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The Case Manager Assistant - LPN assists with the coordination of the patient's care and services. Promotes quality care using a collaborative process that coordinates, monitors, and evaluates services according to the needs of and interpersonal contact with patients. in accordance with all applicable laws, regulations, and Life Care standards. • Nursing diploma (associate's or bachelor's degree in nursing), • Currently licensed/registered in applicable State. Must maintain an active nurse (LPN) license in good standing throughout employment., • One (1) year of clinical experience in post-acute care setting preferred, • Prior case management, utilization review, and discharge planning experience preferred, • Generate written communication that is clear, concise, and well-organized, • Excellent organizational skills and be efficient in prioritizing and managing time and assignments, • Contribute to the organization's goals and objectives and support the organizational strategic plans, • Expert knowledge in field of practice, • Make independent decisions when circumstances warrant such action, • Knowledgeable of practices and procedures as well as the laws, regulations, and guidelines governing functions in the post-acute care facility, • Implement and interpret the programs, goals, objectives, policies, and procedures of the department, • Perform proficiently in all competency areas including but not limited to: general manager duties, patient rights, and safety and sanitation, • Maintains professional working relationships with all associates, vendors, etc., • Maintains confidentiality of all proprietary and/or confidential information, • Understand and follow company policies including harassment and compliance procedures, • Displays integrity and professionalism by adhering to Life Care's Code of Conduct and completes mandatory Code of Conduct and other appropriate compliance training, • Demonstrate efficient use of relevant computer systems including but not limited to the ability to enter and retrieve data, • Serve as liaison to external case managers, family, physicians, and community resources, • Train and education patients, families, associates, and other providers of care, • Implement the standards of practice for care management, ethical performance, and functions relevant to coordination of care, • Exhibit excellent customer service and a positive attitude towards patients, • Assist in the evacuation of patients, • Demonstrate dependable, regular attendance, • Concentrate and use reasoning skills and good judgment, • Communicate and function productively on an interdisciplinary team, • Sit, stand, bend, lift, push, pull, stoop, walk, reach, and move intermittently during working hours

Job Description POSITION SUMMARY The Advanced Practice Mobile Provider delivers comprehensive primary healthcare services to a diverse patient population, often working in a mobile health unit and supporting agricultural workers, local schools, and health events. This role requires flexibility with varied schedules and locations, performing a wide range of clinical duties independently and occasionally floating to different health centers as needed. Responsibilities are conducted according to established clinical standards and organizational policies. EXPECTATIONS Every Adelante Healthcare employee will strive to maximize their performance and contribution to Adelante Healthcare and the community we serve every day. Employees are expected to work in a manner that demonstrates a commitment to quality, patient safety, employee engagement, innovation, and the highest standards of personal integrity, professionalism, and competence. OUR CORE VALUES • Inclusion, • Nurture, • Service, • Purposeful, • Integrity, • Resilient, • Engaged ESSENTIAL SKILLS AND EXPERIENCE: • Graduate from an approved Nurse Practitioner school or Physician Assistant school., • Nurse Practitioner certificate issued by the Arizona Board of Nursing or active Physician Assistant certificate issued by Arizona Regulatory Board of Physician Assistants., • Valid Arizona Advanced Practice license or valid Arizona Physician Assistant License., • Valid DEA certificate., • Current BLS., • Demonstrated understanding of clinical methods and techniques, • Ability to meet and deal effectively with clients, associates, and the public., • Valid AZ driver’s license., • Ability to provide care across the lifespan (birth through end of life)., • Demonstrates strong clinical skills, including suturing, toenail removal, staple removal, and foreign body removal., • Commitment to Adelante Healthcare mission, vision, and values., • Competency in dealing with people of various cultures and social status., • Certification to perform cardiopulmonary Resuscitation for the Health Care Professional (CPR) and AED through courses that follow the guidelines from the American Heart Association and Red Cross (cognitive and skills evaluations)., • Valid Level One Fingerprint Clearance Card issued by the Arizona Department of Public Safety for all specialty behavioral health locations. POSITION REPONSIBILITIES • Health Care Delivery, • Provide high quality health care services including the following:, • Accessible and available health services to patients for which the Provider is credentialed and privileged to Educate and communicate with those served concerning their diagnosis and treatment of their medical conditions, appropriate preventive measures, and use of the health care system, • Prove treatment that is consistent with clinical impressions and working diagnoses, • Appropriate, accurate and complete electronic medical record entries, in a timely manner, • Adequate and appropriate transfer of information for continuity of care, • Evaluate patients in a timely, courteous, and professional manner o Completes all required documentation for billing of services provided, • Promote and demonstrate good customer service to both external and internal customers, • Consult, refer, and collaborate with other disciplines involved in the delivery of total patient care, • Advise management on performance deficiencies of medical auxiliary personnel (incl. M.A.s), • Demonstrate knowledge of and ability to interpret licensing standards for Advanced Practitioner practice (scope of practice for NP or PA), • Assume the role and duties of other clinical personnel, as necessary, • Rotate call for emergencies in the evenings and on weekends and holidays, as assigned, • Attend continuing medical education (CME) programs as paid for by Adelante Healthcare and if required to maintain licensure. Maintain credentialing and privilege in good standing Quality Management/Risk Management, • Demonstrate evidence of continuing professional growth by involvement in quality improvement programs and participation in peer review, medical record audits, continuing education, and the review of protocols and procedures, • Review results of utilization and quality monitoring and participate in the analysis of services, • Communicate necessary information to the Medical Director concerning operations and suggestions for improvement, • Be knowledgeable and adhere to all policies and procedures related to client services, • Assure compliance with rules and regulations as set forth by the Department of Health and Human Services and other contracted health care plans Community Relations, • Represent Adelante Healthcare (AHC) if requested in groups addressing the health care needs of the community, • Participate in the planning and development of recent programs and services by identifying specific community health needs and programs to meet those needs • Assist individuals and the community to assume responsibility for the prevention of illness and the promotion, maintenance, and restoration of health, • Function as a liaison and address community groups regarding AHC and its’ services, as requested, • Understand your role in the Disaster Plan and that safety is a condition of employment, • Participate in other activities such as health fairs, classes, and community events Professional Networking, • Attend monthly provider meetings and combined staff meetings, • Participate and complete all required training, • Demonstrate skills and behaviors consistent with Language of Caring, • Contribute to the training and proficiencies of clinical personnel, including medical students, in a culturally competent capacity. Collaborate with the staff in a positive and constructive manner., • Promote collegial relationships with other clinical staff and providers in the community • Provide coverage for other Adelante sites, when necessary NONESSENTIAL SKILLS AND EXPERIENCE: • Three (3) years of experience in community health, • Bilingual - Spanish preferred, • Experience conducting well-child visits Additional Duties and Responsibilities, • Perform other duties as requested or assigned by the Medical Director or Chief Clinical Officer, • Other duties as requested or assigned Patient Centered Medical Home (PCMH) and Integrated Care Team (ICT) All employees are responsible for promoting and participating in interdisciplinary communication and collaboration to enhance the delivery of quality across the health care system., • Employees should maintain an environment which supports and engages patients and co-workers in a caring team-based model to promote wellness and improve health outcomes., • Adherence to Compliance and Code of Conduct All employees are required to comply with Adelante Healthcare’s written standards, including its Compliance Program and Code of Conduct, policies and procedures and reporting of any conduct that potentially violates Adelante’s legal or compliance requirements. Such compliance will be an element considered as part of the regular performance evaluation. PHYSICAL DEMANDS AND WORK ENVIRONMENT • The physical demands and work environmental characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Physical demands: • While performing the duties of this job, the employee may be required to sit for long periods of time, is required to stand, walk, use hands to handle or feel objects, tools or controls; reach with hands and arms; climb steps/stairs; balance; stoop, kneel, crouch or crawl; talk or hear; smell; manage stress as it relates to essential job functions., • The employee must frequently lift and/or move up to twenty-five pounds without assistance and may occasionally be required to lift or move up to fifty pounds with assistance. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. Work environment: • While performing the duties of this position, the employee will frequently work as part of the mobile health unit at community events and outreach locations., • This role requires working outdoors and being exposed to varying weather conditions, weather permitting, during travel and while providing services at mobile or off-site locations., • The noise level in the work environment is typically moderate but may increase during community events. The employee may also be exposed to health hazards, including contagious diseases and bloodborne pathogens, when providing services in clinical or mobile settings

RN IMM Case Management II Registered Nurse with Bachelors of Science in nursing (BSN) degree or Registered Nurse with Associates degree in nursing (ADN) plus five years utilization review or case management experience required. RN IMM Case Management IV Masters degree in nursing plus 5 years utiliza

National Case Management certification preferredRN IMM Case Management IIRegistered Nurse with Bachelors of Science in nursing (BSN) degree or Registered Nurse with Associates degree in nursing (ADN) plus five years utilization review or case management experience required. RN IMM Case Management IV

Job Description Hi, we're Oscar. We're hiring a Senior Analyst, Special Investigations Unit Clinical Investigator to join our SIU. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: The Senior Analyst, SIU Clinical Investigator detects and audits aberrant billing patterns within claims and clinical documentation, using forensic clinical expertise to protect the integrity of healthcare spend. You will perform comprehensive pre-payment and post-payment reviews of medical records to ensure billed services align with established clinical guidelines, CMS regulations, and contractual obligations. Beyond individual claim accuracy, you will analyze provider behavior to identify schemes such as record cloning, upcoding, and unbundling that may be invisible to automated systems. As a clinical subject matter expert, you will act to translate audit findings into relevant education. You will facilitate professional discussions with colleagues and providers to correct billing behaviors and promote long-term compliance. You will partner with clinical and non-clinical investigators to build evidentiary files for potential recovery, legal action, or referrals to appropriate outside agencies. You will report into the Investigations Manager, SIU. Work Location: This is a remote position, open to candidates who reside in: Arizona, Florida, Georgia, Illinois, Iowa, Kansas, Michigan, Missouri, Nebraska, New Jersey, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas and Virginia. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. If you live within commutable distance to our New York City office (in Hudson Square) or our Tempe office (off the 101 at University Ave), you will be expected to come into the office at least three days each week. Otherwise, this is a remote / work-from-home role. Thursdays are a required in-office day for team meetings and events, while your other two office days are flexible to suit your schedule. The base pay for this role in the states of New Jersey and New York is: $72,036 - $94,546 per year. The base pay for this role in all other locations is: $64,832 - $85,092 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: • Identify and conduct clinical audits into suspected FWA with high autonomy, • Document findings, to include formal reports, graphs, audit logs, and other supporting documentation., • Metrics to align with unit goals., • Participate in the development and presentation of FWA-related education for Oscar teams, • Compliance with all applicable laws and regulations, • Active, unrestricted Registered Nurse (RN) license, • 3+ years of direct patient care clinical experience. Case Management experience a bonus., • 2+ years of experience in Medical Review, Utilization Management, or Clinical Documentation Improvement, featuring demonstrated expertise in the forensic application of complex clinical guidelines (e.g., MCG, CMS, and specialty-specific professional organizations) to multifaceted medical records., • Bachelor of Science in Nursing (BSN), Associate Degree in Nursing (ADN) with a Bachelor of Science in Health Administration, Clinical Informatics, or a related Medical Science field, or Associate Degree in Nursing (ADN) with 5+ years of specialized clinical audit experience., • Experience working in health insurance with competency regarding claims processing, billing, reimbursement, or provider contracting., • Experience delivering feedback or education to providers/physicians in a professional, non-confrontational, and persuasive manner., • Identifying trends, for example "cloned documentation" or change in billing habits of a provider., • Experience with HIPAA, data privacy, and/or data security processes At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team () to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

Job Description Are you a Surgical Nurse Practitioner (RNFA) seeking change to a new and rewarding position in the amazing Phoenix, AZ Metro Area? Our nationally renowned Cancer Center is hiring an experienced Surgical NP(RNFA) NOW! Our interview process is fast, and these positions are for immediate fill! Please review the position details below and apply today for immediate consideration Relocation allowance and other incentives!! Salary is experience driven and will be discuss in detail during initial discussion Schedule/Clinic hours: Permanent Full Time: 4x10s Position duties and overview: Performs first assistant duties in the OR and/or clinic with complete knowledge of the disease process and whole patient care scenario, including, but not limited to positioning, preparation and draping of the patient; tissue manipulation; utilization of tying and suturing materials; drain/tube insertion; deep and superficial wound closure; application of internal devices and any other autonomous duties or procedures delegated by the supervising surgeon. Performs non-anesthesia minor surgical procedures without in-room supervision. Meets the specific needs of the attending surgeon and maintains the technical skills necessary to handle a broad range of procedures including but not limited to colorectal (including robotic cases), breast, plastic (including microvascular cases), orthopedic, gynecologic (including robotic cases), head & neck, thoracic (including robotic cases) and urologic (including robotic cases) services. Consults, collaborates, and communicates well with the surgeon and other consulting medical providers, and healthcare professionals such as hospitalists, intensivists, pain management, cardiologists, respiratory therapists, physical/occupational therapists, nurses, etc. to meet the needs of the patients. Evaluates diagnoses and treats illnesses and injuries in the clinic, pre-op area, inpatient wards, and internal medicine clinic. Evaluates care and orders and interprets appropriate labs, special studies (i.e., radiographic studies), IVs, diet, and therapeutic interventions as required. Educates and counsels patients. Performs comprehensive and problem-focused histories and physical examinations, including pre-operative H & Ps and evaluations, post-operative evaluations, discharge documentation and follow up evaluations on surgical patients in the clinic, pre-op area, inpatient wards, and internal medicine clinic. Maintains the skills and knowledge base of a certified PA or NP/APRN as required by the applicable state and national licensing authorities. Prescribes schedule II, III, IV or V controlled substances as defined in the federal controlled substances act of 1970 (P.L. 91-513; 84 Stat. 1242; 21 United States Code section 802) and prescription only medications. Writes orders as indicated for pre-operative, in-operative, post-operative and clinical follow-up care and completes documentation in a timely fashion. Ability to navigate the clinical information systems as needed to perform job duties. Knowledge and proficient with how to document patient orders, history, and physicals, review the PACS System, and navigate through the surgical information system. Strictly adheres to the Universal Protocol, while performing the role of Surgical Assistant in the operating suite under the direction of the supervising physician and/or while performing other medical procedures. Provides call coverage and onsite patient rounding, in accordance with the Hospital Call Program. Certifications/ Qualifications: Must be a certified APRN with RNFA certification with robotic experience! Hepatobiliary, transplant, surgical oncology, or microscopic training preferred. Excellent Benefits and Incentives: Full benefits, dental, health, financial and professional development. Please apply today for immediate consideration or call (954)939-0272 for additional information! About us: For over a decade, Palm Health Resources has been providing healthcare recruitment services and is well versed in matching medical talent for permanent, locum to perm and locum opportunities.

Job Description Hi, we're Oscar. We're hiring a Nurse Supervisor to join our Utilization Management Clinical Quality team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: You will provide day-to-day oversight and management of the team. You will also own daily Nurse team operations, including queue and volume throughput and staffing, and also serve as the primary escalation point for your teams. You will support strategic and clinical initiatives as needed. You will report into the Manager, Clinical Programs Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote Pay Transparency: The base pay for this role is: $91,908 - $120,629 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses. Responsibilities: • Own daily workforce management, including staffing and queue assignments, PTO/leave, and payroll/compensation., • Manage queue on a daily basis, ensuring compliance with regulatory timelines, staff coverage, and coordination with internal teams for forecasting and timely handling of ad hoc escalations, • Ensure team adheres to department policies and workflows and serve as continual champion of the Oscar mission., • Drive and own the success of clinical auditing and performance through ongoing evaluations; effectively use Oscar tools to monitor and trend nurse productivity and auditing data for assessment and reporting., • Support the onboarding and training of newly-hired clinicians and partner with the Clinical Quality & Training team on the development and maintenance of clinical training and resource material., • Partner with the Talent Acquisition team on clinical hiring initiatives., • Complete medical necessity and level of care reviews using clinical judgment and the Plan's designated clinical guidelines, if applicable., • Comply with department performance and quality metrics, and adhere to training and remediation requirements., • Compliance with all applicable laws and regulations (DO NOT REMOVE - REQUIRED), • Active, unrestricted Registered Nurse (RN) licensure from the United States and in the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC), • Associate Degree and/or Bachelors of Nursing from an accredited school of nursing, • 5+ years healthcare experience (including at least 2 years clinical practice in an acute care setting), • 3+ years of utilization review experience at a managed care plan or provider organization, • 1+ years of direct-report leadership of a clinical team at a managed care plan or healthcare organization including in a virtual environment., • Experience in healthcare quality assurance, • Strong understanding of NCQA accreditation standards for utilization management, case management or population health, HEDIS measures and other regulatory requirements, • CCM or MCG certification, • Experience analyzing and interpreting performance and other forms of data At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team () to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

Job DescriptionReports To: Regional Chief Executive Officer Direct Reports: Local Chief Nursing Officers/Directors of Nursing (DONs) Executive Clinical Partner: Arizona Regional Chief Medical Officer (CMO) Location: Arizona (Multi-Site Portfolio) FLSA Status: Exempt – Executive Travel: 60–85%Position Summary The Regional Chief Nursing Officer (CNO) serves as the senior clinical and operational nursing executive responsible for care delivery excellence, hospital throughput, utilization management, labor performance, regulatory readiness, leadership development, and portfolio-wide standardization across all Arizona facilities. Reporting to the Regional CEO, the CNO provides direct supervision of Local Facility CNO and Directors of Nursing (DONs), who serve as the highest on-site leaders overseeing cross-functional hospital operations including Nursing and Environmental Services, and Dietary services. The CNO works in structured partnership with the Arizona Regional Chief Medical Officer (CMO) to ensure standardized, evidence-based, high-quality care delivery processes are implemented consistently across the region. Also works closely with the Regional Chief of Facilities and Administration (CFA) regarding Lab, Radiology, Supply, and Front Desk / Patient Access issues and concerns. The CNO serves as the ultimate nursing authority for the region and may assume interim on-site leadership responsibilities during DON vacancies or operational instability. Essential Functions & Responsibilities 1. Care Delivery Oversight • Establish and maintain standardized care delivery processes across all facilities., • Ensure evidence-based nursing practice and regulatory compliance., • Monitor patient safety, quality indicators, and clinical performance trends., • Implement portfolio-wide clinical best practices., • Ensure compliance with:, • Centers for Medicare & Medicaid Services Conditions of Participation, • Center for Improvement in Healthcare Quality (CIHQ) accreditation standards, • Arizona Department of Health Services licensure requirements 2. Oversight of Local Facility Leadership • Provide direct supervision and performance oversight of all facility CNO/DON team., • Ensure CNOs/DONs maintain operational accountability across their sites., • Monitor site-level regulatory readiness., • Establish leadership performance expectations., • Develop corrective action plans when necessary.Each CNO/DON oversees cross-functional departments including:, • Nursing (ED & Inpatient), • Radiology, • Laboratory, • Front Office/Registration, • Plant Operations/Supply, • Environmental Services (contracted), • Dietary (if applicable) 3. Throughput & Flow Management • Oversee ED throughput and patient flow performance., • Monitor inpatient length of stay., • Reduce LWOT and delay metrics., • Standardize bed management and care transition processes., • Deploy rapid improvement strategies when metrics decline. 4. Utilization Management • Ensure appropriate admission status determinations., • Monitor observation vs inpatient compliance., • Oversee case management performance., • Support documentation integrity to protect reimbursement., • Reduce avoidable payer denials related to clinical processes. 5. Labor & Productivity Oversight • Develop regional nursing staffing frameworks., • Monitor productivity benchmarks across facilities., • Control overtime and traveler utilization., • Align departmental labor performance with financial targets established by the COO., • Oversee labor efficiency within Nursing and EVS / Food Service departments. 6. Mentorship & Leadership Development • Mentor and coach Local DONs., • Develop structured leadership development programs., • Identify and cultivate high-potential leaders., • Establish succession planning across the portfolio., • Standardize onboarding for new nursing and site leaders., • Provide hands-on operational support when performance gaps exist. 7. Portfolio Best Practice Development • Identify high-performing care processes across facilities., • Standardize and deploy best practices region-wide., • Reduce variability in care delivery., • Implement cross-site benchmarking dashboards., • Lead portfolio-wide quality improvement initiatives. 8. Clinical Governance Partnership with Regional CMO • Coordinate with Regional CMO to align medical and nursing standards., • Participate in development of standardized care pathways., • Review quality trends and sentinel events collaboratively., • Support physician engagement and clinical integration initiatives., • Operationalize clinical strategies developed at the regional level. 9. Regulatory & Survey Readiness • Maintain continuous accreditation readiness., • Lead Nursing preparation for regulatory and accreditation surveys., • Oversee corrective action plan development and closure. 10. Interim Leadership Authority • Serve as interim DON during site vacancies., • Provide temporary on-site leadership during operational instability., • Stabilize underperforming facilities., • Lead recruitment and onboarding of new DONs., • Assume direct oversight of cross-functional site teams when required. • Participate in development of new and expanding service lines., • Evaluate clinical feasibility of growth initiatives., • Assess staffing implications of expansion., • Support physician recruitment and onboarding., • Ensure scalable care delivery models are implemented regionally. Performance Metrics • Patient safety and quality indicators, • ED throughput performance, • Inpatient length of stay, • LWOT reduction, • Labor productivity and overtime control, • Utilization accuracy, • Zero repeat clinical survey citations, • DON leadership development outcomes, • Bachelor’s degree in nursing, • Active Registered Nurse (RN) license, • Minimum 7 years hospital leadership experience, • Multi-site operational oversight experience, • Experience leading accreditation surveysPreferred, • Master’s degree (MSN, MHA, MBA), • Experience in micro-hospital or acute care model, • Experience partnering with physician leadership, • Clinical governance leadership, • Leadership development and mentorship, • Throughput optimization, • Utilization management expertise, • Regulatory compliance mastery, • Interdisciplinary collaboration, • Change management EFq6qK2tI2

Job Description At The CORE Institute, we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes the following: • Competitive Health & Welfare Benefits, • Monthly $43 stipend to use toward ancillary benefits, • HSA with qualifying HDHP plans with company match, • 401k plan with company match (Part-time employees included), • Employee Assistance Program that is available 24/7 to provide support A Case Manager/Utilization Review Nurse, in collaboration with patients/families, physicians and the interdisciplinary team, provides leadership and advocacy in the coordination of patient-centered care across the continuum to facilitate optimal transitions and progression in care. • Conduct concurrent and retrospective reviews of patient medical records to verify the medical necessity of services provided., • Assess admission criteria and length of stay, applying standardized clinical guidelines such as InterQual or MCG to justify care levels., • Issue pre-authorizations for procedures, medications, and durable medical equipment by providing clinical information to insurance carriers., • Collaborate with physicians and other healthcare providers to discuss patient care plans and ensure alignment with coverage policies., • Facilitate communication between medical staff and payers to resolve issues related to treatment plans and reimbursement., • Identify and refer cases to case management or social work for complex discharge planning needs., • Prepare and submit clinical appeals to insurance companies when services are denied, providing documentation to support medical necessity., • Associate Degree in Nursing (ADN) required,, • Three to five years of clinical experience in a direct patient care setting within an acute care hospital required., • A current and unrestricted Arizona Registered Nurse (RN) license., • Medical Necessity Analysis: This skill involves a detailed evaluation of patient medical records. The nurse must critically assess the documented clinical information to determine if the proposed treatments, procedures, and services are medically appropriate and necessary according to established standards., • Payer-Provider Liaison: Acting as a crucial communication link, the nurse must effectively mediate between healthcare providers and insurance payers. This requires translating clinical information into the language of insurance requirements to resolve discrepancies and pre-emptively address potential denials., • Patient Assessment: Conduct comprehensive assessments of patients' medical, emotional, and social needs to develop individualized discharge plans that ensure continuity of care., • Care Coordination: Collaborate with healthcare providers, including doctors, nurses, and therapists, to create an integrated plan of care that addresses clinical needs, equipment, home care, and other requirements., • Discharge Planning: Determine the appropriate discharge disposition based on factors such as living situation, mobility, cognitive status, and available support systems. This includes deciding whether patients can return home with services or require care in a facility., • Arranging Services: Coordinate necessary post-discharge services, such as home health care, rehabilitation, and durable medical equipment, ensuring that these services are in place after the patient leaves the hospital., • Communication: Maintain clear communication with all parties involved in the patient's care, including insurance providers, to secure coverage for post-discharge services and ensure that receiving providers are informed of the patient's needs and changes in their condition., • Ability to work in a high-stress, fast-paced environment., • Ability to develop relationships with providers, staff, patients, families, and payors., • Ability to work cooperatively and professionally in a team environment.

Job Description Adult Primary Care Physician We are seeking Primary Care Physicians who are certified in Internal Medicine, Family Medicine, Emergency Medicine, or Geriatrics. Must be eligible for enrollment to provide services to Medicare and Medi-Cal participants. All-Inclusive Care for the Elderly program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to our values, team culture, and mission. PACE program which serves as our patients’ health insurer as well as directly provides comprehensive primary care and social services to keep them living safely in their communities. Reporting to the Chief Medical Officer, the Medical Director will be at the center of an IDT, providing care. PACE is an ideal job for a clinician, as it allows you to spend ample time engaging with and truly caring for patients without the mis-aligned incentives of fee-for-service. Essential Job Duties: • Provide primary care and acute illness evaluation and treatment for a panel of approximately 150 participants, • Perform comprehensive assessments for participants and coordinate with the IDT to develop a comprehensive care plan for each participant, • Be an engaged member of the IDT, communicating participant changes, collaborating on care planning arrangements, and coordinating 24-hour care delivery, • Work collaboratively with network providers and other members of the IDT to ensure effective care coordination, particularly around hospital discharge, short-term, and long-term placement, • Provide direction and guidance to Nurse Practitioners, • Oversee participants’ use of medical specialists and inpatient care, • Participate in rotating night and weekend call, • Oversee all care of participants in the nursing home, providing regular visits as dictated by PACE standards and participants’ needs, • Review outcome and utilization data, including adverse events, hospitalizations, and use of specialists, in collaboration with the IDT to identify opportunities for improved care and operations Requirements Job Requirements: • Successful completion of a residency program accredited by the Accreditation Council for Graduate Medical Education, • Master’s degree/doctorate degree, • Board Certification – Internal Medicine or Family Practice, • Board Certification – Geriatrics preferred, • Active California Physician License without restrictions, • State CDS Certification and DEA Registration, • Valid state driver’s license with a clean DMV record, • Copy of recent vehicle insurance required, • Excellent clinical, organizational, and communication skills in settings with frail, elderly participants, their families, and the IDT Compensation: $250,000-$280,000 with quarterly bonus Benefits:: Benefits Include: apply your clinical expertise in new ways as we rapidly expand. You will have the opportunity to design the way we work in the context of an encouraging and loving environment where every person feels uniquely cared for. • Medical insurance coverage (Medical, Dental, Vision), • Work/life balance - we mean it! 17 days of personal time off (PTO), 12 holidays observed annually, and sick time, • 401 K savings + match, • Advancement opportunities - we’ve got a track record of hiring and promoting from within, meaning you can create your own path!, • CME and Paid Time Away, • Equity grants – typically reserved for executives, we want all team members to celebrate our success as a rapidly scaling company, • Malpractice Insurance, • And additional benefits Generous time off - weekends off, 17 days PTO, 6 sick days, & 12 paid holidays Relocation assistance up to $50,000 and $10,000 sign-on bonus CME reimbursement and malpractice/tail coverage Growth opportunities to become a medical director 401K savings + match, as well as equity grants Medical insurance coverage (Medical, Dental, Vision) Regular hours of 8am-5pm, Monday through Friday, including home visits Rotating on-call schedule - a few nights or weekends per month, available by phone only

The registered nurse (RN) is accountable for the coordination of nursing care, including direct patient care, patient/family education and transitions of care. All entry-level associate degree registered nurses with a RN start date of April 1, 2020 and after must provide documented evidence of progr

Responsible for the day-to-day program operations and supporting the growth of the assigned single site Home Therapies program in coordination with the Business Unit management, in-center staff and other support functions.Ensures provision of quality patient care in accordance with policies, procedu

The registered nurse (RN) is accountable for the coordination of nursing care, including direct patient care, patient/family education and transitions of care. All entry-level associate degree registered nurses with a RN start date of April 1, 2020 and after must provide documented evidence of progr

Home Therapies Program PURPOSE AND SCOPE: Responsible for the day-to-day program operations and supporting the growth of the assigned single site Home Therapies program in coordination with the Business Unit management, in-center staff and other support functions.Ensures provision of quality patie

The registered nurse (RN) is accountable for the coordination of nursing care, including direct patient care, patient/family education and transitions of care. All entry-level associate degree registered nurses with a RN start date of April 1, 2020 and after must provide documented evidence of progr

Foothills Sports Medicine Physical Therapy.A member of the Confluent Health family, is looking for a Full Time Front Desk Medical Receptionist to join our Tempe team!.Location: Tempe, Arizona 85284.How Foothills and Confluent Health Supports You:.Structured training, hands on learning and mentorship

The registered nurse (RN) is accountable for the coordination of nursing care, including direct patient care, patient/family education and transitions of care. All entry-level associate degree registered nurses with a RN start date of April 1, 2020 and after must provide documented evidence of progr

Associate Patient Care Coordinator.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 the

The registered nurse (RN) is accountable for the coordination of nursing care, including direct patient care, patient/family education and transitions of care. As a Magnet Facility, we have great resources to allow our nurses to deliver. All entry-level associate degree registered nurses with a RN s

Commercial Drywall Project Manager/Estimator.GPAC: #1 Commercial Drywall Recruiting Firm in North America: WORK FOR A LEADING CONTRACTOR.I am working with multiple well-respected, firmly established Commercial Drywall Contractors seeking experienced Project Managers and Estimators.This is an excitin

The registered nurse (RN) is accountable for the coordination of nursing care, including direct patient care, patient/family education and transitions of care. All entry-level associate degree registered nurses with a RN start date of April 1, 2020 and after must provide documented evidence of progr

Review plans, specifications, and proposals to determine project requirements. Prepare and review invoices, purchase orders, and job costing reports.

Associate Patient Care Coordinator.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 the

Associate Patient Care Coordinator.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 the

Associate Patient Care Coordinator.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 the

Associate Patient Care Coordinator.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 the

Service Estimator/Project Manager - Commercial HVAC.For over 45 years, MPSW has been a trusted source for engineered HVAC solutions in Arizona.We represent top-tier manufacturers and provide technical sales support for nearly every system typebacked by expert design assistance, energy analysis, and

Generates, reviews, and analyzes patient data reports and follows up on issues and inconsistencies as necessary.

Generates, reviews, and analyzes patient data reports and follows up on issues and inconsistencies as necessary.

Facility Services, LLC is a family-owned business providing specialized cleaning and maintenance services to commercial clients in the greater Phoenix, AZ area.The company focuses on restoring HVAC systems and other infrastructure to their original performance specifications, ensuring safety, effici

Actively contribute to quality control efforts, constructability reviews, and technical excellence.

SEW, with its innovative and industry-leading cloud platforms, delivers the best Digital Customer Experiences (CX) and Workforce Experiences (WX), powered by AI, ML, and IoT Analytics to the global energy, water, and gas providers.At SEW, the vision is to Engage, Empower, and Educate billions of peo

Coordinates with the Construction Project Manager on design activities including programming, design review meetings, construction documents review, site logistics, and construction administration.

Competitive Salary + Bonus, 1800.This Jobot Job is hosted by: Amanda Cohen.Are you a fit? Easy Apply now by clicking the "Apply" button and sending us your resume.Salary: $180,000 - $210,000 per year.We're a tightly knit team of attorneys who approach complex business challenges with clari

Aveanna Healthcare - - Responsibilities: Develop and maintain weekly caregiver schedules that meet patient care needs and minimize unstaffed shifts; Proactively communicate and coordinate schedule changes with direct care team members and families; Ensure clinicians are appropriately matched with p

Establishes and enforces policies, procedures, standards and objectives.Directs and supervises staff as well as workflow.Position has budgetary or fiscal accountability.Responsible 24 hours a day for the ongoing effective operation of the assigned nursing department by exerting a leadership role whi

Classroom Teacher/TEACHER, HEALTH CARE.Phoenix Union High School District No.GENERAL STATEMENT OF RESPONSIBILITIES:.The teacher is responsible for creating a safe, intellectually challenging learning environment in which each student is actively engaged in meaningful activities.The teacher uses know

With Restore's continued growth and success, we are excited to hire a Registered Nurse to join one of our locations in the(. We are looking for a positive, energetic individual with a passion for wellness and helping people! As a Registered Nurse at Restore you will be responsible for the administra

Staff Safety (a wearable badge that allows nurses to quickly and discreetly call for help when safety is a concern). This role ensures that care delivery meets quality and utilization standards while achieving optimal clinical outcomes. Additionally, this position mentors newly hired nurses and play

Nurse Practitioner Cardio - Scottsdale, AZ. We are a fast-growing Private Practice and we are looking to add another Nurse Practitioner or Physician Assistant to our amazing team. We are looking for a Full Time Nurse Practitioner or Physician Assistant that can assist us in maintaining this high sta

Plastic Surgery Practice Sales - Patient Care Coordinator.Growing plastic surgery practice in Scottsdale, AZ is seeking a superstar Patient Sales Coordinator with a strong sales background.The practice is owned by a Harvard-trained board-certified plastic and reconstructive surgeon who has performed

At Haven Hospice, we are committed to providing compassionate, patient-centered care for individuals facing life-limiting illnesses while supporting their loved ones every step of the way.We are seeking experienced and empathetic Hospice RN Case Managers to join our dedicated Scottsdale team.In this

Consistently applies the utilization review process as required by the Code of Federal Regulations including the use of Abrazo designated criteria for primary review. Incorporates into the utilization review process the ability to access and interpret clinical information against the designated revi

The Nurse performs this care in accordance with the physician's orders and the plan of care and under the direction and supervision of the Health Services Director. Clearwater Mayo Blvd is a premier luxury senior living community in Phoenix, AZ and is looking for a Licensed Vocational Nurse to join

The Registered Nurse (RN) Case Manager works within an interdisciplinary team to facilitate the patient plan of care throughout the continuum of care by ensuring appropriate utilization management, care coordination, resource utilization, and clinical documentation. Registered Nurse - Case Manager I