RN Clinical Coordinator Intermediate Care Job at American Nursing Care (Colorado Springs)

RN Clinical Coordinator Intermediate Care

Embrace your purpose and unique talents now, and put them to work. We value indi...

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
BSN, preferred
RN License to practice in state of employment as applicable, required
Nursing Specialty Certification, preferred
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

Qualified external applicants may be eligible for a $20,000 sign-on bonus
Depending on your location, you may be eligible for up to $8,000 in relocation assistance
health/dental/vision, FSA, matching retirement plans, paid time off, tuition assistance, adoption assistance, and more
full-time benefit eligible team members may receive a minimum of 14 paid time off days, including holidays annually
401(k), 403(b), and other defined benefits offerings

Fulltime

Rare Condition Manager

To support high-quality, cost-effective care by coordinating services for member...

Location

United States , Phoenix

Salary:

Not provided

Blue Cross Blue Shield of Arizona

Expiration Date

Until further notice

Requirements

2 year(s) of experience in full-time equivalent of direct clinical care to the consumer
Associate’s Degree in general field of study or Post High School Nursing Diploma
Active, current, and unrestricted license to practice in the State of Arizona (or an endorsement to work in Arizona) as an active, current, and unrestricted license to practice nursing in either the State of Arizona or another state in the United States recognized by the Nursing Licensure Compact (NLC) as an RN
Intermediate PC proficiency
Intermediate skill in use of office equipment, including copiers, fax machines, scanner and telephones
Intermediate skill in word processing, spreadsheet, and database software
Maintain confidentiality and privacy
Advanced and current clinical knowledge
Practice interpersonal and active listening skills to achieve customer satisfaction
Interpret and translate policies, procedures, programs, and guidelines

Job Responsibility

Perform assessments, condition management education, training, and other clinically-based activities to coordinate care among providers, members, and family to implement the care plan
Make and answer a diverse and high volume of condition management-related member calls on a daily basis
Identify holistic member needs considering whole-person health, to include condition-specific needs, behavioral health needs, and social drivers of health needs
Analyze medical records, claims data, and other information sources
Explain to customers a variety of information concerning the organization’s services, including but not limited to, contract benefits, changes in coverage, eligibility, BCBSAZ programs, provider networks, etc
Present status reports on cases to the manager/supervisor and, when indicated, to the medical director
Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries
Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines
Maintain all standards in consideration of state, federal, BCBSAZ, URAC, and other accreditation requirements
Maintain complete and accurate records per department policy

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

Integrated Care Manager - Adult

Responsible for promoting continuity of care through a collaborative process tha...

Location

United States , Phoenix

Salary:

Not provided

Blue Cross Blue Shield of Arizona

Expiration Date

Until further notice

Requirements

2 year(s) of experience in full-time equivalent of direct clinical care to the consumer
Associate’s Degree in general field of study or Post High School Nursing Diploma or Master’s Degree in a behavioral health field of study (i.e., MSW, MA, MS, M.Ed.), Ph.D. or Psy.D
Active, current, and unrestricted license to practice in the State of Arizona (or an endorsement to work in Arizona) as a behavioral health professional such as LCSW, LPC, LISAC LMFT, or licensed psychologist (Psy.D. or Ph.D.), OR an active, current, and unrestricted license to practice nursing in either the State of Arizona or another state in the United States recognized by the Nursing Licensure Compact (NLC) as an RN
Within 4 years of hire as a Care Manager employee must hold a certification in case management from the following certifications
Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), Case Management Administrator, Certified (CMAC), Case Management Certified (CMC), Certified Rehabilitation Counselor (CRC), Certified Registered Rehabilitation Counselor (CRRC), Certified Occupational Health Nurse (COHN), Registered Nurse Case Manager (RN, C), or Registered Nurse Case Manager (RN,BC)
Intermediate PC proficiency
Intermediate skill in use of office equipment, including copiers, fax machines, scanner and telephones
Intermediate skill in word processing, spreadsheet, and database software
Maintain confidentiality and privacy
Advanced and current clinical knowledge

Job Responsibility

Assess and collect data related to the member from all care settings. Interview and collaborate with case-related providers, member and family to implement the care plan
Answer a diverse and high volume of health insurance related customer calls on a daily basis
Explain to customers a variety of information concerning the organization’s services, including but not limited to, contract benefits, changes in coverage, eligibility, claims, BCBSAZ programs, provider networks, etc
Analyze medical records and apply medical necessity criteria and benefit plan requirements to determine the appropriateness of benefit requests
Present status reports on all cases to the manager/supervisor and, when indicated, to the medical director
Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries
Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines
Maintain all standards in consideration of state, federal, BCBSAZ, URAC, and other accreditation requirements
Maintain complete and accurate records per department policy
Demonstrate ability to apply plan policies and procedures effectively

Fulltime

New

Performance Improvement Coordinator II

Location

United States , Charlotte

Salary:

35.50 - 53.25 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Bachelor's Degree required
Master's Degree preferred
RN or other clinical licensure preferred
certification in health care quality, patient safety or related accreditation entity preferred, required within 1 year of employment
5 to 7 years experience in healthcare or directly related field
2 to 4 years leadership experience preferred
Knowledge of Lean Concepts preferred
Intermediate to advanced computer skills with demonstration of skill and competence in use of all Microsoft Office applications preferred
Previous experience or knowledge of TJC preferred
Must have the ability to clearly communicate verbally, in person, and in writing with patients, families, agencies and the health care team

Job Responsibility

Expertly facilitates performance improvement efforts and coaches others in the development of performance improvement capabilities with emphasis on process redesign and measurement
provides direction to the department and business unit leadership in the planning of a systematic, organization-wide approach to continuous quality improvement
Serves as a team leader, preceptor, mentor and coach to quality management staff, as well as a system expert for performance improvement training and new initiatives
assists leadership with review of performance improvement coordinator work product and makes recommendations for staff performance appraisal
Maintains competence in applicable licensure, certification, accreditation and other regulatory body requirements
Coordinates department and facility Performance Improvement Committee meetings, analyzes trends of performance metrics/business unit level dashboards, identifies opportunities for improvement, develops and maintains management action plans, measures success of these action plans and creates the records and follow-up metrics for each meeting and activity
reassesses approach to maximize success
Provides consultation to teammates and leadership in areas of quality, compliance, accreditation and safety
Facilitates assessments, develops, implements and evaluates corrective action plans based on past surveys and preparatory tracer activities
Develops strategies for improvement that include considerations for leading practice research and shares implementation results across the System

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Fulltime

New

Patient Safety Coordinator

Patient Safety Coordinator for Atrium Health, a remote full-time day position. T...

Location

United States

Salary:

35.50 - 53.25 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Bachelor's Degree required
Master's Degree preferred
RN or other clinical licensure preferred
certification in health care quality, patient safety or related accreditation entity preferred, required within 1 year of employment
5-7 years experience in healthcare or directly related field
2-4 years leadership experience preferred
Knowledge of Lean Concepts preferred
Intermediate to advanced computer skills with demonstration of skill and competence in use of all Microsoft Office applications preferred
Previous experience or knowledge of TJC preferred
PMP Certification preferred

Job Responsibility

Expertly facilitate patient safety improvement efforts and coaches other facilities and teammates in the development of performance improvement capabilities with emphasis on process redesign and measurement
provides direction to the department and facility leadership in the planning of a systematic, organization-wide approach to continuous quality improvement
Serves as a team leader, preceptor, mentor and coach to patient safety teammates, as well as a System expert for patient safety training and new initiatives
assists leadership with review of patient safety coordinator work product and makes recommendations for teammates' performance appraisal
Prepares Quality reports, scorecards and presentations
Coordinates department and facility patient safety meetings, analyzes trends of performance metrics, identifies opportunities for improvement, develops action plans, measures success of these action plans and creates the records and follow-up metrics for each meeting and activity
reassesses approach to maximize success
Organizes and coordinates the annual facility leadership conference, resulting in the review, analysis and development of the Patient Safety Plan
Conducts leading practice research and shares implementation results across the System to hardwire best practices
Provides education and training on patient safety initiatives, including project management, process redesign, rapid design and measurement

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program
Premium pay such as shift, on call, and more based on a teammate's job
Incentive pay for select positions
Opportunity for annual increases based on performance

Fulltime

New

Clinical Risk Management Analyst

Location

United States , Aurora

Salary:

38.20 - 57.30 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

If RN, Active, unrestricted registered nurse (RN) multi-state compact and/or single-state license with privileges to practice in the state(s) where the RN is providing client nursing services
Graduate of a Board of Nursing approved nursing education program
Typically requires 5 years of experience in healthcare, quality and/or risk management, which includes experience in risk management principles, and continuous quality improvement tools and concepts
Knowledge of federal, state and other external health care regulations and standards and ability to research those regulations
Knowledge of evidence based, best practice resources to promote efficiency and effective outcomes
Working knowledge of process improvement methods and statistical tools
Effective conflict management and resolution skills
Basic working knowledge of medical terminology, clinical concepts and disease management
Intermediate computer skills including experience in using Microsoft Office (Excel, Word, Power Point, Access) or similar products
Strong written and oral communication skills including good presentation skills

Job Responsibility

Collaborates with claims adjustors and defense counsel in managing claims including assessment of liability, ensuring establishment of appropriate reserves, maintaining complete and up-to-date case files, and assisting in procurement of medical records and documents necessary for evaluation and defense of cases
Facilitates timely response and investigation of adverse and significant events
Collects and evaluates data concerning incident reports, aggregates data summaries, and develops monthly and quarterly risk management reports that provide a summary of current claims and litigation, to include an analysis of trends
Shares reports with appropriate leadership and advises and recommends actions for process improvement
Maintains an accurate, up-to-date database reflecting the status and essential elements of current claims and litigation
Analyzes patient concerns or complaints to determine the root of the matter, identifies any trends, and determines how best to address the concern or complaint
Reviews and gathers pertinent information from patient records
Collaborates with other risk staff in the prompt, equitable resolution of claims
Provides consultative and resource support to staff regarding all aspects of risk management
Coordinates, facilitates, implements and participates in care management and quality improvement initiatives

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Fulltime

Nurse Aide Proctor

We are seeking experienced Registered Nurses (RNs) with a background in long-ter...

Location

United States , Watertown

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Active, unrestricted Registered Nurse (RN) license in the state of operation
Minimum of one (1) year of experience in long-term care or experience caring for the chronically ill of any age
Intermediate to advanced computer skills, including Microsoft Office, Outlook, and web-based applications
Valid Driver’s License and a reliable vehicle for travel to test events
Access to a personal computer/laptop and printer for administrative coordination
Ability to stand for the duration of the exam (up to 8 hours)
Ability to lift up to 50 lbs (testing mannequin)
BA/BS degree is preferred
Staff development or training experience is a strong plus

Job Responsibility

Clinical Skill Evaluation: Perform objective observation and scoring of candidates demonstrating clinical nursing skills
Examination Proctoring: Administer and proctor computerized knowledge-based examinations for nursing aide certification
Site Management: Ensure the testing site is correctly set up, cleaned, and secured
verify candidate identification and manage the flow of the testing environment
Technical Troubleshooting: Maintain technical proficiency to manage computer-based testing, including rebooting workstations and resetting passwords as necessary
Documentation & Reporting: Resolve candidate issues on-site and report any occurrences that fall outside of established guidelines to the supervisor
Professional Liaison: Maintain strong working relationships with regional testing facilities and serve as a professional representative of the testing program

What we offer

Mileage reimbursement available for travel exceeding 30 miles
Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance
Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan

RN Clinical Coordinator Intermediate Care

American Nursing Care

Location:
United States , Colorado Springs

Category:
Nursing

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
December 17, 2025

Looking for more opportunities? Search for other job offers that match your skills and interests.

Similar Jobs for RN Clinical Coordinator Intermediate Care