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<h4><em><strong>How you'll change lives</strong></em></h4><p>As a Registered Nurse (RN) at US Renal Care, you'll be an integral part of a cross-functional team, working under the supervision of a Charge Nurse and assisting and supervising Patient Care Technicians (PCTs) to care for patients living with kidney disease.</p><h4><em><strong>What you'll be doing</strong></em></h4><p><strong>Patient care.</strong> You'll work directly with patients to provide safe, comfortable, and high-quality dialysis treatment. Responsibilities include completing and documenting physical assessments before and after treatments and monitoring patients during treatment. You'll ensure quality renal care by completing monthly reviews of patient medication profiles and administering medications according to physician orders. </p><p><strong>Teamwork.</strong> You'll be a critical member of an interdisciplinary team to provide all required patient assessment and care planning activities. You'll also make sure center staffing requirements are met at all times under the direction of the Administrator and according to state regulations for staffing ratios.</p><p><strong>Safety &amp; Quality.</strong> Working under the supervision of a Charge Nurse, you'll adhere to all company policies and procedures and state and federal laws and regulations. You'll participate in all required staff meetings and continuing education offerings.</p>

U.S. Renal Care

Dialysis Registered Nurse MWF

<p><b>Salary Range:&nbsp;</b>&nbsp;$88,854.00&nbsp;(Min.) -&nbsp;$115,509.00&nbsp;(Mid.) -&nbsp;$142,166.00&nbsp;(Max.)</p><p>Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.<br><br>Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.<br></p><h4>Job Summary</h4><p>The Managed Long-Term Services and Supports (MLTSS) Nurse Specialist RN II applies advanced clinical judgment and critical thinking skills to facilitate appropriate physical and behavioral healthcare and social services for L.A. Care members. Utilizes assessments, member-centered care planning, direct provider coordination/collaboration and psychosocial wraparound services to promote effective utilization of available Health Plan benefits including, but not limited to Community Based Adult Services (CBAS), Skilled Nursing Facility (SNF) services, Intermediate Care Facility for Developmentally Disabled (ICF/DD) services, CalAIM Community Supports, Palliative and Hospice Care. Scope of work includes care coordination functions and must adhere to regulatory mandates that apply to Utilization Management (UM) and Care Management (CM). </p><p>This position is responsible for assessing, planning, coordinating, and monitoring care needs to ensure members receive high-quality, cost-effective care that promotes independence and quality of life.&nbsp; The MLTSS Nurse Specialist RN II conducts comprehensive health assessments and is a member of an interdisciplinary team that is key in identifying the physical, psychological and social needs of the member.&nbsp; </p><p>The MLTSS Nurse Specialist RN II collaborates with Skilled Nursing Facilities (SNF), Intermediate Care Facility - Developmentally Disabled (ICF-DD), Community Based Adult Services (CBAS) Centers, Residential Care Facilities for the Elderly (RCFE), Preferred Provider Groups (PPG), CalAIM providers (i.e. Community Supports Vendors), Palliative and Hospice Care Providers and cross functional units to facilitate coordination of services. </p><h4>Duties</h4><p>Responsible for performing assessments and clinical review of medical records to determine appropriate care including physical health, behavioral health, and social determinants of health needs for members referred to; MLTSS administered programs.</p><p>Responsible for UM authorization functions for services requiring prior authorizations in a timely manner with adherence to regulatory requirements. Identify and address gaps in care or overutilization, including overlapping services.</p><p>Engages with members by conducting telephonic nursing follow up and care coordination when necessary, including transitions of care for Long Term Care (LTC) and ICF/DD populations.&nbsp; </p><p>Provides direction to non-clinicians who assist members with accessing services and arranges for all services required while coordinating with the health care team to eliminate duplication of services. </p><p>Interfaces with Medical Directors, social workers, and interdisciplinary care team (ICT). Participates in ICT meetings and makes recommendations for MLTSS and other programs. </p><p>Establishes relationships with referral sources and community resources, such as external providers and care coordinators, while maintaining strict member confidentiality and complying with all Health Insurance Portability and Accountability Act (HIPAA) requirements.&nbsp; </p><p>Performs oversight and monitoring of provider performance for adherence to regulatory standards and contractual agreements. Participate in provider audits and quality improvement initiatives. Partners with Provider Network Management (PNM) and participates in Joint Operations Meetings (JOM). &nbsp;</p><h4>Duties Continued</h4><p>Facilitates care coordination with and provides education on available services to internal and external entities to improve member's short- and long-term goals in collaboration with member, caregivers, family, support systems, and physicians. A person-centered approach minimizes member confusion, and ensures the best care is delivered in the most appropriate setting. </p><p>Documents accurately and comprehensively based on the standards of practice and current organization policies.</p><p>Performs other CM and UM functions as assigned and as needed /required by L.A. Care, to maintain regulatory requirements and company objectives. </p><p>Performs other duties as assigned.&nbsp;</p><h4>Education Required</h4>Associate's Degree in Nursing<h4>Education Preferred</h4>Bachelor's Degree in Nursing<h4>Experience</h4><p><b>Required:</b></p><p>At least 3 years of clinical nursing experience in direct patient care, such as ambulatory care, home care, palliative care, hospice care OR experience in Utilization Review or Care Management will be considered in lieu of direct patient care that may include at least 2 years of relevant Licensed Vocational Nurse (LVN) experience in a UM or CM capacity substituted for 1 year of RN experience.</p><p>Clinical experience working with individuals with chronic illnesses, comorbidities, and/or disabilities in a UM/CM environment. </p><p><b>Preferred:</b></p><p>Experience in utilization review, skilled nursing, home health, discharge planning, behavioral health, community resources, and/or other home and community-based agencies.</p><h4>Skills</h4><p><b>Required:</b></p><p>Excellent verbal and written communication skills; with effective charting practices. </p><p>Excellent organizational, time-management and priority-setting skills.</p><p>Strong clinical skills with a knowledge of care needs for elderly, disabled, and/or frail populations and has applied knowledge of End-of-Life care. </p><p>Customer Service Skills:&nbsp; Provision of excellent customer service required due to frequent communication with providers, members and interdisciplinary team.</p><p>Technical Skills: Must be computer literate and proficient in Microsoft Office (Outlook, Word, Excel, PowerPoint, Teams).&nbsp; Ability to effectively utilize computer and appropriate software and interacts as needed with L.A. Care Information System.</p><p>Ability to maintain strict member confidentiality and complies with all HIPAA requirements.</p><p><b>Preferred:&nbsp;</b></p><p>Bilingual in one of L.A. Care Health Plan’s threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese.</p><h4>Licenses/Certifications Required</h4>Registered Nurse (RN) - Active, current and unrestricted California License<h4>Licenses/Certifications Preferred</h4>Certified Case Manager (CCM)<h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p><br><b>Required:</b><br>Travel to offsite locations for work.</p><p><b>Salary Range Disclaimer:</b> The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p><b>L.A. Care offers&nbsp;a wide range of benefits including</b></p><ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    LVN, Nursing, Travel Nurse, Behavioral Health, Patient Care, Healthcare                                                    </p>

L.A. Care Health Plan

Managed Long Term Services and Supports Nurse Specialist RN II

<p><b>Salary Range:&nbsp;</b>&nbsp;$88,854.00&nbsp;(Min.) -&nbsp;$115,509.00&nbsp;(Mid.) -&nbsp;$142,166.00&nbsp;(Max.)</p><p>Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.<br><br>Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.<br></p><h4>Job Summary</h4><p>The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically necessary referrals that meet established criteria. Assures timely and accurate determination and notification of referrals and reconsiderations based on the referral determination status. Generates approval, modification and denial communications, to include member and provider notification of referral determination. Actively monitors for admissions in any inpatient setting. Performs telephonic and/or onsite admission and concurrent review, and collaborates with onsite staff, physicians, providers, member/family interaction to develop and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service and retrospective claims medical review. Monitors and oversees the collection and transfer of data (medical records) and referral requests by Providers. Acts as a department resource for medical service requests /referral management and processes. Receives incoming calls from providers, professionally handles complex calls, researches to identify timely and accurate resolution steps. Follows up with caller to provide response or resolution steps. Answers all inquiries in a professional and courteous manner.</p><h4>Duties</h4><p>Promote and support team engagements, programs and activities to create and ensure a positive and productive workplace environment.</p><p>Perform telephonic and/or onsite admission and concurrent review, and collaborates with onsite staff, physicians, providers, the member and significant others to develop and implement a successful discharge plan. Process, finalize and facilitate inbound requests that are received from providers. </p><p>Generate appropriate member and provider communication for all determinations within the required timelines as defined by the most current department policy.</p><p>Facilitate/review requests for Higher level of care or skilled nursing/discharge planning needs. Research for appropriate facilities, specialty providers and ancillary providers to utilize for all lines of business. Identification of potential areas of improvement within the provider network.</p><p>Identify and initiate referrals for appropriate members to the various L.A. Care programs/processes and external community based programs or Linked and Carve Out Services (e.g. DDS/CCS/MH). Potential quality of care/potential fraud issues are identified and documented per L.A. Care policy. High risk/high cost cases and reports are maintained and referred to the Physician Advisor/UM Director. Document in platform/system of record. Utilize designated software system to document reviews and/or notes. </p><p>Receive incoming calls from providers, professionally handle complex calls, research to identify timely and accurate resolution steps. Follow up with caller to provide response or resolution steps. Answer all inquiries in a professional and courteous manner.</p><h4>Perform other duties as assigned. </h4><h4>Duties Continued</h4><h4>Education Required</h4>Associate's Degree in Nursing<h4>Education Preferred</h4>Bachelor's Degree in Nursing<h4>Experience</h4><p><b>Required:</b><br>At least 5 years of varied RN clinical experience in an acute hospital setting.</p><p>At least 2 years of Utilization Management/Case Management experience in a hospital or HMO setting .&nbsp;</p><p><b>Preferred:</b><br>Managed Care experience performing UM and CM at a medical group or management services organization.</p><p>Experience with Managed Medi-Cal, Medicare, and commercial lines of business.</p><h4>Skills</h4><p><b>Required:</b><br>Must be computer literate, with expertise in Outlook, Word, Excel, PowerPoint. &nbsp;Effectively utilizes computer and appropriate software and interacts as needed with L.A. Care Information System. Knowledge of personal computer, keyboarding, and appropriate &nbsp;software to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment. Prepare clear, comprehensive written and oral reports and materials.&nbsp;</p><p>Provision of excellent customer service required due to frequent communication with providers and other members of the interdisciplinary team &nbsp;<br><br>Excellent time management and priority-setting skills.</p><p>Maintains strict member confidentiality and complies with all HIPAA requirements.</p><p>Strong verbal and written communication skills. &nbsp; &nbsp;</p><p><b>Preferred:</b><br>Knowledge of National Committee for Quality Assurance (NCQA) requirements for Utilization Management or Care Management (CM).&nbsp;</p><p>Knowledge of Department of Health Care Services (DHCS) or Centers for Medicare and Medicaid Services(CMS) requirements for health plan compliance with UM or CM.</p><h4>Licenses/Certifications Required</h4>Registered Nurse (RN) - Active, current and unrestricted California License<h4>Licenses/Certifications Preferred</h4>Certified Case Manager (CCM)<h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p>May work on occasional weekends and some holidays depending on business needs.</p><p><b>Salary Range Disclaimer:</b> The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.</p><p><b>L.A. Care offers&nbsp;a wide range of benefits including</b></p><ul><li>Paid Time Off (PTO)</li><li>Tuition Reimbursement</li><li>Retirement Plans</li><li>Medical, Dental and Vision</li><li>Wellness Program</li><li>Volunteer Time Off (VTO)</li></ul><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Nursing, Registered Nurse, Medicare, Medicaid, Claims, Healthcare, Insurance                                                    </p>

Utilization Management Nurse Specialist RN II

<br><h4><em><strong>How you'll change lives</strong></em></h4><p>As a Registered Nurse (RN) at US Renal Care, you'll be an integral part of a cross-functional team, working under the supervision of a Charge Nurse and assisting and supervising Patient Care Technicians (PCTs) to care for patients living with kidney disease.</p><h4><em><strong>What you'll be doing</strong></em></h4><p><strong>Patient care.</strong> You'll work directly with patients to provide safe, comfortable, and high-quality dialysis treatment. Responsibilities include completing and documenting physical assessments before and after treatments and monitoring patients during treatment. You'll ensure quality renal care by completing monthly reviews of patient medication profiles and administering medications according to physician orders. </p><p><strong>Teamwork.</strong> You'll be a critical member of an interdisciplinary team to provide all required patient assessment and care planning activities. You'll also make sure center staffing requirements are met at all times under the direction of the Administrator and according to state regulations for staffing ratios.</p><p><strong>Safety &amp; Quality.</strong> Working under the supervision of a Charge Nurse, you'll adhere to all company policies and procedures and state and federal laws and regulations. You'll participate in all required staff meetings and continuing education offerings.</p>

Dialysis Registered Nurse PRN | TTS

Dialysis Registered Nurse TTS

<p>SUMMARY</p><p>The <strong>Administrator</strong> is responsible for the overall daily management and operation of the clinic. The Administrator reports directly to first line regional operational management which may be an Area Director, Regional Director, or Vice President of Operations, depending on the region/demographics.</p><p>ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties and tasks may be assigned.</p><p>GROWTH · Develop and implement processes for program growth in accordance with Company goals. · Plan/coordinate patient scheduling to assure timely acceptance of patients and effective staffing levels. · Implement clinical and operational processes to improve patient health and minimize hospitalizations and missed treatments. · Achieve financial targets to include budget, labor costs, supply costs and expenditures.</p><p>OUTCOMES · Review all incident reports; make recommendations and take action relative to incidents as appropriate; report at monthly QAPI meeting. · Promote quality management program through education and involvement of staff and patients in outcomes as well as overall responsibility to achieve corporate goals for quality. Leads QAPI meetings and quality improvement committees. · Coordinate the functions of all departments and develop standards and methods of measuring patient care services, including a chronological record of services provided to patients as required by the ESRD Network Coordinating Council and Medicare. · Work with staff to maintain chronological, thorough, and appropriate documentation in the patient record of all treatments, activities, and communication with the patient, physician and other healthcare professionals. · Achieve program's target goals for patient outcomes in accordance with quality patient care and Company goals.</p><p>OPERATIONAL&nbsp;READINESS</p><p>· Knowledge of and remain current with federal, state, local laws and regulations, including health care professionals practice act requirements. · Assure that the clinic is in compliance with all applicable federal, state, and local laws and regulations and receives continuing certification from all statutory and regulatory agencies. · Develop, implement and follow up necessary Corrective Action Plans for internal and external surveys. · May assume Charge Nurse's responsibilities as needed. · Responsible for duties listed in Registered Supervising Nurse job description and nursing services policy # C-AD-0110 or must designate Registered Nurse meeting these qualifications. · May fulfill responsibility of facility CEO as delegated by Governing Body. · Conduct and/or participate in both formal and informal meetings with the governing body, Regional Director, Medical Director and the staff. Assure that appropriate staff meetings, in-service education meetings, and team patient care planning meetings are held monthly. Assure that Quality Assessment &amp; Performance Improvement Program is current at all times. · Establish, maintain, and submit all required records and reports concerning staff, patients, and the operational affairs of the center. · Plan, coordinate, and approve effective and efficient staffing to meet patient needs and regulations. · Oversee the maintenance of equipment and supplies to meet current laws and regulations.</p><p>OPERATIONAL READINESS (cont.) · Continuously monitor to ensure that a safe and sanitary physical environment is maintained throughout the facility; that all equipment is maintained and functions properly; and that adequate and appropriate inventory levels of all supplies are available and used correctly. · Supervise the maintenance of equipment, building areas occupied by the center and other property belonging to the center. · Know and understand the water treatment and mechanisms of the equipment of the facility. · Assist, when necessary, with disinfection of equipment and supplies including bicarbonate delivery systems and dialysis machines.</p><p>PARTNERSHIPS · Monitor all contractual agreements; update as needed with corporate oversight. · Maintain collaborative working relationship with Medical Director and physicians. · Establish and maintain a positive relationship with area hospitals, agencies, vendors and the community. · Actively promote GUEST customer service standards; develop effective relationships at all levels of the organization. · Respond effectively to inquiries or complaints.</p><p>STAFF&nbsp;DEVELOPMENT/&nbsp;RETENTION · Ensure all staff meet required qualifications for position held and perform duties within limitations established by and in accordance with company policy/procedures, health care professionals practice acts, applicable state and federal laws and regulations. · Recruit, train, develop, and supervise all personnel. · Maintain effective personnel management and employee relations, including evaluating the performance of all personnel; approving and submitting all hours worked and counseling and disciplining employees. · Uphold management goals of corporation by leading staff in team concepts and promoting a team effort. · Effectively communicates expectations; accepts accountability and holds others accountable for performance.</p><p>ADMINISTRATOR</p><p>State Specific Regulations</p><p>Alabama</p><p>IF DESIGNATED CEO FOR THE CLINIC, MUST: </p><ul><li> Hold at least a baccalaureate degree and has at least one (1) year of experience in a dialysis unit OR</li><li> Meets the qualifications for a qualified physician director or qualified registered supervising nurse.</li></ul><p>Georgia </p><ul><li> Hold at least a baccalaureate degree and has at least one (1) year experience in an end stage renal disease facility OR</li><li> Meets the qualifications for a physician director or a nurse responsible for nursing services for an end stage renal disease facility OR</li><li> Has been acting for at least two (2) years as a facility administrator for an end stage renal disease facility which has been certified for the federal Medicare program.</li></ul><p>Maryland </p><p> IF NOT THE DESIGNATED CEO FOR THE CLINIC, MUST: </p><ul><li> Be 21 years old or older.</li><li> Possess a high school diploma or a high school equivalency diploma.</li><li> Have at least one (1) year of dialysis experience.</li><li> Have no criminal conviction or other criminal history that indicates behavior that is potentially harmful to patients, documented through either a criminal history records check or criminal background check completed within one (1) month before employment.</li></ul><p>New Jersey </p><ul><li> A baccalaureate degree from an accredited college or university and the equivalent of at least one (1) year experience in supervising renal dialysis services OR</li><li> Five (5) years full-time experience in the provision of renal dialysis services and documentation of supervisory experience for at least one (1) year.</li></ul><p>South Carolina </p><ul><li> Hold at least a baccalaureate degree or have a minimum of an associate degree in a health-related field with at least two (2) years experience in ESRD within the past five (5) years.</li></ul><p>Wyoming </p><p> PERSON IN CHARGE OF THE OPERATION OF THE FACILITY TWENTY-FOUR (24) HOURS PER DAY AND IS:</p><ul><li> A physician OR</li><li> A Registered Nurse who has at least six (6) months of experience working in a renal dialysis center OR</li><li> An individual with a bachelors degree and one (1) year experience in health service administration, preferably in a renal dialysis center.</li></ul><p>REGISTERED SUPERVISING NURSE</p><p>State Specific Regulations</p><p>Georgia </p><ul><li> RN with twelve (12) months of experience in clinical nursing, and an additional six (6) months of experience in nursing care of the patient with permanent kidney failure or undergoing kidney transplantation, including training in and experience with the dialysis process OR</li><li> RN with eighteen (18) months of experience in nursing care of the patient with on maintenance dialysis, or the nursing care of the patient with a kidney transplant, including training in and experience with the dialysis process.</li><li> Where the RN responsible for nursing services is also in charge of self-care dialysis training, at least three (3) months of the total required dialysis experience is in training patients in self-care.</li></ul><p>New Jersey </p><p>THIS POSITION IS CONSIDERED DIRECTOR OF NURSING SERVICES IN THE STATE OF NJ AND MUST:</p><ul><li> Have twelve (12) months full time experience in nursing supervision and/or nursing administration obtained in a hemodialysis setting within the last twenty-four (24) months.</li></ul><p>South Carolina</p><p> THIS POSITION IS CONSIDERED DIRECTOR OF NURSING SERVICES IN THE STATE OF SC AND MUST: </p><ul><li> Be a registered nurse with at least eighteen (18) months of experience in clinical nursing, with at least six (6) months experience in care of patients with ESRD.</li></ul><p>Texas </p><p>THIS POSITION ALSO MAY BE KNOWN AS THE DIRECTOR OF NURSING IN THE STATE OF TX AND MUST:</p><ul><li> Have at least eighteen (18) months experience as an RN, which includes at least twelve (12) months experience in dialysis within the last twenty-four (24) months; OR </li><li> Have at least eighteen (18) months experience as an RN, and holds a current certification from a nationally recognized board in nephrology nursing or hemodialysis.</li></ul><br>

Dialysis Facility Administrator-Registered Nurse Preferred

<br><h4>Job Description</h4><p><strong>Job Duties</strong></p><ul><li>The Medical Assistant (MA) is responsible for maintaining a highly professional environment, ensuring a collaborative relationship with patients and physicians.</li><li>The MA will assist with the non-clinical tasks required to ensure smooth patient access and flow including scheduling patients which can include follow up office visits, imaging and lab work, preparation of appropriate chart elements.</li><li>The responsibilities of this position would also include pre-authorization process and acting as a liaison between the providers and patient.</li></ul><p>The Medical Assistant will work collaboratively with staff to ensure all proper records are received and all appropriate testing is completed prior to appointment/surgery date.</p><p><strong>Job Requirements:</strong></p><ul><li>High school graduate or equivalent – <strong>Required.</strong></li><li>one-year previous medical back-office experience –&nbsp;<strong>Required.</strong></li></ul><p>Schedule:</p><p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; MON- FRI 8 am to 5 pm</p>

17 Healthcare Jobs in Long Beach, CA, USA