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case manager registered nurse fully remote

CVS Health

<div><p>We&rsquo;re building a world of health around every individual &mdash; shaping a more connected, convenient and compassionate health experience. At CVS Health&reg;, you&rsquo;ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger &ndash; helping to simplify health care one person, one family and one community at a time.</p><p></p><p><b>
Position Summary</b></p><p><b>
This is a remote work from home role anywhere in the US with virtual training.</b></p><p></p><p>
American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support cost-effective quality care for members.</p><p></p><p><b>
Key Responsibilities</b></p><ul><li><p>
This position consists of working intensely as a telephonic case manager with patients and their care team for fully and/or self-insured clients.</p></li><li><p>
Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory standards while assessing benefits and/or member&rsquo;s needs to ensure appropriate administration of benefits.</p></li><li><p>
Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.</p></li><li><p>
Assessments utilize information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality.</p></li><li><p>
Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management.</p></li><li><p>
Using a holistic approach, consults with clinical colleagues, supervisors, Medical Directors and/or other programs to overcome barriers to meeting goals and objectives.</p></li><li><p>
Utilizes case management processes in compliance with regulatory and company policies and procedures.</p></li><li><p>
Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversations.</p></li><li><p>
Identifies and escalates member&rsquo;s needs appropriately following set guidelines and protocols.</p></li><li><p>
Need to actively reach out to members to collaborate/guide their care.</p></li><li><p>
Perform medical necessity reviews.</p></li></ul><p><b><br>
Required Qualifications</b></p><ul><li><p>
5+ years&rsquo; experience as a Registered Nurse with at least 1 year of experience in a hospital setting.</p></li><li><p>
The AHH RN Case manager position requires the nurse to support members across multiple states. A RN who resides in a compact state is required to have an active multistate license through the Nurse Licensure Compact (NLC), allowing practice across participating states with one license. Nurses residing in non‑compact states must hold an individual, state‑specific RN license for each state they support.</p></li><li><p>
1+ years&rsquo; experience documenting electronically using a keyboard.</p></li><li><p>
1+ years&rsquo; current or previous experience in Oncology, Transplant, Specialty Pharmacy, Pediatrics, Medical/Surgical, Behavioral Health/Substance Abuse or Maternity/ Obstetrics experience.</p></li></ul><p><b><br>
Preferred Qualifications</b></p><ul><li><p>
1+ years&rsquo; Case Management experience or discharge planning, nurse navigator or nurse care coordinator experience as well as experience with transferring patients to lower levels of care.</p></li><li><p>
1+ years' experience in Utilization Review.</p></li><li><p>
CCM and/or other URAC recognized accreditation preferred.</p></li><li><p>
1+ years&rsquo; experience with MCG, NCCN and/or Lexicomp.</p></li><li><p>
Bilingual in Spanish preferred.</p></li></ul><p><b><br>
Education</b></p><ul><li><p>
Diploma or Associates Degree in Nursing required.</p></li><li><p>
BSN preferred.</p></li></ul><p></p><p><b>
Anticipated Weekly Hours</b></p>
40<p></p><p><b>
Time Type</b></p>
Full time<p></p><p><b>
Pay Range</b></p><p>
The typical pay range for this role is:</p><p></p>
$54,095.00 - $155,538.00<p></p><p>
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.</p><p><br>
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.</p><p></p><p><b>
Great benefits for great people</b></p><p></p><p>
We take pride in our comprehensive and competitive mix of pay and benefits &ndash; investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:</p><ul><li><p><b>
Affordable medical plan options,</b> a <b>401(k) plan </b>(including matching company contributions), and an <b>employee stock purchase plan</b>.</p></li><li><p><b>
No-cost programs for all colleagues </b>including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</p></li><li><p><b>
Benefit solutions that address the different needs and preferences of our colleagues</b> including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</p></li></ul><p></p><p>
For more information, visit https://jobs.cvshealth.com/us/en/benefits</p><p></p>
This job does not have an application deadline, as CVS Health accepts applications on an ongoing basis.<p></p><p>
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</p></div>

Case Manager, Registered Nurse - Fully Remote

AIS HealthCare

<div><p>Fully remote and autonomous position providing infusions in the home setting for patients in the <b>Atlanta, GA </b>area</p>
<p>
AIC (Advanced Infusion Care) is looking for a remote full-time Infusion Nurse (RN) Special Projects in the <b>Atlanta, GA</b>. area. In this role you will be able to continue to provide quality in-home patient care while working remotely on other special projects as assigned. A full description of essential duties and responsibilities, as well as education/experience and qualification requirements, are outlined below.</p>
<p>
AIC is a branch of AIS Healthcare offering great benefits, including health, vision and dental insurance, long term disability insurance, life insurance, generous vacation package, 401K plan with employer match, growth, and more!</p>
<p>
The full-time special projects infusion nurse will visit patients in greater <b>Atlanta</b> and surrounding areas with occasional travel of up to 150-200 miles one way. Mileage is reimbursed and a cell phone stipend is paid monthly.</p>
<p><b>
As a Home Infusion STAT RN you will&hellip;</b></p>
<ul><li>Provide infusion therapies in our patients' homes, primarily for our <i>STAT patients</i>.</li></ul>
<ul><li>Assist with quality initiatives, patient and nurse education, patient scheduling, and the management of the local nursing team.</li></ul>
<ul><li>Have excellent written and verbal customer service skills in order to interact with the patient, physician, pharmacist and other partners.</li></ul>
<ul><li>Provide one-on-one home infusion nursing care visits and patient education in accordance with the physician's plan of treatment.</li></ul>
<ul><li>Additional licensure may be required in multi-state service areas</li></ul>
<ul><li>Challenge your clinical nursing (RN) skills by receiving continuous training on leading edge technology and clinical requirements in specialty infusion. Certification and recertification expenses can be reimbursed for eligible RNs such as Immune Globulin Certified Nurse (IgCN)!</li></ul>
<p>
Registered Nurses (RN) with AIS Healthcare, have a uniquely rewarding setting to use their exceptional nursing skills. As a national leader in the home infusion / IVIG field, we seek those special RNs who not only possess strong clinical expertise with creative ideas but who also have the kind of deep compassion and sensitivity it takes to treat people in their homes.</p>
<p>
Learn more about us: www.aiscaregroup.com</p>
<p>
Infusion, Home Infusion, RN, Registered Nurse, IV Therapy, Home Health, Hospice, ER, Trauma, ICU, Pediatrics, PRN, Vascular Access, IV Team, Oncology, PICC, Central Line, Infusion clinic, Ambulatory infusion, Cath lab, Transplant, Case Manager</p>
<p><b>
Required Qualifications:</b></p>
<ul><li>Registered Nurse with current license in <b>Georgia </b>andthe ability to be licensed in other states. Additional licensure may be required in multi-state service areas.</li></ul>
<ul><li>Minimum one year nursing experience; IV-related experience a plus</li></ul>
<ul><li>Have and maintain current CPR certification</li></ul>
<ul><li>Possess a valid and current driver's license and auto insurance (Liability limits of at least $100,000/$300,000 or $300,000 CSL and no business exclusion clause)</li></ul>
<ul><li>Have experience with Microsoft Office, Excel, Outlook and Word to document and track patient care activity.</li></ul>
<p><b>
Preferred Qualifications:</b></p>
<ul><li>Three years' nursing experience</li></ul>
<ul><li>One year infusion experience</li></ul>
<ul><li>Home healthcare experience</li></ul>
<ul><li>CRNI or IgCN certification preferred, not required</li></ul>
<p><b>
Education:</b> RN Diploma, Associates or B.S. degree in nursing</p>
<p>
At AIS Healthcare, we go beyond the expected, giving patients and providers more of what they need to thrive. Throughout our targeted drug delivery (TDD) and infusion care divisions, we&rsquo;re committed to advancing quality and improving the lives of everyone we serve.</p>
<p>
At our state-of-the-art compounding pharmacies, we exceed industry standards to produce medications of the highest quality and sterility. We take extra steps and make extra investments to ensure every person, every process and every protocol puts patient safety first.</p>
<p>
Beyond our pharmacies, our skilled nursing staff provides patient-specific care services to patients across the country. From in-home Ig therapy to TDD pump refills and maintenance, our nurses are trained to do more to offer specialized care that leads to better outcomes.</p>
<p>
Throughout the treatment process, we partner with providers to increase efficiency and enhance the care experience for everyone. We offer care coordination and patient engagement, and handle patient onboarding, billing and payment.</p>
<p>
Inside our company, we are committed to respecting and empowering everyone who works with us, continually finding new ways to increase diversity and inclusion throughout our operations. We also invest in our communities, working to increase opportunity and reduce inequality through partnerships and social justice initiatives.</p></div><p></p>

Home Infusion / STAT RN

<div><p>We&rsquo;re building a world of health around every individual &mdash; shaping a more connected, convenient and compassionate health experience. At CVS Health&reg;, you&rsquo;ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger &ndash; helping to simplify health care one person, one family and one community at a time.</p><p></p><p><b>
Position Summary</b></p><p></p><p><b>
This is a remote work from home role anywhere in the US with virtual training.</b></p><p></p><p>
American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support cost-effective quality care for members.</p><p></p><p><b>
Key Responsibilities</b></p><ul><li><p>
This position consists of working intensely as a telephonic case manager with patients and their care team for fully and/or self-insured clients.</p></li><li><p>
Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory standards while assessing benefits and/or member&rsquo;s needs to ensure appropriate administration of benefits.</p></li><li><p>
Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.</p></li><li><p>
Assessments utilize information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality.</p></li><li><p>
Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management.</p></li><li><p>
Using a holistic approach, consults with clinical colleagues, supervisors, Medical Directors and/or other programs to overcome barriers to meeting goals and objectives.</p></li><li><p>
Utilizes case management processes in compliance with regulatory and company policies and procedures.</p></li><li><p>
Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversations.</p></li><li><p>
Identifies and escalates member&rsquo;s needs appropriately following set guidelines and protocols.</p></li><li><p>
Need to actively reach out to members to collaborate/guide their care.</p></li><li><p>
Perform medical necessity reviews.</p></li></ul><p><b><br>
Required Qualifications</b></p><ul><li><p>
5+ years&rsquo; experience as a Registered Nurse, including at least 1 year in a hospital setting.</p></li><li><p>
The AHH RN Case manager position requires the nurse to support members across multiple states. A RN who resides in a compact state is required to have an active multistate license through the Nurse Licensure Compact (NLC), allowing practice across participating states with one license. Nurses residing in non‑compact states must hold an individual, state‑specific RN license for each state they support</p></li><li><p>
1+ years&rsquo; experience documenting electronically using a keyboard.</p></li><li><p>
1+ years&rsquo; current or previous experience in Oncology.</p></li></ul><p><b><br>
Preferred Qualifications</b></p><ul><li><p>
1+ years&rsquo; Case Management experience or discharge planning, nurse navigator or nurse care coordinator experience as well as experience with transferring patients to lower levels of care.</p></li><li><p>
1+ years' experience in Utilization Review.</p></li><li><p>
CCM and/or other URAC recognized accreditation preferred.</p></li><li><p>
1+ years&rsquo; experience with MCG, NCCN and/or Lexicomp.</p></li><li><p>
Bilingual in Spanish preferred.</p></li><li><p>
Bachelors Degree</p></li></ul><p><b><br>
Education</b></p><ul><li><p>
Diploma or Associates Degree in Nursing required.</p></li></ul><p></p><p><b>
Anticipated Weekly Hours</b></p>
40<p></p><p><b>
Time Type</b></p>
Full time<p></p><p><b>
Pay Range</b></p><p>
The typical pay range for this role is:</p><p></p>
$54,095.00 - $155,538.00<p></p><p>
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.</p><p><br>
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.</p><p></p><p><b>
Great benefits for great people</b></p><p></p><p>
We take pride in our comprehensive and competitive mix of pay and benefits &ndash; investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:</p><ul><li><p><b>
Affordable medical plan options,</b> a <b>401(k) plan </b>(including matching company contributions), and an <b>employee stock purchase plan</b>.</p></li><li><p><b>
No-cost programs for all colleagues </b>including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</p></li><li><p><b>
Benefit solutions that address the different needs and preferences of our colleagues</b> including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</p></li></ul><p></p><p>
For more information, visit https://jobs.cvshealth.com/us/en/benefits</p><p></p>
This job does not have an application deadline, as CVS Health accepts applications on an ongoing basis.<p></p><p>
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</p></div>

Case Manager, Registered Nurse (Oncology experience required)

Emory University

<div>Discover Your Career at Emory University:
<div>
Emory University is a leading research university that fosters excellence and attracts world-class talent to innovate today and prepare leaders for the future. We welcome candidates who can contribute to the excellence of our academic community.</div>
Description:
<div>
KEY RESPONSIBILITIES:
</div><ul><li>Functions as an expert research nurse or coordinates a multi-center trial.
</li><li>Provides direction in auditing and monitoring activities.
</li><li>Collaborates with multidisciplinary researchers to establish research programs that integrate new advances in clinical trials management.
</li><li>Develops and conducts patient and family education.
</li><li>Provides leadership and expertise in identifying and writing research grants, publications in medical and nursing literature, study materials, brochures and correspondence.
</li><li>Conducts ongoing training of clinical trials staff, providing updated information on internal processes and resources and external benchmarks.
</li><li>For multi-site studies, ensures sites fully understand and comply with study protocol and provides training of site coordinators and/or supervision of site coordinators.
</li><li>Actively participates in planning and evaluation processes to improve and advance clinical research within the organization.</li><li>
Leads or chairs committees or task forces to address and resolve significant operational issues.
</li><li>Along with Principal Investigator, may represent a study at Patient Safety Monitoring Board meetings at the NIH.
</li><li>Regularly functions as a preceptor or mentor.</li></ul><div>
MINIMUM QUALIFICATIONS:</div><ul><li>
Licensed as a Registered Nurse in the state of Georgia.
</li><li>Four years research nursing experience or four years of clinical nursing experience in a related specialty and two years of research nursing experience.
</li><li>Certified Research Administrator (CRA) or Clinical Research Coordinator (CRC) preferred.
</li><li>Must be credentialed through Emory Healthcare in RN II category.</li></ul><p>
PREFERRED QUALIFICATION:</p><ul><li>
Clinical Research experience</li></ul><p>
NOTE: Position tasks are generally required to be performed in-person at an Emory University location. Remote work from home day options may be granted at department discretion. Emory reserves the right to change remote work status with notice to employee.
</p>Additional Details:
<div>
Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law. Emory University does not discriminate in admissions, educational programs, or employment, including recruitment, hiring, promotions, transfers, discipline, terminations, wage and salary administration, benefits, and training. Students, faculty, and staff are assured of participation in university programs and in the use of facilities without such discrimination. Emory University complies with Section 503 of the Rehabilitation Act of 1973, the Vietnam Era Veteran's Readjustment Assistance Act, and applicable executive orders, federal and state regulations regarding nondiscrimination, equal opportunity, and affirmative action (for protected veterans and individuals with disabilities). Inquiries regarding this policy should be directed to the Emory University Department of Equity and Civil Rights Compliance, 201 Dowman Drive, Administration Building, Atlanta, GA 30322. Telephone: 404-727-9867 (V) | 404-712-2049 (TDD).</div><div></div><div><br>
Emory University is committed to ensuring equal access and providing reasonable accommodations to qualified individuals with disabilities upon request. To request this document in an alternate format or to seek a reasonable accommodation, please contact the Department of Accessibility Services at accessibility@emory.edu or call 404-727-9877 (Voice) | 404-712-2049 (TDD). We kindly ask that requests be made at least seven business days in advance to allow adequate time for coordination.</div></div>

Clinical Research Nurse III- School of Medicine, Infectious Diseases

Kaiser Permanente

<div><div><b>Job Summary:</b></div><br>
<br>
<p>Responsible for carrying out medical necessity reviews on all designated referrals for Home Care, DME Specialty Care services. The activities will include telephonic review for medical necessity of the designated services using established criteria and guidelines for coordination of services. Eligibility and benefit reviews will be performed as necessary. Identification of patients for case management, quality improvement reviews, and communication with inpatient care coordinators, case managers, providers, Customer Service, Claims, Contracts and Benefits - Appeals, Risk Management are responsibilities of the position.</p><div><b><br>
Essential Responsibilities:</b></div><br>
<br>
<ul><li>Responsible for the day to day review activities as outlined above. Utilizes established criteria to perform medical necessity review for all members requiring home health and DME services. All referral reviews will be performed within the required timeframe and with adherence to the decision notification process. Refers all cases that do not meet established criteria to the appropriate review physician. Performs benefit and eligibility reviews on referrals. Provides investigation and preparation of cases requiring review of the Chief of QRM according to the established guidelines. Understands the Complex Case Management Program and referral process; Refers patients to the Complex Case Managers according to procedure. Provides correspondence in accordance to policy and procedure for members with respect to service requests. Interacts with vendors to ensure that resources are being utilized appropriately while maintaining quality outcomes.<ul><li>
Establishes and maintains contact with case manager regarding requests and review status as appropriate.</li><li>
Refers the patient to the social workers as appropriate. Performs quality of care and service reviews using identified quality indicators. Reviews the utilization reports with the Supervisor to assure appropriateness of reviews and makes adjustments based on findings. Remains knowledgeable of contract benefits and current, relevant state and Federal regulations, criteria, documentation requirements and laws that affect managed care and case/utilization management. Maintains effective interaction/communication with members of the medical staff, health care teams, intake coordinators, complex case managers, social workers, inpatient care coordinators, referral coordinators, Member Services, Claims, Contracts and Benefits-Appeals, Risk Management and Kaiser Permanente medical offices to facilitate the review process. Builds effective working relationships with other department. Under the guidance of the supervisor, participates in the maintenance of all QRM policies and procedures related to the Transitional Care Review Program. Participates in call rotation to support after hours and weekend requests for quality resource management services.Refers cases identified as risk management, peer review or quality issues to QAIR and Risk Management.</li><li>
Document Review Activities according to documentation guidelines. Issue letters of non - coverage to members not meeting established medical necessity criteria. Works cross-functionally with other departments in striving to meet organizational goals and objectives. Achieves and maintains an understanding of relevant state and federal regulations, criteria, and documentation requirements and laws that affect managed care, home health and case/utilization management. Knowledgeable and compliant with regional personnel policies and procedures. Knowledgeable and compliant with QRM departmental and unit specific policies and procedures. Participates in annual regional and departmental compliance training. Knowledgeable and compliant with Principles of Responsibility. Consistently supports compliance and the Principles of Responsibility (Kaiser Permanentes Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state and local laws and regulations, accreditation and licenser requirements (if applicable), and Kaiser Permanentes policies and procedures.</li><li>
Responsible for assisting the Medical Office Administration, Customer Services and Provider Relations in investigating concerns and issues. Access to protected health information (PHI) will be limited to the minimum necessary required to effectively perform the job. Demonstrates understanding of HIPAA privacy regulations by maintaining confidentiality of Protected Health Information (PHI). Demonstrates doing the right thing and doing things the right way is an underlying premise in all work related activities and is able to identify location of copy of Principles of Responsibility. Develops and maintains an awareness of how to report compliance issues and concerns. Identifies issues of wrong doing and promptly investigates and reports to immediate supervisor or Director of Regional Compliance. Assures an atmosphere and culture for staff to report issues of wrong doing. Other duties as assigned.</li></ul></li></ul><div><br>
<b>Basic Qualifications:</b></div>
<div>Experience</div><br>
<br>
<ul><li>Minimum three (3) years of clinical nursing OR completed Kaiser Permanente Nurse Residency Program in KP Georgia.</li></ul><div>
Education</div><br>
<br>
<ul><li>B.S. in Nursing or four (4) years of directly related experience.</li><li>
High school diploma or GED required.</li></ul><div>
License, Certification, Registration</div>
<ul><li>Registered Professional Nurse License (Georgia)<br>
</li></ul><div>
<b>Additional Requirements:</b></div><br>
<ul><li>
Working knowledge of all relevant federal, state, local and regulatory requirements, including Medicare.</li><li>
Functional knowledge of computers.</li><li>
Experience in ICD9/CPT4 coding.</li><li>
Experience in home health and durable medical equipment coordination.</li><li>
Experience with managed health care delivery systems.</li></ul><div>
<b>Preferred Qualifications:</b></div><br>
<br>
<ul><li>Minimum three (3) years of clinical nursing with preferred experience home health, rehabilitation or skilled nursing care.</li><li>
Minimum two (2) years of experience in utilization or case management, discharge planning and quality improvement in a managed care or health care setting preferred.</li><li>
Preferred experience with managed care or health care delivery systems.</li><li>
CCM preferred.</li><li>
B.S. in Nursing.</li></ul><br>
PrimaryLocation : Georgia,Atlanta,Regional Office - 9 Piedmont<br>
HoursPerWeek : 40<br>
Shift : Day<br>
Workdays : Mon, Tue, Wed, Thu, Fri<br>
WorkingHoursStart : 08:30 AM<br>
WorkingHoursEnd : 05:00 PM<br>
Job Schedule : Full-time<br>
Job Type : Standard<br>
Employee Status : Regular<br>
Employee Group/Union Affiliation : GUP|UFCW|Local 1996<br>
Job Level : Entry Level<br>
Job Category : QA, UR &amp; Case Management<br>
Department : Regional Office - 9 Piedmont - UR-Care at Home - 2808<br>
Travel : No<br>
Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.</div>

RN, Specialty Care Review

Rowan

<div><div>At Rowan, we are all about making ear piercing experiences a celebration full of joy! Rowan is an innovative ear-piercing and hypoallergenic jewelry brand that brings safety to the forefront with our team of licensed nurses &ndash; and celebration to every customer with our joyful approach to piercings and jewelry. Our priority is to offer a fun, celebratory, and safe ear piercing experience for everyone. When we say piercing for all, we mean it. <i>Everybody</i> is invited to this ear party!</div><div></div><div><b><br>
About This Role:</b></div>
<div></div>
<div>Rowan's Piercing Studio Nurse, reporting to the Studio Manager, is dedicated to providing a safe, clean, and joyful ear-piercing experience. As a Rowan Nurse you will leverage your highly respected nursing skills and expertise to perform piercings with the utmost care and precision. Nurses are our skin-saving, infection-fighting, and customer-calming superheroes &ndash; essential skills that make Rowan&rsquo;s signature clinical ear piercing services a true delight. Your role is all about building trust and excitement, turning each piercing into a fun and memorable milestone!</div>
<div></div>
<div><b>What you&rsquo;ll do:</b></div>
<h3 class="jobSectionHeader"><b>Customer Service:
</b></h3><ul><li>Create magical and memorable customer experiences by combining top-notch clinical care with a celebratory atmosphere during each piercing session.</li>
<li>Ensure customer's safety and comfort and smooth flow of customer care.</li>
<li>Provide confident, clear, and professional communication with clients throughout their entire piercing experience.</li>
<li>Create a comforting atmosphere for customers, easing their concerns to ensure a relaxed and confident piercing experience.</li>
<li>Educate customers on aftercare, promoting Rowan's After Care to support healing and ensure their well-being.</li>
<li>Conduct a thorough ear evaluation to find the perfect earring placement and offer personalized styling advice.</li>
<li>Actively monitor the customer experience, quickly addressing and resolving any issues to maintain Rowan's clinical piercing standards.</li>
<li>Maintain a sterile and aseptic environment at the nurse station and on the procedure tray, ensuring all surfaces, instruments, and supplies are clean and properly sanitized to prevent contamination and promote customer safety.</li>
<li>Use your expert knowledge of skin care and infection control and prevention to provide professional and personalized piercing services.</li>
</ul><h3 class="jobSectionHeader"><b>Studio Support:</b></h3><ul>
<li>Collaborate with the Studio Manager to keep operations running smoothly and foster a joyful, celebratory atmosphere.</li>
<li>Flexibility to fill shifts as needed.</li>
<li>May mentor and train new nurses to uphold Rowan's Clinical Piercing Standards, including shadowing piercing services and observing customer interactions.</li>
<li>Stay attentive to anything that could impact the customer experience, and quickly report any issues to management while collaborating to resolve them.</li>
</ul><h3 class="jobSectionHeader"><b>Inventory and Supplies:</b></h3><ul>
<li>Ensure all piercing stations, including the nurse cart, mayo stand, and nurse nook, are always stocked with the necessary supplies and ready for any customer needs.</li>
<li>Ensure the safety and cleanliness of our services by sterilizing jewelry and needle piercing instruments.</li>
</ul><h3 class="jobSectionHeader"><b>Studio Operations:</b></h3><ul>
<li>Follow state, federal, and CDC guidelines closely to ensure a sanitary and safe piercing experience.</li>
</ul><h3 class="jobSectionHeader"><b>Sales:</b></h3><ul>
<li>Ensure high-quality performance to support key studio metrics, including revenue growth, efficiency in piercing services (e.g., piercings per hour), increasing average order value, and boosting sales.</li>
<li>Educate customers on Rowan After Care, and the benefits of bringing home an extra pair of hypoallergenic, non-piercing jewelry to promote healing.</li>
</ul><h3 class="jobSectionHeader"><b>Reporting and Communication:</b></h3><ul>
<li>Quickly address and escalate operational concerns, ensuring clear communication with management and team members to implement solutions efficiently.</li>
</ul><h3 class="jobSectionHeader"><b>What you bring to the table:</b></h3><ul>
<li>Required Certifications: Active RN or LPN/LVN License.</li>
<li>Professional and engaging customer care approach.</li>
<li>Warm, friendly, team player with an entrepreneurial spirit.</li>
<li>Excited to create celebratory, memorable experiences for our customers.</li>
<li>Skilled in providing both technical and non-technical information to customers and community members.</li>
<li>Interest in working in a retail environment with sales goals.</li>
<li>Obsessive attention to detail.</li>
<li>Availability to work a flexible schedule, including during peak times such as holidays and weekends.</li>
<li>Open to all experience levels; newly licensed nurses are welcome. Additional training in pediatrics and/or ear piercing is a plus.</li>
<li>Dedicated to delivering exceptional service and maintaining a safe, clean environment for every customer.</li>
</ul><h3 class="jobSectionHeader"><b>Nurse Benefits &amp; Perks:
</b></h3><ul><li>Compensation: $23-48 per hour, consisting of $23 an hour base wage plus an estimated $25 per hour in tips once fully trained!</li>
<li><i>While Piercing Nurses keep 100% of earned tips, tips are customer-provided, are not guaranteed and can vary by location.</i></li>
<li>Ongoing training and career pathways to grow your nursing career at Rowan.</li>
<li>Paid accrued Vacation and Sick Time for full-time employees.</li>
<li>Medical/Dental/Vision Health Plans for full time employees.</li>
<li>Employee Assistance Program (EAP) Resources.</li>
<li>401k and Roth IRA Plans.</li>
<li>Generous employee discounts on our amazing products and services!</li>
<li>Team Member Referral Bonus plan for Studio positions.</li>
</ul><div>Check us out on CBS News - Chicago! - Transforming Nurses into Professional Piercers</div><div></div><div><b><br>
About Us: </b>Rowan is an innovative ear-piercing and hypoallergenic jewelry brand that brings safety to the forefront with our team of licensed nurses&mdash;and celebration to every guest with our joyful approach to piercings and jewelry. Our brick-and-mortar locations across the US also provide a long-overdue alternative to the standard mall piercing. At Rowan, we believe that every ear piercing is a milestone and it should be celebrated. We believe in &ldquo;Piercing for All&rdquo;.</div><div></div><div><br>
Check us out on CNBC's How I Made It</div><div>
Check us out on the TODAY Show on NBC &mdash; How 1 woman is reinventing the ear piercing experience (today.com)</div><div></div><div><br>
How Rowan Has Created a New Pathway for Nurses<br>
</div><div></div><br>
<div><b>Important note: </b>Rowan believes in teamwork, collaboration, and diversity. We know our team is stronger together and we commit to staying true to these values as we grow. In a remote setting, interviewing at Rowan may include phone interviews, virtual &ldquo;on-site&rdquo; interviews, and on-the-job mock cases. We are committed to run a thorough process for candidates with whom we identify a potential match, and we will do our best to follow-up with each and every applicant! If you&rsquo;re on the fence, just give it a try! We are an equal opportunity employer and we encourage everyone to apply!</div><div></div><div><br>
Rowan is an equal opportunity employer. All applicants will be considered for employment without regard to race, religious creed (including religious dress and grooming practices), color, national origin (including language use and possession of a driver's license issued to persons unable to prove their presence in the United States is authorized under federal law), ancestry, physical disability, mental disability, medical condition, genetic information, registered domestic partner status, marital status, sex (including pregnancy), sexual orientation, gender, gender identity (including transgender identification), gender expression, age for individuals over forty years of age, military and veteran status of any person, or any other consideration made unlawful by federal, state, or local laws (&ldquo;protected characteristics&rdquo;).
</div><p>We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.</p></div>

Piercing Studio Nurse

<div><div><b>Job Summary:</b></div><br>
<br>
<p>Responsible for coordinating care for identified members with complex medical conditions in collaboration with hospital physicians, QRM staff (IPCC, CM, SW, PTSP), practitioners, medical office staff and other providers. The goal is to support and facilitate a smooth transition from the acute care setting or skilled nursing facility to alternative levels of care or home. Collaborates with physicians, telephonic care coordinators, inpatient case management/ social workers, telephonic to create a safe discharge plan for identified complex patients. Key job functions include assessment of identified members, development of a safe discharge plan from acute inpatient, skilled nursing, LTAC and Inpatient Rehab facilities. Coordinates post-acute services and follow- up medical care to ensure continuity of care. The Acute Transitional Case Manager (TCM) will identify and communicate any barriers to discharge plan. Ensures appoints and coordination of post-acute services with vendors.</p><div><b><br>
Essential Responsibilities:</b></div><br>
<br>
<ul><li>Responsible for all transitional case management activities outlined above.</li><li>
Conducts timely reviews and refers Transitional Case Management Program or Complex Case Management within designated timeframe per policy and procedure and evaluates priority for continuity of care case management based on established guidelines.</li><li>
Performs a thorough and objective telephonic assessment of the member including physical, psychosocial, environmental, financial, and health status expectation through the use of hospital records, contact with the member/family or significant others.</li><li>
Develops an individual, mutually established plan of care based on the assessment and utilizing motivational techniques, in conjunction with the KP Hospitalists and other practitioners that identifies specific interventions, objectives and goals with anticipated targeted dates for accomplishment.</li><li>
Attends patient care conferences (rounds) as scheduled with QRM physicians, and Telephonic IPCC work together to discuss clinical course, discharge planning and provide feedback on planned interventions, or barriers to care for member self-management to avoid delays and promote smooth transition.</li><li>
Proactively, implements the plan of care and specific interventions that will lead to the accomplishment of goals as defined. This may entail implementation prior to member discharge.</li><li>
Coordinates the resources necessary to accomplish the goals,and makes recommendations for modifications to the plan of care as necessary.</li><li>
Performs telephonic outreach to identified members within 48 hours post hospital discharge and completes assessment of member status.</li><li>
Coordinates and communicates plan of care to the Primary and/or Specialist Care providers, including follow-up appointment.</li><li>
Makes referral to other KP programs for continued care support.</li><li>
Documents all case management interactions and interventions according to departmental guidelines.</li><li>
Coordinates and participates in complex case management conferences on a regular basis for members involved in the care and updates the plan of care as necessary.</li><li>
Continuously coordinates, monitors, tracks and evaluates all care and services rendered to ensure that quality care is being delivered and in the most appropriate setting.</li><li>
Re-assess and reinforce members self-management skills, including symptom and medication management.</li><li>
Acts as a resource to facility Case Managers and discharge planners.</li><li>
Provides case management updates to practitioners and health care teams.</li><li>
Collaborates with the healthcare team to provide referral information and regarding community resource referrals.</li><li>
Arranges, coordinates and facilitates appointments for the member as necessary.</li><li>
Builds effective working relationships with practitioners and other departments within the health plan.</li><li>
Works in conjunction with disease specific population based care department as appropriate.</li><li>
Consults with Chief of QRM for potential non-approvals, benefit exceptions and other issues as appropriate.</li><li>
Assists in the development of guidelines and protocols.</li><li>
Investigates, identifies and reports problems and inefficiencies in existing systems, and recommends changes when appropriate to the Supervisor.</li><li>
Under the guidance of the Supervisor and in consultation with other QRM staff, participates in the coordination, planning, development, implementation, and maintenance of all QRM policies and procedures.</li><li>
Monitors utilization trends concerning inpatient and outpatient care in the market area, keeping appropriate management informed.</li><li>
Refers cases identified as risk management, peer review or quality issues to Quality and Risk Management.</li><li>
Provides documentation regarding any pertinent patient information or arrangements for inclusion in the members medical record.</li><li>
Works cross-functionally with other departments in striving to meet organizational goals and objectives.</li><li>
Participates in call rotation to support after hours and weekend referrals for quality resource management services.</li><li>
Acts as a team coach for respective areas of responsibility regarding enhanced customer service, quality of work performed and productivity of staff.</li><li>
Knowledgeable and compliant with regional personnel policies and procedures.</li><li>
Knowledgeable and compliant with QRM departmental and unit specific policies and procedures.</li><li>
Participates in annual regional and departmental compliance training.</li><li>
Knowledgeable and compliant with Principles of Responsibility.</li><li>
Develops and maintains an awareness of how to report compliance issues and concerns. Consistently supports compliance and the Principles of Responsibility (Kaiser Permanentes Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state and local laws and regulations, accreditation and licenser requirements (if applicable), and Kaiser Permanentes policies and procedures.</li><li>
Your access to protected health information (PHI) will be limited to the minimum necessary required to effectively perform your job.</li><li>
May perform other duties as assigned.</li><li>
Other duties as assigned.</li></ul><div><b><br>
Basic Qualifications:</b></div><div>
Experience</div><ul><li>
Minimum three (3) years acute hospital discharge planning or prior experience in case management as an RN.</li></ul><div>
Education</div><ul><li>
High School Diploma or General Education Development (GED) required.</li></ul><div>
License, Certification, Registration</div><ul><li>
Registered Professional Nurse License (Georgia) OR Licensed Clinical Social Worker (Georgia) OR Licensed Master Social Worker (Georgia)</li></ul><div><b>
Additional Requirements:</b></div><ul><li>
Complex Case Management experience.</li><li>
Experience acute patient populations including Medicare members.</li><li>
Functional knowledge of computers.</li><li>
Must be able to travel within the Atlanta metro area</li></ul><div><b>
Preferred Qualifications:</b></div><ul><li>
Bachelors Degree in Nursing or four (4) years of experience in a directly related field.</li></ul><div><b>
Notes:</b></div><ul><li>
With rotating weekends</li></ul><br>
PrimaryLocation : Georgia,Atlanta,Regional Office - 9 Piedmont<br>
HoursPerWeek : 40<br>
Shift : Day<br>
Workdays : Mon, Tue, Wed, Thu, Fri<br>
WorkingHoursStart : 08:30 AM<br>
WorkingHoursEnd : 05:30 PM<br>
Job Schedule : Full-time<br>
Job Type : Standard<br>
Employee Status : Regular<br>
Employee Group/Union Affiliation : GUP|UFCW|Local 1996<br>
Job Level : Entry Level<br>
Job Category : QA, UR &amp; Case Management<br>
Department : Regional Office - 9 Piedmont - Rgnl Clinical Innovation - 2808<br>
Travel : No<br>
Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.</div>

RN Quality Risk Management Acute Case Manager

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