telephonic nurse case manager

DAVIES

<div><h3 class="jobSectionHeader">Description</h3><div> 
Our Story</div><div>
Imagine being part of a team that&rsquo;s not just shaping the future but actively driving it. At Davies North America, we&rsquo;re at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors.</div><div>
 
We are looking for a Telephonic Nurse Case Manager (RN), who independently manages medical aspects of Workers&rsquo; Compensation claims, ensuring the delivery of high-quality, timely, and cost-effective care to injured employees. 
</div><div>This role monitors, analyzes, evaluates, and coordinates medical treatment throughout the continuum of care to promote medically appropriate, prompt return-to-work outcomes. The Telephonic Case Manager proactively identifies barriers to recovery, develops action plans, and serves as both patient advocate and clinical resource while maintaining compliance with regulatory and client-specific guidelines.</div><h3 class="jobSectionHeader"> 
Key Responsibilities</h3> 
<ul>
<li>
Provide telephonic case management for Workers&rsquo; Compensation cases.</li>
<li>Assess medical appropriateness of treatment plans and coordinate services to optimize recovery and cost efficiency.</li>
<li>Develop, implement, and modify individualized case management care plans.</li>
<li>Perform ongoing clinical assessments and review medical records to ensure quality and timely care.</li>
<li>Identify and address barriers to recovery with proactive action planning.</li>
<li>Coordinate communication between injured workers, employers, providers, insurers, and other stakeholders.</li>
<li>Promote and document return-to-work capability at each medical milestone.</li>
<li>Ensure compliance with state-mandated treatment guidelines, nationally published protocols, and client requirements.</li>
<li>Track outcomes including patient satisfaction, return-to-work progress, and disability duration.</li>
<li>Utilize utilization review tools when indicated (pre-certification, concurrent review, retrospective review, medical director review).</li>
<li>Monitor provider and vendor performance to ensure quality and appropriate care delivery.</li>
<li>Maintain detailed and accurate documentation within the case management system.</li>
<li>Serve as a patient advocate while adhering to all legal, ethical, accreditation, and regulatory standards.</li>
<li>Participate in Quality Assurance, Grievance, or other committees as assigned.</li>
<li>Provide training or mentorship to claims staff or junior team members as appropriate.</li>
<li>Perform additional duties as assigned.</li></ul><div></div><h3 class="jobSectionHeader"> 
Skills, knowledge &amp; expertise</h3> 
<ul>
<li>
Active, unrestricted RN license.</li>
<li>Minimum 3 years of clinical experience (medical-surgical, orthopedic, neurological, ICCU, industrial, ER, or occupational health).</li>
<li>Workers&rsquo; Compensation case management experience preferred.</li>
<li>Strong knowledge of treatment guidelines and utilization management principles.</li>
<li>Excellent verbal and written communication skills.</li>
<li>Ability to work independently in a remote environment.</li>
<li>Proficiency in computer systems and claims/case management software.</li>
<li>Telephonic case management experience.</li>
<li>Experience applying evidence-based disability duration guidelines.</li>
<li>Prior experience training or mentoring staff.</li></ul><div></div><h3 class="jobSectionHeader"> 
Equal Employment Opportunity &amp; Legal Notices</h3><div> 
Benefits</div><div>
At Davies North America, we are dedicated to supporting the well‑being and future of our qualifying employees. Our comprehensive benefits package includes:</div><ul>
<li>Medical, dental, and vision plans to support your health and that of your family</li>
<li>A 401(k) plan with employer matching</li>
<li>Time‑off policies, including Discretionary Time Off (DTO) for exempt employees and Paid Time Off (PTO) for non‑exempt employees</li>
<li>Paid holidays</li>
<li>Life insurance and short‑term and long‑term disability coverage</li>
</ul><div>Benefit offerings, eligibility, and required employer contributions may vary based on role, classification, and applicable federal, state, and local laws, including those tied to an employee&rsquo;s primary work location. 
</div><div>Where required by law, the Company provides paid sick leave, paid family and parental leave, and other mandated benefits in accordance with applicable state and local requirements. 
</div><div>Diversity and Inclusion</div><div>
Davies is dedicated to fostering a diverse and inclusive workplace that embraces a wide range of perspectives and experiences. We believe that diversity of thought is essential for innovation and creativity, and we actively promote an environment where all voices are valued and heard. 
 
Compensation Transparency:
 
The salary range listed reflects the full compensation band for this role across all locations. Actual compensation will be based on factors such as skills, experience, qualifications, and geographic location, which may impact the final offer. We share ranges to remain transparent and consistent with pay equity practices.
 
 
Background Check &amp; Fair Chance Compliance
</div><div>Any background check or review of criminal history, if applicable to the role, will be conducted only after a conditional offer of employment and in compliance with applicable federal, state, and local laws, including fair‑chance hiring requirements. 
 
Massachusetts Notice 
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.</div><div>
 
We do not use sites like Facebook, Craigslist, or Telegram to recruit or interview potential employees or contractors. If you have been asked to provide any information through any method other than our career portal, please email us at recruitment@davies-group.com</div> 
<h3 class="jobSectionHeader">
About Davies</h3><div>
We are a specialist professional services and technology firm, working in partnership with leading insurance, highly regulated and global businesses. 
 
We help our clients to manage risk, operate their core business processes, transform and grow. We deliver professional services and technology solutions across the risk and insurance value chain, including excellence in claims, underwriting, distribution, regulation &amp; risk, customer experience, human capital, digital transformation &amp; change management. 
 
Our global team of more than 8,000 professionals operate across ten countries, including the UK &amp; the U.S. Over the past ten years Davies has grown its annual revenues more than 20-fold, investing heavily in research &amp; development, innovation &amp; automation, colleague development, and client service. Today the group serves more than 1,500 insurance, financial services, public sector, and other highly regulated clients.</div></div>

RN Telephonic Nurse Case Manager

AmeriHealth Caritas

<div>For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.
Your career starts now. We are looking for the next generation of health care leaders.
At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we would like to connect with you.
Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.
Discover more about us at www.amerihealthcaritas.com.
Responsibilities:
The Clinical Case Manager assists members who are eligible for LTSS in obtaining the services they need as required by DSHP Plus LTSS in New Castle county. He or she contributes to the LTSS case management process by performing telephonic and/or face-to-face assessments for the identification, evaluation, coordination and management of member&rsquo;s needs, including physical health, behavioral health, social services and long term services and supports. This position is also responsible for completing Level of Care Redeterminations for home and community based members annually. This requires clinical review when evaluating the need for a member to remain in the program. The Clinical Case Manager will also provide clinical support to his/her non-licensed counterparts and may act as a secondary case manager when a member is experiencing an acute episode.<ul><li>
Coordination of care for medically complex LTSS Members receiving private duty nursing (PDN)</li><li>
Performs follow-up on outstanding items of need and maintains a calendar or PDN Coverage.</li><li>
Establish communication method to effectively communicate with multiplePDN agencies and member/member representative.</li><li>
Coordinates and collaborates with prior authorization team to make sure all necessary precertifications for required services are submitted for review. Assists in obtaining the Letter of Medical Necessity (LOMN) as needed</li><li>
Coordinate with provider network team in the utilization of non-contracted providers or facilities as necessary following the single case agreement (SCA) process</li><li>
Conducts reevaluation of level of care annually or more frequently as needed in accordance with DSHP Plan Plus LTSS requirements.</li><li>
Provides clinical support to non-licensed case managers as needed.</li><li>
Conduct condition specific assessments with members with chronic conditions. Provide education and routine follow-up with member.</li><li>
Perform initial clinical assessment of new members, develop care plan, and initiate services.</li><li>
Facilitate person-centered planning team meetings to coordinate care and services. Identify, coordinate, and assist participants in gaining access to needed LTSS and other Covered Services, as well as non-covered medical, social, housing, educational, and other services and supports.</li><li>
Provides information to participants and conducts monitoring of authorized services and supports for Participants.</li><li>
Informs participants about available LTSS required needs assessments, the care plan process, service alternatives and service delivery options.</li><li>
Informs participants of their rights and responsibilities as well as assists with the complaint, grievance, and DHS Fair Hearing process.</li><li>
Collects additional necessary information, including participant preferences, strengths, and goals to inform the development of the Plan of Care.</li><li>
Conducts comprehensive needs assessments annually or more frequently as needed in accordance with requirements.</li><li>
Review and acting upon worklists in Jiva, including monitoring of new members</li><li>
Authorize urgent services when needed</li><li>
Monitoring critical incident reporting/documentation, recommending/taking action w/ other corporate entities as required</li><li>
Liaison activities with Physical health Care Coordination program</li><li>
Working with LTSS and DSNP members to complete comprehensive assessments, care plans, medication reconciliation, monitoring follow-up and progress, and assisting with discharge planning/transitions of care.</li></ul>
Education/Experience:<ul><li>
Delaware licensed RN required.</li><li>
Ability to travel throughout entire state of DE.</li><li>
Valid driver&rsquo;s license required</li><li>
Knowledge of the home and community-based service system and how to access and arrange for services</li><li>
Experience conducting LTSS needs assessments and monitoring LTSS delivery</li><li>
Ability to provide informed advocacy</li><li>
Ability to interact with members face to face</li><li>
Ability to interact with health care professionals in a professional manner</li><li>
Ability to travel up to 75%</li><li>
Duties may include case management responsibilities based on business needs. This role is also a part of the contingency plan, where a caseload may be assigned in the event of a staffing need</li></ul>
Our Comprehensive Benefits Package
Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.</div>

Clinical Case Manager DE Long Term Services & Support-Private Duty Nursing

Optum

<div>$10,000 Sign-on Bonus for External Candidates
Telephonic After-Hours Call - Evenings, Nights &amp; Rotating Weekends Required
Full-Time (40 Hours) 
Optum Home &amp; Community Care, part of the Optum family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere. As a team member of our Optum team, together in an interdisciplinary care environment, we help patients navigate the health care system and connect them to key support services. This preventive care can help patients stay well at home. We're connecting care to create a seamless health journey for patients across settings. Join us to start Caring. Connecting. Growing together. 
The Telehealth Urgent Care program is a comprehensive integrated care delivery program. The National On Call advanced practice clinician (APC) is responsible for providing telephonic/telehealth care and direction to patients, caregivers and facility staff providing 24/7 coverage including holidays. 
In this remote role you will provide virtual care for patients in various settings. This excellent opportunity affords a collaborative role bringing enormous satisfaction in the care and comfort of our patients. In this role you will have the ability to achieve work life balance. Optum is transforming care delivery with innovative and personal care. As one of the largest employers of APCs, Optum offers unparalleled career development opportunities. 
Scheduling: 
This is a Full Time, work from home position requiring various shift coverage with a mix of weekday, weeknights, weekend, and holiday coverage. While shift times can vary, we provide coverage to members 24/7 including all company recognized holidays.<ul><li>
Flexibility and the ability to adapt are a must as you will cross cover multiple markets and teams</li><li>
Availability and Coverage expectations for this role<ul><li>
24/7 coverage</li><li>
Position requires a minimum commitment of 40 hours per week</li><li>
Every other weekend coverage between 8-12 hour shifts covering both day and night shifts is required based on business needs</li><li>
Expectations that your are working or have approved PTO for 26 weekends a year. Each FT/PT employee is eligible to have up to 6 weekend shifts a year for PTO</li> 
<li>
Unapproved time away/Unpaid Time Off will result in need to add additional weekend shift to your schedule based on need</li></ul></li><li>
Holidays are required for all APCs on a rotation basis</li><li> 
Holiday scheduling is completed at the beginning of the year for advanced planning. Holiday coverage is provided beginning at 5pm, the end of the last business day, to 8am of the resumption of business hours</li></ul> 
Primary Responsibilities:<ul><li>
Available on provided telephonic platform, both taking and placing calls to coordinate and manage care for members between care givers, facilities, hospitals, primary care providers and the Optum field colleagues<ul><li>
Available to use video platform based on clinical need</li><li>
Working hours should be performed in a secure location as patient privacy is required</li></ul></li><li>
Utilize EMR proficiently to provide acute care to members during all shifts and holiday hours</li><li>
Care Delivery<ul><li>
Deliver cost-effective, quality care to members</li><li>
Manage both medical and behavioral, chronic, and acute conditions effectively, and in collaboration with a physician or specialty provider</li><li>
Perform comprehensive assessments and document findings in a concise/comprehensive manner that is compliant with documentation requirements and Center for Medicare and Medicaid Services (CMS) regulations</li><li>
Responsible for ensuring encounter is documented appropriately to support the diagnosis at that visit</li><li>
The APC is responsible for ensuring that all quality elements are addressed and documented</li><li>
Utilizes evidenced based practice guidelines</li><li>
Must attend and complete all mandatory educational and MyLearning training requirements</li></ul></li><li>
Care Coordination<ul><li>
Coordinate care as members transition through different levels of care and care settings</li><li>
Monitor the needs of members and families while facilitating any adjustments to the plan of care as situations and conditions change</li><li>
Review orders and interventions for appropriateness and response to treatment to identify the most effective plan of care that aligns with the patients' needs and wishes</li><li>
Address and be able to have advanced care plan conversations with members and families</li><li>
Evaluate the plan of care for cost effectiveness while meeting the needs of members, families, and providers to decrease high costs, poor outcomes and unnecessary hospitalizations</li></ul></li><li>
Program Enhancement Expected Behaviors<ul><li>
This is a virtual patient facing role that requires excellent customer service to all parties including members/families, facilities, the entire interdisciplinary care team (PCPs/specialists) and Optum staff</li><li>
Regular and effective communication with internal and external parties including physicians, patients, key decision-makers, nursing facilities, field staff and other provider groups</li><li>
Ability to meet shift scheduling requirements, and attendance expectations</li><li>
Exhibit original thinking and creativity in the development of new and improved methods and approaches to concerns/issues</li><li>
Function independently and responsibly with minimal need for supervision</li><li>
Demonstrate initiative in achieving individual, team, and organizational goals and objectives</li><li>
Participate in quality initiatives</li><li>
Availability to check Optum email intermittently for required trainings, communications, and monthly scheduling</li></ul></li></ul> 
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:<ul><li>
Education:<ul><li>
NP: Graduate of an accredited Master of Science Nursing or Doctor of Nursing Practice program</li></ul></li><li>
Active and unrestricted license in the state which you reside, as well as State of Ohio, and ability to obtain in other required locations.</li><li>
Ability to gain a collaborative practice agreement, if applicable in your state</li><li>
APCs working in jurisdictions that authorize APCs to practice autonomously or without formal supervision must have obtained approval to practice autonomously or without formal supervision from their licensing board, if applicable. New hires who are eligible and have not applied prior to hire date, must apply to practice autonomously or without supervision within 1 month of hire. If not eligible to practice autonomously or without formal supervision at hire, the APC must begin working towards meeting the requirement within 1 month of hire, if applicable, and apply for approval to practice autonomously or without formal supervision within 3 months of becoming eligible</li><li>
Active Nurse Practitioner certification through a national board:</li><li>
NP: Board certified through the American Academy of Nurse Practitioners or the American Nurses Credentialing Center, with certification in one of the following:<ul><li>
Family Nurse Practitioner</li><li>
Adult Nurse Practitioner</li><li>
Gerontology Nurse Practitioner</li><li>
Adult-Gerontology Acute Care Nurse Practitioner</li></ul></li><li>
Current, active DEA licensure/prescriptive authority or ability to obtain post-hire, per state regulations (unless prohibited in state of practice)</li><li>
Ability to work scheduled shifts in accordance with scheduling policies</li><li>
Proficient computer skills including the ability to document medical information with written and electronic medical records</li></ul> 
Preferred Qualifications:<ul><li>
3+ years of clinical experience as an APC</li><li>
Active and unrestricted license in the additional states: Wisconsin, Missouri</li><li>
Experience in meeting the medical needs of patients with complex behavioral, social and/or functional needs</li><li>
Experience working in a nursing home, or with seniors in an acute care facility</li><li>
Understanding of Geriatrics, Chronic Illness, and acute disease management</li><li>
Understanding of Advanced Illness and end of life discussions</li><li>
Ability to develop and maintain positive customer relationships</li><li>
Adaptability to change</li></ul> 
Compensation for this specialty generally ranges from $109,500 - $164,000. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. 
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. 
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. 
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.</div>

Telephonic Nurse Practitioner - Ohio License Required

<div>$10,000 Sign-on Bonus for External Candidates
Telephonic After-Hours Call - Evenings, Nights &amp; Rotating Weekends Required
Part-Time (20 Hours) 
Optum Home &amp; Community Care, part of the Optum family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere. As a team member of our Optum HouseCalls team, together in an interdisciplinary care environment, we help patients navigate the health care system and connect them to key support services. This preventive care can help patients stay well at home. We're connecting care to create a seamless health journey for patients across settings. Join us to start Caring. Connecting. Growing together. 
The Telehealth Urgent Care program is a comprehensive integrated care delivery program. The National On Call advanced practice clinician (APC) is responsible for providing telephonic/telehealth care and direction to patients, caregivers and facility staff providing 24/7 coverage including holidays. 
In this remote role you will provide virtual care for patients in various settings. This excellent opportunity affords a collaborative role bringing enormous satisfaction in the care and comfort of our patients. In this role you will have the ability to achieve work life balance. Optum is transforming care delivery with innovative and personal care. As one of the largest employers of APCs, Optum offers unparalleled career development opportunities. 
Scheduling: 
This is a Part Time, work from home position requiring various shift coverage with a mix of weekday, weeknights, weekend, and holiday coverage. While shift times can vary, we provide coverage to members 24/7 including all company recognized holidays.<ul><li>
Flexibility and the ability to adapt are a must as you will cross cover multiple markets and teams A</li><li>
Availability and Coverage expectations for this role<ul><li>
24/7 coverage</li><li>
Position requires a minimum commitment of 20 hours per week</li><li>
Every other weekend coverage between 8-12 hour shifts covering both day and night shifts is required based on business needs</li><li>
Expectations that your are working or have approved PTO for 26 weekends a year. Each FT/PT employee is eligible to have up to 6 weekend shifts a year for PTO</li> 
<li>
Unapproved time away/Unpaid Time Off will result in need to add additional weekend shift to your schedule based on need</li></ul></li><li>
Holidays are required for all APCs on a rotation basis</li><li> 
Holiday scheduling is completed at the beginning of the year for advanced planning. Holiday coverage is provided beginning at 5pm, the end of the last business day, to 8am of the resumption of business hours</li></ul> 
Primary Responsibilities:<ul><li>
Available on provided telephonic platform, both taking and placing calls to coordinate and manage care for members between care givers, facilities, hospitals, primary care providers and the Optum field colleagues<ul><li>
Available to use video platform based on clinical need</li><li>
Working hours should be performed in a secure location as patient privacy is required</li></ul></li><li>
Utilize EMR proficiently to provide acute care to members during all shifts and holiday hours</li><li>
Care Delivery<ul><li>
Deliver cost-effective, quality care to members</li><li>
Manage both medical and behavioral, chronic, and acute conditions effectively, and in collaboration with a physician or specialty provider</li><li>
Perform comprehensive assessments and document findings in a concise/comprehensive manner that is compliant with documentation requirements and Center for Medicare and Medicaid Services (CMS) regulations</li><li>
Responsible for ensuring encounter is documented appropriately to support the diagnosis at that visit</li><li>
The APC is responsible for ensuring that all quality elements are addressed and documented</li><li>
Utilizes evidenced based practice guidelines</li><li>
Must attend and complete all mandatory educational and MyLearning training requirements</li></ul></li><li>
Care Coordination<ul><li>
Coordinate care as members transition through different levels of care and care settings</li><li>
Monitor the needs of members and families while facilitating any adjustments to the plan of care as situations and conditions change</li><li>
Review orders and interventions for appropriateness and response to treatment to identify the most effective plan of care that aligns with the patients' needs and wishes</li><li>
Address and be able to have advanced care plan conversations with members and families</li><li>
Evaluate the plan of care for cost effectiveness while meeting the needs of members, families, and providers to decrease high costs, poor outcomes and unnecessary hospitalizations</li></ul></li><li>
Program Enhancement Expected Behaviors<ul><li>
This is a virtual patient facing role that requires excellent customer service to all parties including members/families, facilities, the entire interdisciplinary care team (PCPs/specialists) and Optum staff</li><li>
Regular and effective communication with internal and external parties including physicians, patients, key decision-makers, nursing facilities, field staff and other provider groups</li><li>
Ability to meet shift scheduling requirements, and attendance expectations</li><li>
Exhibit original thinking and creativity in the development of new and improved methods and approaches to concerns/issues</li><li>
Function independently and responsibly with minimal need for supervision</li><li>
Demonstrate initiative in achieving individual, team, and organizational goals and objectives</li><li>
Participate in quality initiatives</li></ul></li></ul>
Availability to check Optum email intermittently for required trainings, communications, and monthly scheduling. 
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:<ul><li>
Active and unrestricted license in the state which you reside, as well as State of Colorado, and ability to obtain in other required locations</li><li>
Ability to gain a collaborative practice agreement, if applicable in your state</li><li>
APCs working in jurisdictions that authorize APCs to practice autonomously or without formal supervision must have obtained approval to practice autonomously or without formal supervision from their licensing board, if applicable. New hires who are eligible and have not applied prior to hire date, must apply to practice autonomously or without supervision within 1 month of hire. If not eligible to practice autonomously or without formal supervision at hire, the APC must begin working towards meeting the requirement within 1 month of hire, if applicable, and apply for approval to practice autonomously or without formal supervision within 3 months of becoming eligible</li><li>
Education:<ul><li>
NP: Graduate of an accredited Master of Science Nursing or Doctor of Nursing Practice program</li></ul></li><li>
Active Nurse Practitioner certification through a national board:</li><li>
NP: Board certified through the American Academy of Nurse Practitioners or the American Nurses Credentialing Center, with certification in one of the following:<ul><li>
Family Nurse Practitioner</li><li>
Adult Nurse Practitioner</li><li>
Gerontology Nurse Practitioner</li><li>
Adult-Gerontology Acute Care Nurse Practitioner</li></ul></li><li>
Current, active DEA licensure/prescriptive authority or ability to obtain post-hire, per state regulations (unless prohibited in state of practice)</li><li>
Ability to work scheduled shifts in accordance with scheduling policies</li><li>
Proficient computer skills including the ability to document medical information with written and electronic medical records</li></ul> 
Preferred Qualifications:<ul><li>
3+ years of clinical experience as an APC</li><li>
Active and unrestricted license in the additional states: Washington, Oregon</li><li>
Experience in meeting the medical needs of patients with complex behavioral, social and/or functional needs</li><li>
Experience working in a nursing home, or with seniors in an acute care facility</li><li>
Understanding of Geriatrics, Chronic Illness, and acute disease management</li><li>
Understanding of Advanced Illness and end of life discussions</li><li>
Ability to develop and maintain positive customer relationships</li><li>
Adaptability to change</li></ul><ul><li> 
All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.</li></ul><div></div> 
Compensation for this specialty generally ranges from $52.64 - $78.85 per hour. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. 
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. 
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. 
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.</div>

Telephonic Nurse Practitioner (Part-Time) - Colorado License Required

<div>$10,000 Sign-on Bonus for External Candidates
Telephonic After-Hours Call - Evenings, Nights &amp; Rotating Weekends Required
Full-Time (40 Hours) 
Optum Home &amp; Community Care, part of the Optum family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere. As a team member of our Optum team, together in an interdisciplinary care environment, we help patients navigate the health care system and connect them to key support services. This preventive care can help patients stay well at home. We're connecting care to create a seamless health journey for patients across settings. Join us to start Caring. Connecting. Growing together. 
The Telehealth Urgent Care program is a comprehensive integrated care delivery program. The National On Call advanced practice clinician (APC) is responsible for providing telephonic/telehealth care and direction to patients, caregivers and facility staff providing 24/7 coverage including holidays. 
In this remote role you will provide virtual care for patients in various settings. This excellent opportunity affords a collaborative role bringing enormous satisfaction in the care and comfort of our patients. In this role you will have the ability to achieve work life balance. Optum is transforming care delivery with innovative and personal care. As one of the largest employers of APCs, Optum offers unparalleled career development opportunities. 
Scheduling:
This is a Full Time, work from home position requiring various shift coverage with a mix of weekday, weeknights, weekend, and holiday coverage. While shift times can vary, we provide coverage to members 24/7 including all company recognized holidays.<ul><li>
Flexibility and the ability to adapt are a must as you will cross cover multiple markets and teams</li><li>
Availability and Coverage expectations for this role<ul><li>
24/7 coverage</li><li>
Position requires a minimum commitment of 40 hours per week</li><li>
Every other weekend coverage between 8-12 hour shifts covering both day and night shifts is required based on business needs</li><li>
Expectations that your are working or have approved PTO for 26 weekends a year. Each FT/PT employee is eligible to have up to 6 weekend shifts a year for PTO</li><li>
Unapproved time away/Unpaid Time Off will result in need to add additional weekend shift to your schedule based on need</li></ul></li><li>
Holidays are required for all APCs on a rotation basis</li><li>
Holiday scheduling is completed at the beginning of the year for advanced planning. Holiday coverage is provided beginning at 5pm, the end of the last business day, to 8am of the resumption of business hours</li></ul> 
Primary Responsibilities:<ul><li>
Available on provided telephonic platform, both taking and placing calls to coordinate and manage care for members between care givers, facilities, hospitals, primary care providers and the Optum field colleagues<ul><li>
Available to use video platform based on clinical need</li><li>
Working hours should be performed in a secure location as patient privacy is required</li></ul></li><li>
Utilize EMR proficiently to provide acute care to members during all shifts and holiday hours</li><li>
Care Delivery<ul><li>
Deliver cost-effective, quality care to members</li><li>
Manage both medical and behavioral, chronic, and acute conditions effectively, and in collaboration with a physician or specialty provider</li><li>
Perform comprehensive assessments and document findings in a concise/comprehensive manner that is compliant with documentation requirements and Center for Medicare and Medicaid Services (CMS) regulations</li><li>
Responsible for ensuring encounter is documented appropriately to support the diagnosis at that visit</li><li>
The APC is responsible for ensuring that all quality elements are addressed and documented</li><li>
Utilizes evidenced based practice guidelines</li><li>
Must attend and complete all mandatory educational and MyLearning training requirements</li></ul></li><li>
Care Coordination<ul><li>
Coordinate care as members transition through different levels of care and care settings</li><li>
Monitor the needs of members and families while facilitating any adjustments to the plan of care as situations and conditions change</li><li>
Review orders and interventions for appropriateness and response to treatment to identify the most effective plan of care that aligns with the patients' needs and wishes</li><li>
Address and be able to have advanced care plan conversations with members and families</li><li>
Evaluate the plan of care for cost effectiveness while meeting the needs of members, families, and providers to decrease high costs, poor outcomes and unnecessary hospitalizations</li></ul></li><li>
Program Enhancement Expected Behaviors<ul><li>
This is a virtual patient facing role that requires excellent customer service to all parties including members/families, facilities, the entire interdisciplinary care team (PCPs/specialists) and Optum staff</li><li>
Regular and effective communication with internal and external parties including physicians, patients, key decision-makers, nursing facilities, field staff and other provider groups</li><li>
Ability to meet shift scheduling requirements, and attendance expectations</li><li>
Exhibit original thinking and creativity in the development of new and improved methods and approaches to concerns/issues</li><li>
Function independently and responsibly with minimal need for supervision</li><li>
Demonstrate initiative in achieving individual, team, and organizational goals and objectives</li><li>
Participate in quality initiatives</li><li>
Availability to check Optum email intermittently for required trainings, communications, and monthly scheduling</li></ul></li></ul> 
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:<ul><li>
Active and unrestricted license in the state which you reside, as well as State of Colorado, and ability to obtain in other required locations</li><li>
Ability to gain a collaborative practice agreement, if applicable in your state</li><li>
APCs working in jurisdictions that authorize APCs to practice autonomously or without formal supervision must have obtained approval to practice autonomously or without formal supervision from their licensing board, if applicable. New hires who are eligible and have not applied prior to hire date, must apply to practice autonomously or without supervision within 1 month of hire. If not eligible to practice autonomously or without formal supervision at hire, the APC must begin working towards meeting the requirement within 1 month of hire, if applicable, and apply for approval to practice autonomously or without formal supervision within 3 months of becoming eligible</li><li>
Education:<ul><li>
NP: Graduate of an accredited Master of Science Nursing or Doctor of Nursing Practice program</li></ul></li><li>
Active Nurse Practitioner certification through a national board:</li><li>
NP: Board certified through the American Academy of Nurse Practitioners or the American Nurses Credentialing Center, with certification in one of the following:<ul><li>
Family Nurse Practitioner</li><li>
Adult Nurse Practitioner</li><li>
Gerontology Nurse Practitioner</li><li>
Adult-Gerontology Acute Care Nurse Practitioner</li></ul></li><li>
Current, active DEA licensure/prescriptive authority or ability to obtain post-hire, per state regulations (unless prohibited in state of practice)</li><li>
Ability to work scheduled shifts in accordance with scheduling policies</li><li>
Proficient computer skills including the ability to document medical information with written and electronic medical records</li></ul> 
Preferred Qualifications:<ul><li>
3+ years of clinical experience as an APC</li><li>
Active and unrestricted license in the additional states: Washington, Oregon</li><li>
Experience in meeting the medical needs of patients with complex behavioral, social and/or functional needs</li><li>
Experience working in a nursing home, or with seniors in an acute care facility</li><li>
Understanding of Geriatrics, Chronic Illness, and acute disease management</li><li>
Understanding of Advanced Illness and end of life discussions</li><li>
Ability to develop and maintain positive customer relationships</li><li>
Adaptability to change</li></ul> 
Compensation for this specialty generally ranges from $109,500 to $164,000. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. 
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. 
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. 
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.</div>

Telephonic Nurse Practitioner - Colorado License Required

HonorHealth

<div>Overview: Looking to be part of something more meaningful? At HonorHealth, you&rsquo;ll be part of a team, creating a multi-dimensional care experience for our patients. You&rsquo;ll have opportunities to make a difference. From our Ambassador Movement to our robust training and development programs, you can select where and how you want to make an impact. HonorHealth offers a diverse benefits portfolio for our full-time and part-time team members designed to help you and your family live your best lives. Visit honorhealth.com/benefits to learn more. Join us. Let&rsquo;s go beyond expectations and transform healthcare together. HonorHealth is one of Arizona&rsquo;s largest nonprofit healthcare systems, serving a population of five million people in the greater Phoenix metropolitan area. The comprehensive network encompasses six acute-care hospitals, an extensive medical group with primary, specialty and urgent care services, a cancer care network, outpatient surgery centers, clinical research, medical education, a foundation, an accountable care organization, community services and more. With nearly 17,000 team members, 3,700 affiliated providers and close to 2,000 volunteers dedicated to providing high quality care, HonorHealth strives to go beyond the expectations of a traditional healthcare system to improve the health and well-being of communities across Arizona. Learn more at HonorHealth.com. Responsibilities: Job Summary 
Guides care coordination for high risk acute care patients, and facilitate the discharge plan for patients with medically complex post-acute care needs. Analyzes medical records to determine legitimacy of admission, treatment, and length of stay in acute setting in accordance with patient needs, regulatory standards and insurance company guidelines. Advocates for patients/families and liaisons with key team member to ensure that patient healthcare needs are being addressed. Collaborates with physicians and assists in the facilitation of healthcare resources to ensure services and care are delivered in a timely manner. The RN Case Manager works in collaboration with patients, providers, and key stakeholders in coordinating health services and referrals to assist with ensuring safe discharge. 
Essential Functions 
<ul><li>
Collaborates with patient/significant others as well as other members of the health care team in determining the appropriate level of care, utilization of resources and length of stay (utilizing electronic admission and discharge criteria program and physician input).
</li><li>Communicates with stakeholders, appropriate health care related information, both verbally and in written form, to ensure timely coordination care and services for patients receiving inpatient care. Identified point of contact for managing transitions of care.
</li><li>Reevaluates transition of care needs daily and coordinates transition to next level of case management or care coordination services. Performs concurrent review of patient treatment plans in accordance with the hospital policies and third party reimbursement systems.
</li><li>Assists in the maintenance of department logs and databases, department statistics, and utilization review documents according to hospital policy and state/ federal regulations.
</li><li>Performs other duties as assigned.</li></ul>
Education 
<ul><li>
Bachelor's Degree in Nursing or healthcare related field. - Preferred</li><li>
Associate's Degree in Nursing from an accredited NLN/CCNE institution, or diploma from an accredited NLN/ACEN institution. - Required</li></ul>
Experience 
<ul><li>
3 years clinical experience in a hospital setting - Required</li><li>
5 years as an RN in Case Management - Preferred</li><li>
7 years as a Registered Nurse (RN) - Preferred</li><li>
Other Experience in an outpatient clinical setting working with PCP, Home Health or Rehab - Preferred</li></ul>
Licenses and Certifications 
<ul><li>
Case Mgmt/Social Services\CCM - Certified Case Manager Certification in Case Management - Preferred</li><li>
Nursing\RN - Registered Nurse - State Licensure And/Or Compact State Licensure Current RN (AZ or State Compact Licensure) - Required</li></ul>
Facility: Shea Medical Center Department: Case Management Work Hours: 40 Shift: Day Position Type: Full-Time</div>

Registered Nurse - Case Manager Shea

Curana Health

<div>:
<div>
At Curana Health, we&rsquo;re on a mission to radically improve the health, happiness, and dignity of older adults&mdash;and we&rsquo;re looking for passionate people to help us do it.</div><div></div><div> 
As a national leader in value-based care, we offer senior living communities and skilled nursing facilities a wide range of solutions (including on-site primary care services, Accountable Care Organizations, and Medicare Advantage Special Needs Plans) proven to enhance health outcomes, streamline operations, and create new financial opportunities.</div><div></div><div> 
Founded in 2021, we&rsquo;ve grown quickly&mdash;now serving 200,000+ seniors in 1,500+ communities across 32 states. Our team includes more than 1,000 clinicians alongside care coordinators, analysts, operators, and professionals from all backgrounds, all working together to deliver high-quality, proactive solutions for senior living operators and those they care for.</div><div></div><div> 
If you&rsquo;re looking to make a meaningful impact on the senior healthcare landscape, you&rsquo;re in the right place&mdash;and we look forward to working with you.</div><div></div><div> 
For more information about our company, visit CuranaHealth.com.</div>
Summary:

The Care Ally, Case Manager is a key member of the interdisciplinary care team (ICT). They use a collaborative process of assessment, planning, implementing, coordinating, monitoring, and evaluating options and services required to meet the members health and social needs. They act as a liaison between our Members, their Responsible Parties and/or Power of Attorneys (RP/POAs), Advance Plan Provider/PCP, and key Align Senior Care stakeholders. The Care Ally, Case Manager reports to the Supervisor of Case Management.
Essential Duties &amp; Responsibilities:

Responsibilities<ul><li>
Executes on strategies and goals set by the Align Senior Care Board of Directors, the Senior Leadership Team, and Executive Director for managing and improving overall Member experience.</li><li>
Contacts Plan members to conduct a comprehensive health assessment of the individual, develop a plan of care, and participate in the facilities interdisciplinary care team meeting.</li><li>
Serves as health coach to educate the member, the family and/or caregiver, about disease status and treatment, plan benefits, community resources, and resource options</li><li>
Collaborates with members of the interdisciplinary care team and medical director(s) to facilitate appropriate treatment for members</li><li>
Routinely follows up with member as scheduled to assess progress towards goals</li><li>
Communicates with the member and/or caregiver to assist with the development of health goals and identify interventions to achieve these goals</li><li>
Provide patient-centered intervention, such as making and verifying appointments, performing medication and care compliance initiatives.</li><li>
Acts as front-line support with Members and their RP/POAs to ensure the needs of the Member are met. Serves as a connection point among Members, their Communities, their Care Team, and Align Senior Care internal departments.</li><li>
Regularly engages Align Senior Care Members and RP/POAs in-person or by phone to provide education and assistance with utilizing Align Senior Care benefits. Including but not limited to. checking on upcoming specialist appointments, connecting members to supplemental benefits and providers, identifying immediate Member needs, and answering any questions the Member or RP/POA may have.</li><li>
Communicates Member health updates from Care Team to RP/POAs.</li><li>
Coordinates with the Care Team for non-urgent health or clinical questions.</li><li>
Works directly with internal departments to solve Member Grievances, Utilization Management, and Billing related issues.</li><li>
Updates Member and RP/POA contact information such as changes of address, email, or phone numbers.</li><li>
Actively supports Account Manager in identifying and securing contracts with &quot;preferred&quot; Providers.</li><li>
Assists Members, RP/POAs, and Partner Communities with locating in-network providers and scheduling/facilitation of appointments.</li><li>
Assists with (on request of member or APP) coordination of home health and therapy visits, ordering of Durable Medical Equipment, and utilization of supplemental benefits for Members.</li><li>
Monitors and, if needed, facilitates care team meetings with facility team, member, responsible partie(s) and the APP/clinical team.</li><li>
Ensures documentation of care team meetings and transmits to Plan.</li><li>
Monitors care plan updates, facilitates APP and PCP input into care plan, and distributes care plan as needed to care team members.</li><li>
Monitors midnight reports/community census to help identify member transitions to hospital or other care levels.</li></ul>
Qualifications:

Education &amp; Experience<ul><li>
One (1) year of clinical practice experience in at least one of the following areas: case management, home health, critical care, medical/surgical, discharge planning, concurrent review, or obstetric/neonatal care.</li><li>
Proficiency using basic computer skills in Microsoft Office such as Word, Excel, and Outlook, including the ability to navigate multiple systems and keyboarding.</li><li>
Case management certification preferred.</li></ul>
Professional Certification Or Licenses<ul><li>
Registered nurse license, active and unencumbered state license in the state where job duties are performed is required. BSN preferred</li></ul>
OR<ul><li>
Active Licensed Social Worker (LSW). Bachelor's degree in social work (BSW) required</li></ul><div></div><div> 
We&rsquo;re thrilled to announce that Curana Health has been named the 147th fastest growing, privately owned company in the nation on Inc. magazine&rsquo;s prestigious Inc. 5000 list. Curana also ranked 16th in the &ldquo;Healthcare &amp; Medical&rdquo; industry category and 21st in Texas.</div><div></div><div> 
This recognition underscores Curana Health&rsquo;s impact in transforming senior housing by supporting operator stability and ensuring seniors receive the high-quality care they deserve.</div></div><div></div>

Care Ally, RN Case Manager - PST time zone

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