Registered Nurse

Clinical Nurse Specialist Pediatric Hematology/Oncology

Golisano Children's Hospital is seeking a Clinical Nurse Specialist (CNS) for th...

Location

United States , Fort Myers

Salary:

36.79 - 49.67 USD / Hour

Lee Health

Expiration Date

Until further notice

Requirements

Master's in Nursing from a nationally accredited program that prepares the graduate as a Clinical Nurse Specialist
5 Years of Clinical Nursing experience
CNS experience preferred
Registered Nurse License (State of Florida)
BLS (American Heart Association / Basic Life Support)
Certification in specialty required within one year of hire
As appropriate to clinical specialty area: ACLS// TNCC// ENPC or PALS required within one year of hire.

Job Responsibility

Provide clinical excellence while focusing on patient quality, education and hands on support at the bedside for patients requiring specialized care
Influence patient care outcomes nursing practices across acute and critical care services
Influence the development of organizational systems that support nursing practice and patient care standards
Provide system-wide clinical expertise
Develop innovative evidence-based procedures, policies and programs that improve quality of nursing care delivery and resource management for acute or critical care services
Provide collaborative/consultative services to promote outcome focused professional nursing practice.

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

Bladder and Bowel Nurse Specialist

In conjunction with the Clinical Nurse Manager, the Clinical Nurse Specialist co...

Location

United Kingdom , South Yorkshire

Salary:

Not provided

Clinisupplies

Expiration Date

Until further notice

Requirements

Registered Nurse
Post registration experience within a urology / continence environment
First level degree in a health-related subject or working towards
Demonstrable experience of teaching or delivering training
Qualification and /or evidence of working with adults who have complex continence issues
Passion to win
a self-starter and has a sense of urgency to achieve results
Competitive and works hard to exceed targets
Ability to self-motivate when needed
Ability to demonstrate sound knowledge and application of NMC Code of Conduct and Scope of Professional Practice

Job Responsibility

Promote the use of Nightingale home delivery service for patients requiring specialist products
Actively seek potential business opportunities on behalf of the organization
Ensure individuals are offered a holistic assessment and their individual needs are managed appropriately
Manage patient referrals of individuals requiring support and management of their continence need
Work in collaboration to develop a service for individual clients in their own home or in a clinic environment
Work autonomously with individuals to ensure high standards of care are delivered in the promotion of continence and management of incontinence
Undertake clinical procedures, investigations, or interventions competently whilst maintaining a safe, dignified, and confidential environment for the client
Participate in delivering training for the development of others
Maintain a high standard of professional competency within a framework of clinical governance
Always maintain a professional attitude in the best interest of the clients and professionals in accordance with the NMC Code of Conduct

What we offer

26 days holiday (increasing with service) plus a day off for your birthday
pension
access to private healthcare
profit related pay

Fulltime

Bladder and Bowel Nurse Specialist

In conjunction with the Clinical Nurse Manager, the Clinical Nurse Specialist co...

Location

United Kingdom , East & Northeast London

Salary:

Not provided

Clinisupplies

Expiration Date

Until further notice

Requirements

Registered Nurse
Post registration experience within a urology / continence environment
First level degree in a health-related subject or working towards
Demonstrable experience of teaching or delivering training
Qualification and /or evidence of working with adults who have complex continence issues
Passion to win
a self-starter and has a sense of urgency to achieve results
Competitive and works hard to exceed targets
Ability to self-motivate when needed
Ability to demonstrate sound knowledge and application of NMC Code of Conduct and Scope of Professional Practice

Job Responsibility

Promote the use of Nightingale home delivery service for patients requiring specialist products
Actively seek potential business opportunities on behalf of the organization
Ensure individuals are offered a holistic assessment and their individual needs are managed appropriately
Manage patient referrals of individuals requiring support and management of their continence need
Work in collaboration to develop a service for individual clients in their own home or in a clinic environment
Work autonomously with individuals to ensure high standards of care are delivered in the promotion of continence and management of incontinence
Undertake clinical procedures, investigations, or interventions competently whilst maintaining a safe, dignified, and confidential environment for the client
Participate in delivering training for the development of others
Maintain a high standard of professional competency within a framework of clinical governance
Always maintain a professional attitude in the best interest of the clients and professionals in accordance with the NMC Code of Conduct

What we offer

26 days holiday (increasing with service) plus a day off for your birthday
Pension
Access to private healthcare
Profit related pay