Outpatient Nursing Jobs

CMA Manager/Supervisor ER Outpatient Full-time
VNS Health

Clinical Evaluation Manager

VNS Health New York, NY
Overview 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 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 plan’s 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 individual’s 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 member’s 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. Qualifications 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 Education: Associate's Degree in Nursing or a Master’s degree in Occupational Therapy required Bachelor's Degree or Master’s 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 Pay Range USD $85,000.00 - USD $106,300.00 /Yr. About Us VNS Health is one of the nation’s largest nonprofit home and community-based health care organizations. Innovating in health care for more than 130 years, our commitment to health and well-being is what drives us — we 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 the communities and people we serve in New York and beyond.
RN Outpatient Full-time
OSF HealthCare

Registered Nurse RN Anticoagulation Clinic

OSF HealthCare Rockford, IL
Total Rewards "Your life - our Mission" OSF HealthCare is dedicated to provide Mission Partners with a comprehensive and market-competitive total rewards package that includes benefits, compensation, recognition and well-being offerings that focus on the whole person and engage with their current stage of life and career. Click here to learn more about benefits and the total rewards at OSF. Pay range for this position is $30.11 - $43.84/hour. Actual pay is based on years of licensure. This is an Hourly position. Overview Sign on Bonus Eligible $5,000 with a 2 yr work commitment POSITION SUMMARY: The Registered Nurse protects, promotes and restores health and wellness, by practicing at the highest level of licensure; collaborates with providers and multidisciplinary care team members to provide care coordination across the continuum; assesses and supports physical symptoms; provides psychological support to patients, friends, and families; mentors assigned team members; promotes best practices; maintains professional disposition at all times. Qualifications REQUIRED QUALIFICATIONS: Licenses/Certifications: IL OR MI RN License RN license in current state American Heart Association (BLS for Health Care Providers) PREFERRED QUALIFICATIONS: Education: BSN Experience: 6 months experience as an RN in a healthcare environment Other skills/knowledge: Electronic Medical Record and Microsoft application basic proficiency Other requirements/information: Ability to regularly and timely travel between various sites OSF HealthCare is an Equal Opportunity Employer.
RN Outpatient Part-time
Legacy Health

RN Staff Nurse Ambulatory Clinic - Primary Care

Legacy Health Tualatin, OR
Overview Your positive attitude immediately puts visitors to the ambulatory clinic at ease. As an integral member of the collaborative care team, you carefully assess each patient’s situation and advise on the appropriate care plan to ensure the best possible outcomes. In short, you embody the Legacy mission of making life better for others. The RN Staff Nurse Ambulatory-Clinic is responsible for patient care within an assigned department/unit and participates as a member of the health care team in cooperation with and under the direction of the clinical manager or designee as defined by the relevant Standards and Scope of Practice for the Registered Nurse. The RN Staff Nurse Ambulatory-Clinic assesses, analyzes, plans, implements and evaluates patient care following established patient care standards for Legacy Health System including those for patient assessment and transfer. The LMG Tualatin RN will be engaged in a nurse-led visit model of care which will include seeing patients for clinical concerns such as wound care,nail care, and blood pressure checks. The nurse will work closely withclinic providers to collaborate and create a team-based approach for annual wellness visits, as well as other co-visit models of care. The RN engages with and is comfortable with an ambulatory nursingapproach to patient care in a primary care setting. Responsibilities Responsible for patient care within an assigned department/unit and participates as a member of the health care team in cooperation with and under the direction of the clinical manager or designee as defined by the relevant Standards and Scope of Practice for the Registered Nurse. The RN Staff Nurse Ambulatory-Clinic assesses, analyzes, plans, implements and evaluates patient care following established patient care standards for Legacy Health System including those for patient assessment and transfer. Qualifications Education: As required by licensure. BSN or degree in progress strongly preferred. BSN may be required for specific assignments; experienced RNs without a BSN may be hired based on clinical experience with approval of the site CNO. Experience: One-year registered nursing experience or completion of either the Legacy Health RN Residency program or a nursing residency program that is equivalent in content, curriculum and duration. Additional clinical experience requirements may vary dependent upon the specific department in which the position is utilized. Licensure: Current applicable state RN license required. AHA BLS for Healthcare Providers. Knowledge/Skills: Demonstrated ability of positive interpersonal and communication skills with colleagues, patients, families, physicians and the community. Keyboard skills and ability to navigate electronic systems applicable to job functions. . Licensure Current applicable state RN license required. AHA BLS for Healthcare Providers. Pay Range USD $48.16 - USD $71.94 /Hr. Our Commitment to Health and Equal Opportunity Our Legacy is good for health for Our People, Our Patients, Our Communities, Our World. Above all, we will do the right thing. If you are passionate about our mission and believe you can contribute to our team, we encourage you to apply—even if you don't meet every qualification listed. We are committed to fostering an inclusive environment where everyone can grow and succeed. Legacy Health is an equal opportunity employer and prohibits unlawful discrimination and harassment of any type and affords equal employment opportunities to employees and applicants without regard to race, color, religion or creed, citizenship status, sex, sexual orientation, gender identity, pregnancy, age, national origin, disability status, genetic information, veteran status, or any other characteristic protected by law. To learn more about our employee benefits click here: www.legacyhealth.org/For-Health-Professionals/careers/benefiting-you