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clinical care nurse (rn)

clinical care nurse rn

CenterWell

<div><h1 class="jobSectionHeader"><b>Become a part of our caring community and help us put health first</b><br>
</h1>
The Clinical Care Nurse (RN) is a clinic-based nursing role focused on improving patient outcomes. You will support safe Transitions of Care (TOC), reduce avoidable ED utilization, and drive Medicare Advantage Stars and quality performance. The Clinical Care RN plays a critical role in advancing clinical quality and supporting patients across transitions of care to improve patient outcomes.
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CenterWell/Conviva clinic locations may be available in the following areas: Grove Park, Greenbriar<br>
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As a Clinical Care RN, you will contribute to Medicare Advantage Stars ratings by proactively identifying care opportunities, engaging patients and providers, and driving evidence-based interventions. You will balance direct patient education and outreach with data-driven quality improvement efforts. The Clinical Care RN aligns daily responsibilities with organizational values, integrity, respect, empathy, and commitment to health equity &ndash; to enhance patient health outcomes and satisfaction.<p></p><div><div><p><b>
Role Scope</b></p></div><div><ul><li><p>
Transitions: Care transition support, follow-up coordination, and avoidable readmission prevention for discharged inpatient, observation and emergency department patients.</p></li></ul></div><div><ul><li><p>
Quality: Medicare Advantage Stars, HEDIS and quality performance across value-based population.</p></li></ul></div><div><ul><li><p>
Population Health: Deliver culturally appropriate chronic disease education to activate patients are chronic disease self-management, particularly in DM, HTN, CHF and COPD.</p></li></ul></div><p></p><div><p><b>
Duties and Responsibilities</b>:</p></div><div><ul><li><p>
Analyze clinical data and trends from platforms such as Athena EMR and DataHub to identify gaps in care related to Stars and HEDIS measures and Transitions of Care and post-hospitalization needs, prioritizing high-impact opportunities.</p></li></ul></div><div><ul><li><p>
Proactively identify recently discharged inpatient, observation and emergency department patients and coordinate timely post-discharge follow-up in alignment with TOC and Transitional Care Management (TCM) requirements, with the aim of addressing root causes of utilization and supporting patients to prevent avoidable readmissions or return visits.</p></li></ul></div><div><ul><li><p>
Conduct targeted patient and provider outreach via phone, telehealth and in-clinic visits to close care opportunities, provide tailored education on preventive care, chronic disease management, and medication management.</p></li></ul></div><div><ul><li><p>
Conduct post-discharge outreach to assess understanding of discharge instructions, bottles-out medication reconciliation, symptom monitoring, and follow-up appointment adherence. Identify and escalate barriers, collaborating with providers and care team to prevent readmissions and avoidable ED utilization.</p></li></ul></div><div><ul><li><p>
Collaborate effectively with interdisciplinary teams, including providers, care assistants, center administrators, medical assistants, pharmacy, and quality improvement staff&mdash;to implement evidence-based interventions and optimize workflows.</p></li></ul></div><div><ul><li><p>
Document all outreach efforts, clinical interactions, and outcomes accurately and in compliance with organizational and CMS regulatory standards.</p></li></ul></div><div><ul><li><p>
Prepare, participate and discuss patients in center huddles and high-risk rounds with providers and the center-based and interdisciplinary team.</p></li></ul></div><div><ul><li><p>
Participate in quality improvement projects, provider education sessions, team huddles to stay current with evolving clinical guidelines and organizational priorities.</p></li></ul></div><div><ul><li><p>
Monitor progress toward Stars and Transitional Care Management goals, proactively identify barriers, and help develop innovative solutions to improve clinical performance and patient engagement.</p></li></ul></div><div><ul><li><p>
Support clinic operations through provider collaboration, care coordination, and community education initiatives.</p></li></ul></div><div><ul><li><p>
Coordination and facilitation of center and market-based Wellness Events-focused in-person engagement for Stars care opportunity closures.</p></li></ul></div><div><ul><li><p>
Maintain patient confidentiality in accordance with HIPAA.</p></li></ul></div></div><div><ul><li><p>
Document patient encounters accurately and timely in the indicated platform (e.g., medical record).</p></li></ul></div><div><ul><li><p>
Follow organizational policies related to safety, infection control, and attendance.</p></li></ul></div><div><ul><li><p>
Perform other duties as assigned.</p></li></ul></div><p></p><h1 class="jobSectionHeader"><b><br>
Use your skills to make an impact</b><br>
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</b></h1><div><div><p><b>Required Qualifications:</b></p></div><div><ul><li><p>
Must meet one of the following requirements: Associate&rsquo;s degree in nursing (ADN) or Bachelor&rsquo;s degree in nursing (BSN).</p></li></ul></div><div><ul><li><p>
Active, unrestricted RN license (state specific as applicable).</p></li></ul></div><div><ul><li><p>
3+ years' clinical nursing experience with exposure to transitions of care, quality improvement, managed care, or population health management.</p></li></ul></div><div><ul><li><p>
Proficiency with electronic health records (e.g., Athena EMR), data analytics tools (e.g., DataHub, Compass Rose, SalesForce HealthCloud &ndash; per your prior employer&rsquo;s population health tools), and Microsoft Office Suite.</p></li></ul></div><div><ul><li><p>
Willing and able to complete and maintain Basic Life Support training.</p></li></ul></div><p></p><div><p><b>
Preferred Qualifications:</b></p></div><div><ul><li><p>
Knowledge of Medicare Advantage Stars, HEDIS, CAHPS, and CMS quality requirements.</p></li></ul></div><div><ul><li><p>
Experience with Transitions of Care, hospital discharge or ER follow up programs.</p></li></ul></div><div><ul><li><p>
Strong clinical judgment, data analysis skills, and ability to apply evidence-based practices.</p></li></ul></div><div><ul><li><p>
Excellent communication and motivational interviewing skills to educate and empower members.</p></li></ul></div><div><ul><li><p>
Commitment to health equity, inclusiveness, and patient-centered care.</p></li></ul></div><div><ul><li><div><p>
Basic Life Support trained.</p></div></li></ul><p></p><p><b>
Additional Information</b></p></div><div><p><b><i>
Core Competencies:</i></b></p></div><div><ul><li><p>
Clinical quality improvement and strategic gap closure.</p></li></ul></div></div><div><div><ul><li><p>
Transitions of Care coordination and post-discharge support.</p></li></ul></div><div><ul><li><p>
Member and provider engagement with motivational interviewing.</p></li></ul></div><div><ul><li><p>
Regulatory compliance and documentation accuracy.</p></li></ul></div><div><ul><li><p>
Data interpretation and actionable reporting.</p></li></ul></div><div><ul><li><p>
Cross-functional collaboration and teamwork.</p></li></ul></div><div><ul><li><p>
Time management balancing administrative and outreach duties.</p></li></ul></div><p></p><div><p><b><i>
Values &amp; Mission Alignment:</i></b></p></div><div><ul><li><p>
Demonstrate integrity, respect, and empathy in all interactions.</p></li></ul></div><div><ul><li><p>
Uphold the mission to improve health outcomes and member satisfaction through proactive, compassionate care.</p></li></ul></div><div><ul><li><p>
Champion continuous learning, innovation, and professional growth.</p></li></ul></div><p></p><div><p><b><i>
Work Information:</i></b></p></div><div><p>
This role requires an in-center presence, involving daily commute to assigned clinic(s) and occasional (quarterly) travel within the market to alternative clinic(s) for strategic meetings.</p></div><div><ul><li><p><b>
Workstyle: Clinic-based, in-center 5 days per week</b><b>.</b></p></li></ul></div><div><ul><li><p><b>
Location:</b> Must reside in designated market area, in reasonable commutable distance to assigned clinic(s).</p></li></ul></div><div><ul><li><p><b>
Hours: </b>Monday&ndash;Friday, 8:00 AM&ndash;5:00 PM; additional time may be required.</p></li></ul></div><p></p><div><p><b><br>
TB Statement</b>:</p></div><div><p>
This role is considered patient facing and is part of Humana's Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.</p></div><p></p><div><p><b><br>
Driving Statement</b>:</p></div></div><div><p>
This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.</p></div><p></p><p><b>
Scheduled Weekly Hours</b></p><p></p>
40<p></p><p><b>
Pay Range</b></p>
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.<br>
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$71,100 - $97,800 per year<br>
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This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.<p></p><p><b>
Description of Benefits</b></p>
Humana, Inc. and its affiliated subsidiaries (collectively, &ldquo;Humana&rdquo;) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.<p></p><h1 class="jobSectionHeader"><b><br>
About Us</b><br>
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About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient&rsquo;s well-being.<p></p>
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation&rsquo;s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first &ndash; for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.<p><br>
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<b>Equal Opportunity Employer</b></p><p></p><p>
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.</p></div>

Clinical Care Nurse (RN)

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>
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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>
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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>
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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>
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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>
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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>
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Learn more about us: www.aiscaregroup.com</p>
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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>
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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>
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Education:</b> RN Diploma, Associates or B.S. degree in nursing</p>
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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>
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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>
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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>
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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>
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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

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></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)

Southeast Permanente Medical Group

<div><div><p>We are seeking a nurse practitioner for our busy outpatient endocrinology practice who will be responsible for providing care, including assessing, diagnosing, prescribing, treating and educating patients and working closely with physicians and other clinicians in a team approach to patient care.</p><p><b><i>
Ideal candidates will have a BSN and three years of professional nursing experience in a clinic setting, plus two years of nurse practitioner experience. Candidate must also have current Georgia RN license, advanced registered nurse practitioner license with prescriptive authority and CPR certification.
</i></b></p><p>The Southeast Permanente Medical Group (TSPMG) is one of Georgia&rsquo;s largest independent, physician-owned, multi-specialty medical groups. More than 500 physicians and 150 associate practitioners work together in a unique integrated care model to provide high-quality care to over 300,000 Kaiser Permanente members. Care is delivered at 26 medical offices featuring state-of-the-art equipment, labs, imaging services, and pharmacies. We also provide surgical services and around the clock care at some of the area&rsquo;s top hospitals.</p><p>
TSPMG offers a competitive salary, a generous retirement package, paid time off, health, dental, vision, and life insurance, long and short-term disability, relocation allowance, and more. We also offer numerous clinical and non-clinical learning opportunities and physician leadership development.</p><p>
Atlanta, our home for more than 30 years, is a thriving metropolis that blends southern charm with modern art, music, and culture. Learn more about our beautiful southern city at http://www.atlanta.com/.</p><p>
We are an equal opportunity employer. All applicants will be considered for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, veteran or disability status. We maintain a drug and nicotine free workplace and perform pre-employment substance abuse testing.</p></div></div><p></p>

Nurse Practitioner Endocrinology

Emory Healthcare

<div>Overview:
<div><b>
Be inspired. Be rewarded. Belong. At Emory Healthcare.</b></div><div></div><div><br>
At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide:</div><ul><li>
Comprehensive health benefits that start day 1</li><li>
Student Loan Repayment Assistance &amp; Reimbursement Programs</li><li>
Family-focused benefits
</li><li>Wellness incentives</li><li>
Ongoing mentorship, development, leadership programs and... more!</li></ul>
Description: JOB DESCRIPTION: The Registry Utilization Review Nurse (PRN) is responsible for conducting medical necessity reviews by utilizing Milliman and Interqual Guidelines in conjunction with a review of the patient chart, clinical nursing judgement, and discussions with the attending physician and/or physician advisor. The UR RN (PRN) will perform utilization review by completing a timely and comprehensive review of all new observation and inpatient admissions for status designation as guided by criteria guidelines, patient presentation, and clinical nursing judgement. In addition, concurrent reviews will be completed as required by the payers, by accurately applying appropriate criteria sets. The UR RN (PRN) will ensure that all reviews are completed timely, accurately, and thoroughly by ensuring criteria guidelines applied are addressed in the clinical review. The UR RN (PRN) is responsible for timely communication to the Physicians and Interdisciplinary team as it relates to criteria guidelines and status designation on an individual patient basis. The UR RN (PRN) will ensure that patient hospital days are appropriately reviewed in order to obtain the appropriate authorization from the payer in an effort to ensure appropriate payment for services provided. The UR RN (PRN) will ensure that authorized days and patient actual LOS are reconciled in order to maximize reimbursement for the services provided. The UR RN (PRN) is responsible for real time communication and documentation of authorized, unauthorized or denied days to the Physician and the care team in order to reduce patient and hospital financial risk. The UR RN (PRN) will initiate and facilitate RN to RN discussion and/or Physician to Physician discussion with the payers in order to act as an advocate on behalf of the patient and hospital in an effort to reduce non-covered, non-authorized, or denied services. The UR RN (PRN) will issue and administer notices of non-coverage and potential liability to patients in accordance with predetermined regulations, policies, and procedures. The UR RN (PRN) attends interdisciplinary care planning rounds and serves as a liaison between the clinical care team, the revenue cycle, and the patient to ensure the continuity of patient care. The UR RN (PRN) serves as a resource to the Physician, Interdisciplinary Care Team, and patient for the interpretation of external regulations and organizational policies and procedures as it pertains to the utilization review process. The UR RN will (PRN) ensure compliance with all regulatory requirements as it relates to Government and Commercial Payers and designated Utilization Review Plans, as submitted to the State of Georgia. The UR RN (PRN) will ensure compliance with all third party payers and federal and state regulatory agencies. The UR RN (PRN) will ensure proper use of Case Management Systems and workflows.
<br>
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MINIMUM QUALIFICATIONS: Must have a valid, active unencumbered Nursing license or temporary permit approved by the Georgia Licensing Board. Bachelors degree in nursing preferred or actively being pursued. 2 years recent healthcare experience required. Must meet all quality and productivity expectations and successfully complete yearly competencies. Must be willing to work at least 4 shifts/mo. PHYSICAL REQUIREMENTS (MediumMax 25lbs): up to 25 lbs, 0-33% of the work day (occasionally); 11-25 lbs, 34-66% of the workday (frequently); 01-10 lbs, 67-100% of the workday (constantly); Lifting 25 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing &amp; walking, Occasional sitting, Close eye work (computers, typing, reading, writing), Physical demands may vary depending on assigned work area and work tasks.
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ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks. 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.</div><div></div><div><br>
Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare&rsquo;s Human Resources at careers@emoryhealthcare.org. Please note that one week's advance notice is preferred.</div></div>

Inpatient Utilization Review Registered Nurse PRN / RN

<div>Overview:
<div><b>
Be inspired. Be rewarded. Belong. At Emory Healthcare.</b></div><div>
At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide:</div><br>
<div></div><ul><li>
Comprehensive health benefits that start day 1</li><li>
Student Loan Repayment Assistance &amp; Reimbursement Programs</li><li>
Family-focused benefits
</li><li>Wellness incentives</li><li>
Ongoing mentorship, development, and leadership programs&hellip;. and more!</li></ul>
Description:
<div><b>
The Registered Nurse Clinician is an experienced healthcare professional with a strong understanding of patient care for a specific population. Using clinical knowledge, research, and experience, they adapt to changing situations and personalize care based on the AACN Synergy Model for Patient Care. They serve as a resource for colleagues and advocate for patients and families.</b></div><div><br>
</div><div>Clinical Practice &amp; Patient Care:</div><ul><li>
Delivers safe, effective, and independent nursing care using the nursing process.</li><li>
Performs thorough patient assessments and recognizes the impact of nursing care on outcomes.</li><li>
Develops and implements patient care plans, incorporating patient/family input and adjusting as needed.</li><li>
Documents care accurately and efficiently in electronic and physical records.</li><li>
Identifies patient and family learning needs, recommending appropriate resources.</li><li>
Recognizes cultural differences and individualizes care accordingly.</li></ul><div>
Leadership &amp; Team Collaboration:</div><ul><li>
Delegates appropriately using the Synergy Model of Care.</li><li>
Works effectively with the interdisciplinary team, patient, and family care partners.</li><li>
Functions in a developing leadership role, including Charge Nurse responsibilities when assigned.</li><li>
Assists in orienting staff and students in the absence of a designated preceptor.</li><li>
Demonstrates strong communication and conflict resolution skills.</li></ul><div></div><div><br>
Quality Improvement &amp; Professional Development:</div><ul><li>
Identifies the need for policy revisions based on evidence-based research.</li><li>
Engages in professional growth and actively applies the Synergy Model for Care in practice.</li><li>
Collects, reports, and analyzes data to improve patient care and meet organizational standards.</li><li>
Participates in surveys, interviews, and other methods to identify and resolve areas for improvement.</li><li>
Maintains required points and contact hours per the clinical lattice PLAN system.</li></ul><div></div><div><b><br>
Required Minimum Qualifications:
</b></div><div>Education / Experience:</div><div>
1. *Graduate of an accredited prelicensure Bachelor of Science in Nursing (BSN), AND A. 12 months of recent nursing experience within the past five years, OR B. Recent completion of a re-entry nursing program.</div><div>
OR</div><div>
2. Graduate of an accredited prelicensure Associate Degree in Nursing (ADN) with a minimum of 2 years of recent nursing experience within the past five years</div><div>
Exceptions:</div><div>
1. *Current LPNs employed within the Emory Healthcare (EHC) system who have completed an accredited RN program and obtain RN licensure are eligible to transition into this role while completing the RN Resident Program. 2. Emory LPNs enrolled in an Emory ADN program as of 3/30/2025 must sign an obligation agreement to complete an ADN-to-BSN program within two years of entering the RN Clinician role.</div><div></div><div><br>
Licensure:</div><div>
A valid, unencumbered Registered Nursing License approved by the Georgia Board of Nursing.</div><div>
Certification:</div><ul><li>
BLS certification</li><li>
ACLS may be required for certain departments, post hire</li><li>
Additional certifications may be required based on department and specialty</li><li>
If completing virtual care activities that may include multi-state practice, an active compact/multistate license (eNLC) is required within 60 days of hire.</li></ul><div>
Employees in role prior to 11/09/2025 will have until their next renewal date to achieve compact status.
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<b>JOIN OUR TEAM TODAY!</b> Emory Healthcare (EHC), part of Emory University (EUV), is the most comprehensive academic health system in Georgia and the first and only in Georgia with a Magnet&reg; designated ambulatory practice. We are made up of 11 hospitals-4 Magnet&reg; designated, the Emory Clinic, and more than 425 provider locations. The Emory Healthcare Network, established in 2011, is the largest clinically integrated network in Georgia, with more than 3,450 physicians concentrating in 70 different subspecialties.</div>
Additional Details:
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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.</div><div></div><div><br>
Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare&rsquo;s Human Resources at careers@emoryhealthcare.org. Please note that one week's advance notice is preferred.</div><div></div><div><br>
PHYSICAL REQUIREMENTS: (Medium-Heavy) 36-75 lbs, 0-33% of the work day (occasionally); 20-35 lbs, 34-66% of the workday; (frequently); 10-20 lbs, 67-100% of the workday (constantly); Lifting 75 lbs max; Carrying of objects up to 35 lbs; Occasional to frequent standing &amp; walking; Occasional sitting; Close eye work (computers, typing, reading, writing); Physical demands may vary depending on assigned work area and work tasks.
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ENVIRONMENTAL FACTORS: Factors affecting environmental conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure; Bio-hazardous waste Chemicals/gases/fumes/vapors; Communicable diseases; Electrical shock; Floor Surfaces; Hot/Cold Temperatures; Indoor/Outdoor conditions; Latex; Lighting; Patient care/handling injuries; Radiation; Shift work; Travel may be required; Use of personal protective equipment, including respirators; environmental conditions may vary depending on assigned work area and work tasks.</div></div>

Surgical Oncology Solid Tumors / RN

<b>Description:</b> Job Summary: The RN Clinician is an experienced healthcare professional with a strong understanding of patient care for a specific population. Using clinical knowledge, research, and experience, they adapt to changing situations and personalize care based on the AACN Synergy Model for Patient Care. They serve as a resource for colleagues and advocate for patients and families. Primary duties and responsibilities: Clinical Practice & Patient Care 1. Delivers safe, effective, and independent nursing care using the nursing process. 2. Performs thorough patient assessments and recognizes the impact of nursing care on outcomes. 3. Develops and implements patient care plans, incorporating patient/family input and adjusting as needed. 4. Documents care accurately and efficiently in electronic and physical records. 5. Identifies patient and family learning needs, recommending appropriate resources. 6. Recognizes cultural differences and individualizes care accordingly. Leadership & Team Collaboration: 1. Delegates appropriately using the Synergy Model of Care. 2. Works effectively with the interdisciplinary team, patient, and family care partners. 3. Functions in a developing leadership role, including Charge Nurse responsibilities when assigned. 4. Assists in orienting staff and students in the absence of a designated preceptor. 5. Demonstrates strong communication and conflict resolution skills. Quality Improvement & Professional Development: 1. Identifies the need for policy revisions based on evidence-based research. 2. Engages in professional growth and actively applies the Synergy Model for Care in practice. 3. Collects, reports, and analyzes data to improve patient care and meet organizational standards. 4. Participates in surveys, interviews, and other methods to identify and resolve areas for improvement. 5. Maintains required points and contact hours per the clinical lattice PLAN system. Required
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<b>Minimum Qualifications:</b> Education / Experience: 1. *Graduate of an accredited prelicensure Bachelor of Science in Nursing (BSN), AND A. 12 months of recent nursing experience within the past five years, OR B. Recent completion of a re-entry nursing program. OR, 2. Graduate of an accredited prelicensure Associate Degree in Nursing (ADN) with a minimum of 2 years of recent nursing experience within the past five years Exceptions: 1. *Current LPNs employed within the Emory Healthcare (EHC) system who have completed an accredited RN program and obtain RN licensure are eligible to transition into this role while completing the RN Resident Program. 2. Emory LPNs enrolled in an Emory ADN program as of 3/30/2025 must sign an obligation agreement to complete an ADN-to-BSN program within two years of entering the RN Clinician role. Licensure: A valid, unencumbered Registered Nursing License approved by the Georgia Board of Nursing. Certification: 1. BLS certification 2. ACLS may be required for certain departments, post hire 3. Additional certifications may be required based on department and specialty 4. If completing virtual care activities that may include multi-state practice, an active compact/multistate license (eNLC) is required within 60 days of hire. Employees in role prior to 11/09/2025 will have until their next renewal date to achieve compact status.
<br><br>
<b>PHYSICAL REQUIREMENTS:</b> (Medium-Heavy) 36-75 lbs, 0-33% of the work day (occasionally); 20-35 lbs, 34-66% of the workday; (frequently); 10-20 lbs, 67-100% of the workday (constantly); Lifting 75 lbs max; Carrying of objects up to 35 lbs; Occasional to frequent standing & walking; Occasional sitting; Close eye work (computers, typing, reading, writing); Physical demands may vary depending on assigned work area and work tasks.
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<b>ENVIRONMENTAL FACTORS:</b> Factors affecting environmental conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure; Bio-hazardous waste Chemicals/gases/fumes/vapors; Communicable diseases; Electrical shock; Floor Surfaces; Hot/Cold Temperatures; Indoor/Outdoor conditions; Latex; Lighting; Patient care/handling injuries; Radiation; Shift work; Travel may be required; Use of personal protective equipment, including respirators; environmental conditions may vary depending on assigned work area and work tasks. Additional Details:
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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.
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Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare’s Human Resources at careers@emoryhealthcare.org. Please note that one week's advance notice is preferred.

RN Clinician

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