care visits, routine nursing visits, nursing assessments, discharge visits and client visits ensuring quality and services Monthly home supervisory visits to assess patient, family environment and follow-up documentation. A full job description is available on request. Benefits: Our competitive pay, great benefits, and career growth opportunities make us a great place to work; our benefits include but are not limited to: Medical and Dental Insurance for full time employees Quarterly Performance Bonuses Paid Mileage Tuition reimbursement Paid Days Off  (PTO) Company Cell Phone and much, much more! Preferred Qualifications: Graduate of an accredited school of nursing, preferably BSN. Knowledge of State and Federal regulations. Past experience in management of nursing personnel. Full working knowledge of Medicare, Medicaid, OASIS, and daily operations of homecare agency. CHAP or JCAHO accreditation experience preferred, not essential. Minimum two years of home health experience preferred. RN license in good standing in the state of Texas. Excellent Computer Skills.

Job Title: MDS Coordinator/ADON Company: LA Jewish Home for the Aging Location: Reseda, CA Description: From humble beginnings in 1912, the world-renowned Los Angeles Jewish Home has grown to encompass two beautiful village campuses, providing compassionate, quality care for more than 2,000 seniors each year. We are currently seeking an RN, MDS Coordinator. This position is reponsible for overseeing the process of MDS reporting for the facility Full time position in a very fast paced skilled nursing environment with daytime hours M-F. Candidate must have a current license in the state of CA with at least 3 years nursing experience. Candidate must have demonstrated the following: Time management skills, effective communication skills, ability to work within a team, competence with computers and exemplary customer service skills.

Job Title: Nurse Manager Company: Freehold Endoscopy Associates Location: Freehold, NJ Description: Experienced Nurse Manager to oversee the clinical operations of a 2-room Endoscopy Center. Knowledge of NJ state standards and ambulatory surgical center accreditation requirements. NJ license, certification, Baccalaureate/Masters degree, ACLS required.