Registered Nurse Intermediate Care Job at American Nursing Care (Colorado Springs)

RN Clinical Coordinator Intermediate Care

RN Clinical Coordinators may be eligible for a relocation bonus up to $8,000. Em...

Location

United States , Colorado Springs

Salary:

37.31 - 59.51 USD / Hour

American Nursing Care

Expiration Date

Until further notice

Requirements

Associates Degree in Nursing (Nursing Diploma or by endorsement) required
RN License to practice in state of employment as applicable, required
Minimum of 1 year of direct clinical experience as a Registered Nurse
Physical Requirements: Medium Work - (Exert up to 50lbs force occasionally, and/or up to 20lbs frequently, and/or up to 10lbs constantly)

Job Responsibility

Actively support the department director/manager by coordinating clinical and department activities for the unit
Serve as a clinical nurse and resource to the staff, authorize work procedures and assign duties, shift charge
Demonstrating strong clinical judgment and ensuring high-quality care delivery to each patient
Acting as a vital link between physicians and the patient care team to facilitate seamless communication and collaboration
Maintaining communication and promote cooperation with unit staff and other departments
Provides input and recommendations to the director/manager on coaching, mentoring and performance management of associates
Assumes responsibility and accountability for facilitating, communicating, and collaborating with both the healthcare team, and the patient/family to identify and meet the physical, emotional, and spiritual needs of the patient
Act as a professional role model for all staff by demonstrating ethical/legal/professional nursing
Promotes the optimal health, well-being, and safety of the patient through use of the nursing process and in accordance with patient care standards, guidelines, and the State Nurse Practice Act
Actively serves on unit as a registered nurse and may take patient assignments based on unit and patient needs and acuity

What we offer

Relocation bonus up to $8,000
health/dental/vision, FSA, matching retirement plans, paid time off, tuition assistance, adoption assistance

Fulltime

Medical Appeals/Grievance Specialist II - Registered Nurse

Responsible for utilizing clinical acumen and managed care expertise related to ...

Location

United States , Phoenix

Salary:

Not provided

Blue Cross Blue Shield of Arizona

Expiration Date

Until further notice

Requirements

1 year experience in clinical and health insurance or other healthcare related field
3 years experience in clinical and health insurance or other healthcare related field AND 1 year Managed care experience with a focus in Utilization Management (UM), Prior Authorization (PA), Claims, Case Management and/or Medical Appeals and Grievance (MAG)
5 years experience in clinical and health insurance or other healthcare related field AND 2 years Managed care experience with a focus in Utilization Management (UM), Prior Authorization (PA), Claims, Case Management and/or Medical Appeals and Grievance (MAG)
8 years experience in clinical and health insurance or other healthcare related field AND 3 years above satisfactory job performance in the managed care environment with a focus in Utilization Management (UM), Prior Authorization (PA), Claims, Case Management and/or Medical Appeals and Grievance (MAG)
Associate’s Degree in a healthcare field of study or Nursing Diploma
Active, current, and unrestricted license to practice in the State of Arizona (a state in the United States) or a compact state as a Registered Nurse (RN), a Physical Therapist (PT) or a Licensed Master Social Worker LMSW.
Intermediate PC proficiency
Intermediate skill using office equipment, including copiers, fax machines, scanner and telephones
Maintain confidentiality and privacy
Advanced clinical knowledge

Job Responsibility

Perform in-depth analysis, clinical review and resolution of provider appeals/inquiries, corrected claims and subscriber reconsiderations, member appeals, corrected claims and provider grievances for all lines of business
Identify, research, process, resolve and respond to customer inquiries primarily through written / verbal communication.
Respond to a diverse and high volume of health insurance appeal related correspondence on a daily basis.
Analyze medical records and apply medical necessity criteria and benefit plan requirements to determine the appropriateness of appeal, grievance and reconsideration requests.
Maintain complete and accurate records per department policy.
Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines and required by State, Federal and other accrediting organizations.
Demonstrate ability to apply plan policies and procedures effectively.
Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries.
Attend staff and interdepartmental meetings.
Participate in continuing education and current developments in the fields of medicine and managed care.

Fulltime

Nurse Intermediate Care

As our Registered Nurse (RN), you will be a pivotal healthcare professional, del...

Location

United States , Henderson

Salary:

47.59 - 65.96 USD / Hour

American Nursing Care

Expiration Date

Until further notice

Requirements

One (1) year experience as an RN in an acute intermediate care setting
or as an RN in an acute care setting and successful completion of applicable clinical and didactic SRDH specialty training course(s)
Graduate of an accredited school of nursing
Registered Nurse: NV
Basic Life Support - CPR
Advanced Cardiac Life Support
quarterly American Heart Association (AHA) Resuscitation Quality Improvement (RQI) competency certification post-hire

Job Responsibility

ASSESSMENT: The registered nurse completes initial patient assessment and reassessments as indicated by patient condition
CRITICAL THINKING: The registered nurse demonstrates critical thinking by implementing the nursing process (assessment, diagnosis, planning, implementation, and evaluation)
PHYSICAL ABILITIES: The registered nurse has the physical ability to safely and effectively care for patient population assigned
MEDICATION ADMINISTRATION: The registered nurse manages medication administration and intravenous (IV) access according to physician's orders
DOCUMENTATION: The registered nurse documents nursing care and patient status in accordance with the nursing process
COMMUNICATION: The registered nurse has communication abilities sufficient to promote patient and family centered care by interacting with patients, families, and care-delivery team in verbal and written form

What we offer

health/dental/vision
FSA
matching retirement plans
paid time off
tuition assistance
adoption assistance

Fulltime