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USRC's greatest strength in being a leader in the dialysis industry is our ability to recognize and celebrate the differences in our diverse workforce. We strongly believe in recruiting top talent and creating a diverse and inclusive work climate and culture at all levels of our organization.<ul><li>A Home Therapy nurse trains home hemo or peritoneal dialysis patients in-center and sometimes in the patient’s home.</li><li>We Will Train - In-center hemodialysis, critical care, and home health are great backgrounds.&nbsp; </li><li>Work Schedule – Monday through Friday, 8am to 5pm; Modified schedules are possible based on patient caseload at the facility.</li><li>Competitive on-call pay when placed in on-call rotation. </li><li>Holidays – Home Training Nurses rarely work on a holiday. </li><li>We lead the industry in clinical quality improvement, delivering amongst the best patient outcomes in the U.S. as measured by the CMS ESRD Quality Incentive Program.</li><li>We remain an industry leader in home dialysis with 17% of dialysis treatments delivered in our patients' homes.</li></ul>The Home Therapy Registered Nurse, as qualified by federal and state regulations, provides patient training and ongoing support for all patients choosing a home dialysis modality.&nbsp; This position is accountable for providing quality care to all patients and is committed to delivering superior customer service in all internal and external interactions.&nbsp;&nbsp; ESSENTIAL DUTIES AND RESPONSIBILITIES include the following.&nbsp; Other duties and tasks may be assigned.<ul><li>Knowledge of and comply with federal, state, local laws and regulations, including health care professionals practice act requirements as they pertain to home dialysis program and patient care requirements.</li><li>Train patient (and/or care partner) in the practice of self-care Peritoneal Dialysis or Hemodialysis upon meeting federal and state regulations governing Registered Nurse qualifications.</li><li>Conduct home visits to assess the patient's home environment per policy; initially and minimally annually thereafter.&nbsp; Routinely evaluate patient performance and assess the home environment more frequently as needed to improve care.</li><li>Communicate results of patient assessment, reassessment, and ongoing monitoring to the physician, team members, and others as appropriate to the individual needs of the patient.</li><li>Document all nursing services in the Electronic Medical Record including but not limited to training sessions, routine and non-routine in-person interactions, and phone conversations.&nbsp; Documentation should accurately reflect the patient status and nursing interventions and be written to ensure continuity of care.</li><li>Participate in infection control monitoring, implementation, and recording as requested.</li><li>Be familiar with emergency equipment and all emergency operational procedures.&nbsp; Communicate and regularly review Emergency Preparedness procedures with all home patients, including but not limited to emergency disconnection from dialysis equipment, what to do and who to contact if displaced from home.</li><li>Ensure clinic and patient supply inventory and usage is appropriate for patient prescriptions and place orders in timely manner to avoid fees and penalties.</li><li>Continually seek to improve patient and quality outcomes through tracking and trending of program and patient performance, use of critical thinking skills and root cause analysis to improve patient and quality outcomes.&nbsp; Assist in obtaining data for the continuous quality improvement activities.</li><li>Obtain routine and non-routine laboratory tests as ordered and communicate critical lab values and urgent patient needs to the responsible physician or physician extender in a timely manner.</li><li>Complete and document monthly review of patient medication profiles.&nbsp; Administer medications as ordered by the physician.</li><li>Responsible for performing on call nursing services, nights and weekends, on a rotational basis as needed or assigned.</li><li>Flexible with staffing locations and hours to accommodate patient and USRC home program needs.</li><li>Regular and reliable attendance is required for the position.</li></ul>Home Hemodialysis Only:<ul><li>Coordinate home evaluation with technical services department to ensure that the necessary electrical, plumbing and drainage requirements for proper equipment operation are met prior to patient acceptance into home program.</li><li>Ensure required and appropriate water sampling is complete per policy and product requirements.&nbsp; Monitor and report water sample and culture results.&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</li></ul>

U.S. Renal Care

Dialysis Registered Nurse, Home Hemo & Peritoneal RN

Thank you for your interest in a career at NeighborHealth, formerly East Boston Neighborhood Health Center!As one of the largest community health centers in the country, NeighborHealth is proud to serve the greater Boston area with a strong commitment to the health and well-being of our patients and communities.Whether you're a nurse or physician providing direct care, a manager leading dedicated teams, or part of the essential support staff who keep our operations running smoothly — every role at NeighborHealth is vital. Together, we’re advancing medicine and delivering the best care experience for our patients and community!Interested in this position? Apply online and create a personal candidate account!Current Employees of NeighborHealth- Please use our internal careers portal to apply for positions.To learn more about working at NeighborHealth and our benefits, please visit out our Careers Page.Time Type: Full timeDepartment: PediatricsAll Locations: 10 Gove Street – Taylor BuildingPosition Summary: A registered nurse holds ultimate responsibility for direct and indirect nursing care, including assessment, planning, coordination and evaluation of care toward the goal of maintenance and restoration for optimal functioning and comfort. This includes the ability to conduct a comprehensive assessment that incorporates integration of clinical information and the ability to translate that into a plan of care for the patient/family/care team This position requires universal skills and proficiencies which include demonstrating a comprehensive understanding of the Health Center’s mission and core values--compassion, diversity, innovation, respect, and teamwork--and the department’s immediate needs and long-term goals. In addition, the registered nurse demonstrates initiative, critical thinking, problem solving, leadership qualities, and effectively engages with the clinical team. Schedule: Mon-Fri, 8am-5pm and includes evening, weekend and holiday rotationsEssential Duties &amp; Responsibilities<ul><li>Demonstrates sound clinical judgment/decision making when triaging patients.</li><li>Manages medication refills with appropriate authorization by the provider.</li><li>Provides thorough and concise documentation of patient’s histories, assessments, plans, and treatments. Enters messages as staff messages or telephone encounters in the computer. Enters and views patient letters in the computer. Enters exam encounters in the computer.</li><li>Consistently participates in the activities in the transition of care, recalls, high risk management, in basket management, and vaccines.</li><li>Follows protocols for management of patients with chronic/acute conditions and transitions of care. &nbsp;</li><li>Accepts constructive feedback and incorporates into plan for professional growth and development.</li><li>Recognizes and meets the safety needs of the departmental patient population.</li><li>Participates in the orientation, training, and mentoring of new employees. Provides input into the development of the orientation plan for new employees.</li><li>Actively participates in NeighborHealth programs, committees and departmental meetings.</li><li>Understands organizational structure of &nbsp;the department and unit routine and adheres to NeighborHealth policies</li><li>Responsible for continued professional growth and development. &nbsp;</li><li>Interacts with patients and families in a professional and respectful manner, which reflects the needs and concerns of the individual. Uses communication devices appropriately.&nbsp;</li><li>Promotes a sense of teamwork; maintains a positive attitude. &nbsp;Open to new ideas and embraces change. &nbsp;Provides support and direction to other members of the practice team. Promotes a culture of acceptance, support and collegiality. &nbsp;Shares new found knowledge willingly with team.</li><li>Solves problems independently, in teams, and seek consultation as appropriate.</li><li>Performs other departmental duties as assigned.</li><li>Knowledge, Skills and Abilities Required</li></ul>EDUCATION: <ul><li>Graduate of an Accredited Nursing Program.</li><li>Licensure in Massachusetts as an RN. &nbsp;</li><li>BLS certification Bilingual skills preferred.</li></ul>EXPERIENCE: <ul><li>1 year relevant nursing experience in a community health and/or ambulatory care setting preferred.</li></ul>SKILLS/ABILITIES: <ul><li>Demonstrated ability to communicate effectively both in writing and verbally.</li><li>Familiarity with the use of a personal computer in a Windows environment preferred</li></ul>PAY RANGE: $40/hr up to $60/hr based on experience$10,000 sign on bonus (pro-rated for part time and per diem)EEO &amp; Accommodation Statement:NeighborHealth is an equal employment/affirmative&nbsp;action employer. We ensure equal employment opportunities for all, without regard to race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity and/or expression or any other non-job-related characteristic. If you need accommodation for any part of the application process because of a medical condition or disability, please send an e-mail <a href="mailto:toHRrecruit@NeighborHealth.com" target="_blank">toHRrecruit@NeighborHealth.com</a>&nbsp;or call 617-568-4480 to let us know the nature of your requestFederal Trade Commission Statement: According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website. We do not ask or require downloads of any applications, or “apps.” Job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.E-Verify Program Participation Statement:NeighborHealth participates in the Electronic Employment Verification Program, E-Verify. As an E-Verify employer, all prospective employees must complete a background check before beginning employment.

Come care with us at West Coast University! As a Nursing Faculty member for a certified Great Place to Work, you will guide nursing students to do more than change their own lives – you will help change the lives of every patient they treat throughout their career in healthcare. &nbsp;At West Coast University you will have the opportunity to share your success story with the next generation of nurses as a key member of our student-centered, innovative community!Typical class is 6PM - 10PM some days availableYou will make an impact by: &nbsp;<ul><li>Serving as a mentor, role model and facilitator who provides guidance and academic support for students. </li><li>Demonstrating enthusiasm for teaching, the teaching/learning process and for individual students.</li><li>Applying your skills and experience to your assigned teaching schedule.</li><li>Participating in and contributing to assessment activities of courses/curriculum and programs via a continuous improvement plan set forth by the University.</li><li>Regularly contributing to improvement of class materials and syllabi within prescribed shared governance culture.</li><li>Utilizing a variety of teaching methodologies to instruct students, always with intent to facilitate observable evidence of student fulfillment of prescribed learning outcomes.</li><li>Maintaining scholarly activities.</li><li>Participating in professional growth and service in accordance with university policies.</li><li>Advancing our commitment and focus on the students we serve, and their success as healthcare professionals.</li><li>Fully leveraging our innovative technologies and resources, such as our Simulation and Innovation Labs.</li><li>*If working with students in a Clinical setting you will:<ul><li>Assume complete responsibility for students in clinical facilities. </li><li>Clarify clinical expectations with students.</li><li>Clarify student placement and expectations with clinical facility staff.</li><li>Utilize care planning time to direct students to available resources needed for clinical preparation. </li><li>Assess student knowledge and skill level to ensure safety and optimal care to patients.</li><li>Utilize pre- and post- conference to allow students an opportunity to share learned experiences, ensuring clarity of the correlation between &nbsp;weekly theory content with clinical objectives and experiences.</li><li>Provide feedback of clinical performance immediately after observation of event and of overall performance at midterm and end of semester.</li></ul></li></ul>Your Experience Includes: &nbsp;<ul><li>Working knowledge of Microsoft Office Suite Products, especially Outlook, Word, PowerPoint and other MS office products as needed.</li><li>Working with online learning management systems to further engage the student learning process.</li><li>Compliance with state, federal and local laws/regulations relating to programs, governmental compliance, and other regulatory standards such as state Board of Nursing.</li><li>Clinical RN - Must have a minimum of two (2) year’s prior experience as a registered nurse providing direct patient care and have a minimum of one year experience in the field in which they teach.</li></ul>Education: Education and experience must align with state regulations and comply with the rules and regulations of state authorization agencies.<ul><li>Master’s degree in nursing</li><li>Professional nurse licensure required.</li></ul>Do you want a career that allows you to make a difference in other people’s lives? Discover what it means to truly believe in the work that you do at West Coast University.At West Coast University, we have the privilege of educating students seeking careers in healthcare and guide them through their transformational journey from student to caregiver. Our associates are united behind that purpose and share a deep commitment to our values of teamwork, collegiality, transparency, and a student-centric approach to all we do. This focus creates an aligned, nimble, and consensus-driven culture that is solution-oriented and supports our associates’ professional growth.West Coast University is proud to be an equal opportunity employer. We embrace diversity and are dedicated to creating an inclusive environment for all associates.

West Coast University

Adjunct Nursing Pediatrics Faculty - Simulation

Come care with us at West Coast University! As a Nursing Faculty member for a certified Great Place to Work, you will guide nursing students to do more than change their own lives – you will help change the lives of every patient they treat throughout their career in healthcare. &nbsp;At West Coast University you will have the opportunity to share your success story with the next generation of nurses as a key member of our student-centered, innovative community!Days and evenings available.You will make an impact by: &nbsp;<ul><li>Serving as a mentor, role model and facilitator who provides guidance and academic support for students. </li><li>Demonstrating enthusiasm for teaching, the teaching/learning process and for individual students.</li><li>Applying your skills and experience to your assigned teaching schedule.</li><li>Participating in and contributing to assessment activities of courses/curriculum and programs via a continuous improvement plan set forth by the University.</li><li>Regularly contributing to improvement of class materials and syllabi within prescribed shared governance culture.</li><li>Utilizing a variety of teaching methodologies to instruct students, always with intent to facilitate observable evidence of student fulfillment of prescribed learning outcomes.</li><li>Maintaining scholarly activities.</li><li>Participating in professional growth and service in accordance with university policies.</li><li>Advancing our commitment and focus on the students we serve, and their success as healthcare professionals.</li><li>Fully leveraging our innovative technologies and resources, such as our Simulation and Innovation Labs.</li><li>*If working with students in a Clinical setting you will:<ul><li>Assume complete responsibility for students in clinical facilities. </li><li>Clarify clinical expectations with students.</li><li>Clarify student placement and expectations with clinical facility staff.</li><li>Utilize care planning time to direct students to available resources needed for clinical preparation. </li><li>Assess student knowledge and skill level to ensure safety and optimal care to patients.</li><li>Utilize pre- and post- conference to allow students an opportunity to share learned experiences, ensuring clarity of the correlation between &nbsp;weekly theory content with clinical objectives and experiences.</li><li>Provide feedback of clinical performance immediately after observation of event and of overall performance at midterm and end of semester.</li></ul></li></ul>Your Experience Includes: &nbsp;<ul><li>Working knowledge of Microsoft Office Suite Products, especially Outlook, Word, PowerPoint and other MS office products as needed.</li><li>Working with online learning management systems to further engage the student learning process.</li><li>Compliance with state, federal and local laws/regulations relating to programs, governmental compliance, and other regulatory standards such as state Board of Nursing.</li><li>Clinical RN - Must have a minimum of two (2) year’s prior experience as a registered nurse providing direct patient care and have a minimum of one year experience in the field in which they teach.</li></ul>Education: Education and experience must align with state regulations and comply with the rules and regulations of state authorization agencies.<ul><li>Master’s degree in nursing</li><li>Professional nurse licensure required.</li></ul>Do you want a career that allows you to make a difference in other people’s lives? Discover what it means to truly believe in the work that you do at West Coast University.At West Coast University, we have the privilege of educating students seeking careers in healthcare and guide them through their transformational journey from student to caregiver. Our associates are united behind that purpose and share a deep commitment to our values of teamwork, collegiality, transparency, and a student-centric approach to all we do. This focus creates an aligned, nimble, and consensus-driven culture that is solution-oriented and supports our associates’ professional growth.West Coast University is proud to be an equal opportunity employer. We embrace diversity and are dedicated to creating an inclusive environment for all associates.

Adjunct Nursing Med-Surg Faculty - Simulation

It’s inspiring to work with a company where people truly BELIEVE in what they’re doing! When you become part of the Chapters Health Team, you’ll realize it’s more than a job. It’s a mission. We’re committed to providing outstanding patient care and a high level of customer service in our communities every day. Our employees make all the difference in our success!Role: The Librus APRN is a key clinical leader in the delivery of person-centered, value-based care to Institutional Special Needs Plans (ISNP), ACOs, and high-risk payors residing in Skilled Nursing Facilities, communities, or private homes. Working in alignment with the payor's model of care and under the Librus program, the APRN performs comprehensive clinical assessments, closes care gaps, participates in IDT meetings, ensures accurate HCC coding, reduces unneeded hospitalizations, and delivers high-quality primary and supportive care to medically complex patients. This role also includes providing end-of-life services, including comfort and symptom-focused care without formal hospice enrollment, ensuring quality of life and dignity are prioritized during serious illness and advanced aging.Qualifications: Required:<ul><li>Licensed APRN with active certification (Adult/Geriatric NP, FNP, or similar) in the state of Florida.</li><li>DEA license with prescriptive authority.</li><li>Minimum 3 years of experience as a nurse practitioner, preferably in geriatrics, SNF, hospice, palliative care, or complex care management.</li><li>Demonstrated experience with HCC coding and risk adjustment models.</li><li>Familiarity with Medicare Advantage care gap closure metrics.</li></ul>Preferred:<ul><li>Experience with ISNPs, D-SNPs, or other value-based Medicare models.</li><li>Knowledge of SNF workflows and interdisciplinary care teams.</li><li>Comfort and skill in end-of-life conversations and palliative approaches.</li></ul>Schedule &amp; Travel:<ul><li>Full-time, Monday–Friday with flexibility for urgent needs</li><li>On-site presence in designated SNFs with occasional local travel</li><li>Minimal on-call rotation, shared with other advanced practice providers</li></ul>Competencies:<ul><li>Advanced clinical assessment and diagnostic skills</li><li>Coding and documentation proficiency (HCC, SOAP, risk adjustment)</li><li>Compassionate care mindset with emotional intelligence</li><li>Collaborative leadership across multiple teams</li><li>Strategic time and case management abilities</li></ul>Responsibilities of all employees:<ul><li>Represent the Company professionally at all times through care delivered and/or services provided to all clients.</li><li>Comply with all State, federal and local government regulations, maintaining a strong position against fraud and abuse.</li><li>Comply with Company policies, procedures and standard practices.</li><li>Observe the Company's health, safety and security practices.</li><li>Maintain the confidentiality of patients, families, colleagues and other sensitive situations within the Company.</li><li>Use resources in a fiscally responsible manner.</li><li>Promote the Company through participation in community and professional organizations.</li><li>Participate proactively in improving performance at the organizational, departmental and individual levels.</li><li>Improve own professional knowledge and skill level.</li><li>Advance electronic media skills.</li><li>Support Company research and educational activities.</li><li>Share expertise with co-workers both formally and informally.</li><li>Participate in Quality Assessment and Performance Improvement activities as appropriate for the position.</li></ul>Job Responsibilities: Clinical Care Delivery:<ul><li>Serve as the primary advanced practice provider for assigned ISNP members, High-Needs ACO patients, and similar settings, delivering direct, evidence-based care in collaboration with facility and plan/payor staff.</li><li>Perform routine and urgent clinical assessments, diagnose and manage chronic and acute conditions, and adjust care plans.</li><li>Provide palliative and hospice-like care interventions focused on comfort, dignity, and patient-centered goals.</li></ul>HCC Coding &amp; Gap Closure:<ul><li>Conduct comprehensive annual and episodic assessments to ensure accurate capture of chronic conditions per CMS HCC guidelines.</li><li>Close quality gaps related to screenings, labs, immunizations, and chronic disease management per ISNP, Payor and plan metrics.</li><li>Maintain thorough, compliant documentation to support both care delivery and risk adjustment requirements.</li></ul>Model of Care Alignment:<ul><li>Operate as a clinical champion of the Librus Model of Care, emphasizing proactive interventions, interdisciplinary collaboration, and reduced avoidable hospitalizations.</li><li>Partner with the RN Care Coordinator and facility teams to ensure service continuity, integration, and alignment.</li></ul>Advanced Illness Management:<ul><li>Lead or participate in goals-of-care discussions, advance directive review, and shared decision-making with patients and families.</li><li>Support members through end-of-life transitions with empathy and skill, even without formal hospice enrollment.</li><li>Utilize comfort-focused prescribing and symptom management protocols.</li></ul>Collaboration &amp; Reporting:<ul><li>Attend IDT meetings and collaborate regularly with payor physicians, SNF staff, and Librus leadership.</li><li>Communicate care plans effectively with patients, caregivers, and staff.</li><li>Submit timely and accurate clinical documentation, coding, and quality reporting.</li></ul>This position requires consent to drug and/or alcohol testing after a conditional offer of employment is made, as well as on-going compliance with the Drug-Free Workplace Policy.

Chapters Health System

Nurse Practitioner CareNu

Title: Practical Nursing Instructor CMA to PN-Evening/Weekend Position- Brownsville Campus
Employee Classification:&nbsp;Faculty
Institution:&nbsp;TCAT-Jackson
Department: Practical Nursing
Campus Location: TCAT Jackson
Job Summary
Develop course of study and conduct training program in specialty area. • Confer with administration to gain knowledge and better understand changes in policies, procedures, and technologies. • Formulate teaching outline and determine instructional methods utilizing knowledge of specific training needs and effectiveness of such methods as individualized and group instruction, lecture, demonstration, and conference. • Select or develop teaching aids, demonstration models, multimedia visual aids, and reference materials. • Maintain student records and reports. • Responsible for student placement and assist with studentfollow-up. • Cooperate with outside agencies; work with program advisory committees; conduct visits to business and industry; establish and maintain good public relations with the institution’s general public. • Participate in recruitment of students. • Supervise students’ clinicalexperience as scheduled. • Actively seek potential clinical sites for the provision of clinical training. • Demonstrate a commitment to staying current in the nursing field. 
Job Duties
Minimum Qualifications
Associate Degree in Nursing required. Must hold active licensure as a Registered Nurse in the State of Tennessee, B.S.N. preferred. Must have a minimum of three (3) years of clinical experience as a Registered Nurse within the last five (5) years. Teaching experience preferred. This position will report directly to the Director of Nursing and Allied Health. This position requires evening and weekend availability.
Preferred Qualifications
Knowledge, Skills, and Abilities
Teaching experience preferred. This position will report directly to the Director of Nursing and Allied Health. This position requires evening and weekend availability.
Physical Demands / Working Conditions 
{sTAOther1}

Motlow State Community College


      Practical Nursing Instructor -Evening/Weekend Position- (Grant-Funded) Brownsville Campus
    

Salary Range:&nbsp;&nbsp;$117,509.00&nbsp;(Min.) -&nbsp;$152,762.00&nbsp;(Mid.) -&nbsp;$188,015.00&nbsp;(Max.)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. 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. <h4>Job Summary</h4>The Manager, Appeals &amp; Grievances (A&amp;G) &amp; General Operations (Clinical) is responsible for the daily oversight of clinical appeals and grievances functions within the Appeals &amp; Grievances Department to ensure clinical grievances, complaints, appeals and complex issues are investigated and resolved using regulatory guidance across all lines of business. Provides direct supervision to the A&amp;G clinical team and the unit that supports them in order to assure operational effectiveness which includes the implementation and adherence to L.A. Care's Policies &amp; Procedures that meet Centers for Medicare and Medicaid Services (CMS), the California Department of Health Care Services (DHCS), the California Department of Managed Health Care (DMHC), the Managed Risk Medical Insurance Board (MRMIB), National Committee for Quality Assurance (NCQA) and other rules/ regulations/ standards. The Manager is responsible for establishing and monitoring processes to oversee and coordinate the identification, documentation, reporting, investigation and resolution of all member appeals and grievances in a timely and culturally-appropriate manner. Coordinates, tracks, and resolves internal and external appeal and grievance complaints for L.A. Care Plan Partners, including identifying opportunities for improvement.This position will be a role model for integrity and will establish and maintain effective professional work relationships, working collaboratively with all levels of management and business owners to help guide the discipline of planning, organizing, securing, managing, leading, and controlling resources to achieve specific goals.Manages all aspects of running an efficient &nbsp;team, including hiring, supervising, coaching, training, disciplining, and motivating direct-reports.&nbsp;<h4>Duties</h4>Manage and oversee the handling of clinical grievances and appeals, for L.A. Care and Plan Partner members. Establishes and oversees processes and all relevant member correspondence for accuracy, clarity, and cultural appropriateness and sensitivity. Review and monitor procedures for identifying quality of care issues and work collaboratively with cross-functional departments to appropriately address and resolve member grievances. Serve as the Key Contact for State Fair Hearings, internal and external audits, DMHC and DHCS inquiries. Review and monitor procedures for identifying quality of care issues and work collaboratively with cross-functional departments to appropriately address and resolve member and provider grievances.Responsible for timely daily operations in the A&amp;G Clinical Services Unit and other general operations units. &nbsp;Ensures timely appeal and grievance reporting to regulatory agencies, internal Regulatory Affairs and Compliance Department, internal Quality Oversight Committee, etc. Collaborates with cross-functional departments &nbsp;to ensure the use of appropriate appeal and grievance issue codes, timely resolution, and refers to community partners as appropriate. &nbsp;Lead, participate and provide representation of the A&amp;G Team at Internal and External meetings/ workgroups and acts as the point person for A&amp;G Programs especially the Clinical Programs.Develop and execute on strategic opportunities to improve the overall appeals &amp; grievance process. Create a best in clinical appeals process that is efficient and effective in managing member appeals.Work cross functionally and collaboratively within Appeals and Grievances with key internal partners to build a high functioning, results oriented environment and organization.&nbsp;<h4>Duties Continued</h4>Partner with internal and external stakeholders to build and maintain collaborative relationships and partnerships. Identify areas of connection to leverage and create added value for L.A. Care.Provide input into the development of automation to guide the team to process efficiencies for all lines of business while maintaining compliance and manageable workloads for staff.Responsible for maintaining and updating on an annual basis, or as necessary, appeal and grievance policies and procedures, member correspondence, etc., consistent with regulatory changes. &nbsp;Develop and maintain inventory reports for the appeals process ensuring appropriate productivity, compliance, and inventory management. &nbsp;Identify and implement continuous business process improvement recommendations to leverage organizational added value to the Appeals and Grievances Department. &nbsp;Develop and implement short and long-term strategies to improve team results, reducing administrative expenses.Manage staff , including, but not limited to: monitoring of day to day activities of staff, monitoring of staff performance, mentoring, training, and cross-training of staff, handling of questions or issues, etc. raised by staff, encourage staff to provide recommendations for relevant process and systems enhancements, among others. Supervision of the Clinical Services unit and general operations within Appeals and Grievances. Maintain a team of top talent, providing a culture of teamwork and collaboration.&nbsp;Perform other duties as assigned<h4>Education Required</h4>Bachelor's Degree in Nursing<h4>Education Preferred</h4><h4>Experience</h4>Required:6 years of clinical acute care experience with at least 3 years of experience with health care grievance and/or appeals issues, preferably in a managed care or Medicaid Health Plan environment and/or public services or public benefits programs.At least 3 years of management level operations leadership experience.Experience working with firm deadlines, regulators, detail oriented with the ability to interpret and apply regulationsExperience building relationships with organizations and business partners.Equivalency:&nbsp; Completion of the L.A. Care Management Certificate Training Program may substitute for the supervisory/management experience requirement.Preferred:&nbsp; Managed care experience.<h4>Skills</h4>Required: Excellent analytical, problem solving, planning and implementation skills.Demonstrated strong writing and communication skills.Demonstrates excellent leadership, communication, and negotiation skills with the ability to interact and influence all levels of the organization including executive management and key decision -makers.Demonstrates professional judgement, and critical thinking, to promote the delivery of quality, cost-effective care.Time management and priority setting skills.Excellent understanding of NCQA, DMHC, DOI, DHCS, and CMS regulatory requirements.Knowledge of Coordination of Care, Medicare and Medi-Cal regulations, prior authorization, level of care and length of stay criteria sets.Able to work effectively with various internal departments/service areas, L.A. Care's plan partners, participating provider groups, and other external agencies.Able to operate PC-based software programs including proficiency in Word, Excel and PowerPoint presentations.Excellent verbal, written communication and presentation skills.<h4>Licenses/Certifications Required</h4>Registered Nurse (RN) - Active, current and unrestricted California License<h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4>This position requires work after hours, on weekends, holidays, a hybrid remote schedule, occasional flexibility in hours/shift in critical situations and work on-call.This position requires handling various caseloads and flexibility to adapt to changing priorities which may include but not limited to redistributed work assignments, team projects, and other priorities as assignedSalary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.&nbsp; The range is subject to change.L.A. Care offers&nbsp;a wide range of benefits including<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> Nearest Major Market: Los Angeles Job Segment: Nursing, Registered Nurse, Nurse Management, Medicaid, Medicare, Healthcare

L.A. Care Health Plan

Registered Nurse (RN) Manager, Appeals and Grievances General Operations (Clinical)

Come care with us at West Coast University! As a Nursing Faculty member for a certified Great Place to Work, you will guide nursing students to do more than change their own lives – you will help change the lives of every patient they treat throughout their career in healthcare. &nbsp;At West Coast University you will have the opportunity to share your success story with the next generation of nurses as a key member of our student-centered, innovative community!Typical class is 6PM - 10PMYou will make an impact by: &nbsp;<ul><li>Serving as a mentor, role model and facilitator who provides guidance and academic support for students. </li><li>Demonstrating enthusiasm for teaching, the teaching/learning process and for individual students.</li><li>Applying your skills and experience to your assigned teaching schedule.</li><li>Participating in and contributing to assessment activities of courses/curriculum and programs via a continuous improvement plan set forth by the University.</li><li>Regularly contributing to improvement of class materials and syllabi within prescribed shared governance culture.</li><li>Utilizing a variety of teaching methodologies to instruct students, always with intent to facilitate observable evidence of student fulfillment of prescribed learning outcomes.</li><li>Maintaining scholarly activities.</li><li>Participating in professional growth and service in accordance with university policies.</li><li>Advancing our commitment and focus on the students we serve, and their success as healthcare professionals.</li><li>Fully leveraging our innovative technologies and resources, such as our Simulation and Innovation Labs.</li><li>*If working with students in a Clinical setting you will:<ul><li>Assume complete responsibility for students in clinical facilities. </li><li>Clarify clinical expectations with students.</li><li>Clarify student placement and expectations with clinical facility staff.</li><li>Utilize care planning time to direct students to available resources needed for clinical preparation. </li><li>Assess student knowledge and skill level to ensure safety and optimal care to patients.</li><li>Utilize pre- and post- conference to allow students an opportunity to share learned experiences, ensuring clarity of the correlation between &nbsp;weekly theory content with clinical objectives and experiences.</li><li>Provide feedback of clinical performance immediately after observation of event and of overall performance at midterm and end of semester.</li></ul></li></ul>Your Experience Includes: &nbsp;<ul><li>Working knowledge of Microsoft Office Suite Products, especially Outlook, Word, PowerPoint and other MS office products as needed.</li><li>Working with online learning management systems to further engage the student learning process.</li><li>Compliance with state, federal and local laws/regulations relating to programs, governmental compliance, and other regulatory standards such as state Board of Nursing.</li><li>Clinical RN - Must have a minimum of two (2) year’s prior experience as a registered nurse providing direct patient care and have a minimum of one year experience in the field in which they teach.</li></ul>Education: Education and experience must align with state regulations and comply with the rules and regulations of state authorization agencies.<ul><li>Master’s degree in nursing</li><li>Professional nurse licensure required.</li></ul>Do you want a career that allows you to make a difference in other people’s lives? Discover what it means to truly believe in the work that you do at West Coast University.At West Coast University, we have the privilege of educating students seeking careers in healthcare and guide them through their transformational journey from student to caregiver. Our associates are united behind that purpose and share a deep commitment to our values of teamwork, collegiality, transparency, and a student-centric approach to all we do. This focus creates an aligned, nimble, and consensus-driven culture that is solution-oriented and supports our associates’ professional growth.West Coast University is proud to be an equal opportunity employer. We embrace diversity and are dedicated to creating an inclusive environment for all associates.

Adjunct Nursing OB Faculty - Simulation evenings

Job Requirements This specific restaurant is independently owned and operated by a Whataburger franchise.&nbsp;Please click on the apply button below to be redirected to this franchisee’s website. Once there, you will be able to learn more about this position information and their application process.

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