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Essential Duties and Responsibilities include the following. Other duties and tasks may be assigned.<ul><li>Demonstrate effective use of supplies and staff labor hours.</li><li> May assist with billing log preparation and updates.</li><li>Perform duties as assigned to meet the patient care or operational needs of the clinic</li><li> Obtain blood samples for laboratory analysis as required to complete physician orders.</li><li> Complete and document monthly review of patient medication profiles.</li><li>Knowledge of and comply with applicable health care professionals practice act requirements.</li><li>Perform duties at all times under the supervision of a Charge Nurse and within limitations established by and in accordance with company policy and procedures, applicable state and federal laws and regulations</li><li>Maintain thorough, accurate, and appropriate documentation in the patient record of all treatments, activities, and communication with the patient, physician and other healthcare professionals to include progress reports.</li><li>Report any significant information or change in patient condition to the Charge Nurse.</li><li> Report machine problems to Biomedical Technician and Administrator.</li><li> Participate in staff meetings as required. Attend in-service and continuing education offerings in compliance with company policy and procedure.</li><li>Assist with staff training as requested.</li></ul>

U.S. Renal Care

Dialysis Licensed Vocational Nurse

Salary Range:&nbsp;&nbsp;$88,854.00&nbsp;(Min.) -&nbsp;$115,509.00&nbsp;(Mid.) -&nbsp;$142,166.00&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 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). 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; 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. <h4>Duties</h4>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.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.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; 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. Interfaces with Medical Directors, social workers, and interdisciplinary care team (ICT). Participates in ICT meetings and makes recommendations for MLTSS and other programs. 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; 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;<h4>Duties Continued</h4>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. Documents accurately and comprehensively based on the standards of practice and current organization policies.Performs other CM and UM functions as assigned and as needed /required by L.A. Care, to maintain regulatory requirements and company objectives. Performs other duties as assigned.&nbsp;<h4>Education Required</h4>Associate's Degree in Nursing<h4>Education Preferred</h4>Bachelor's Degree in Nursing<h4>Experience</h4>Required: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.Clinical experience working with individuals with chronic illnesses, comorbidities, and/or disabilities in a UM/CM environment. Preferred:Experience in utilization review, skilled nursing, home health, discharge planning, behavioral health, community resources, and/or other home and community-based agencies.<h4>Skills</h4>Required:Excellent verbal and written communication skills; with effective charting practices. Excellent organizational, time-management and priority-setting skills.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. Customer Service Skills:&nbsp; Provision of excellent customer service required due to frequent communication with providers, members and interdisciplinary team.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.Ability to maintain strict member confidentiality and complies with all HIPAA requirements.Preferred:&nbsp;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.<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> Required: Travel to offsite locations for work.Salary 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: LVN, Nursing, Travel Nurse, Registered Nurse, Hospice, Healthcare

L.A. Care Health Plan

Managed Long Term Services and Supports Nurse Specialist RN II

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!Full-Time OBYou 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><li>Required commitment is three 12-hour shifts per week for each 10-week session at one of our clinical partner sites. Clinical schedules vary by session and may include weekdays, weekends, or night shifts, depending on the specialty.</li><li>Clinicals are scheduled at healthcare facilities within a 50-mile radius of the Ontario campus, in any direction.</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>#LI-CM1Do 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

Nursing Clinical Faculty - Obstetrics

Salary Range:&nbsp;&nbsp;$102,183.00&nbsp;(Min.) -&nbsp;$132,838.00&nbsp;(Mid.) -&nbsp;$163,492.00&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 Payment Integrity Nurse Coder RN III is responsible for investigating, reviewing, and providing clinical and/or coding expertise/judgement in the application of medical and reimbursement policies within the claim adjudication process through medical record review for Payment Integrity and Utilization Management projects. The position serves as a subject matter expert (SME), performing medical records reviews to include quality audits as well as validation of accuracy and completeness of all coding elements. The position is also responsible for guidance related to Payment Integrity initiatives to include concept and cost avoidance development. This position trains and mentors Payment Integrity Nurse Coder, RN staff. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff.<h4>Duties</h4>Performs Quality Audits to include validation of accuracy and completeness of ICD, Rev Code, CPT, HCPCs, APR, DRG, POA, and all relevant coding elements. Audits can include inpatient, outpatient, and professional claims.Serves cross functionally with Utilization Management, Medical Directors, and other internal teams to assist in identification of overpayments as well as other projects.Serves as SME for all Payment Integrity functions to include both Retrospective Data Mining as well as Pre-Payment Cost Avoidance. Identifies trends and patterns with overall program and individual provider coding practices.Responsible for training and mentoring Payment Integrity Nurse Coder, RN staff.Supports the creation and execution of strategies that determine impact of opportunity and recover overpayments as well as prospective internal controls preventing future overpayments of each applicable pipeline opportunity. Works with both internal and external groups to define and develop cost avoidance measures to ensure continued success.Identifies and defines Payment Integrity issues and reviews and analyzes evidence, utilizes data for the purpose of verifying errors and identifying systemic errors, works as an active team member during scheduled engagements and work collaboratively to achieve the goals of the team, and provides feedback to the team lead on any issues identified during research or claims review.Applies subject expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Ensures that the facts and details are correct so that the project’s/program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed.Performs other duties as assigned.<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>Required:At least 8 years of clinical RN experience.At least 3 years of experience in utilization management or clinical coding.Investigation and/or auditing experience.<h4>Skills</h4>Required:Knowledge in CPT, HCPCS, ICD-9, ICD-10, Medicare, and Medicaid rules and regulations.Knowledge of healthcare reimbursement concepts, health insurance business, industry terminology, and regulatory guidelines.Working knowledge of claims coding and medical terminology.Solid understanding of standard claims processing systems and claims data analysis.Strong project leadership and management skills required; ability to prioritize, plan, and handle multiple tasks/demands simultaneously.Excellent interpersonal, verbal, and written communication skills required with excellent analytical and problem-solving skills. Detail oriented and ability to thrive in fast-paced work environment.Must be collaborative and have the ability to establish credibility quickly with all levels of management across multiple functional areas and be able to present findings across all departments.Must be familiar with coordinating benefits between health plan payers.Advanced knowledge of Microsoft Office suite, including Word, Excel and PowerPoint.<h4>Licenses/Certifications Required</h4>Registered Nurse (RN) - Active, current and unrestricted California LicenseCertified Professional Coder (CPC) designation by the American Academy of Professional Codersand/orCertified Coding Specialist (CCS) designation by the American Health Information Management Association (AHIMA).<h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4>Salary 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, Medical Coding, Registered Nurse, Claims, Medicare, Healthcare, Insurance

Payment Integrity Nurse Coder RN III

<h4>How you'll change lives</h4>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.<h4>What you'll be doing</h4>Patient care. 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. Teamwork. 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.Safety &amp; Quality. 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.

Dialysis Registered Nurse TTS

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!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 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:<ul><li>Education and experience must align with state regulations and comply with the rules and regulations of state authorization agencies.</li><li>Master’s degree in nursing</li><li>Professional nurse licensure required.</li></ul>Schedule:<ul><li>Required commitment is three 10-hour day shifts per week for each 10-week session at one of our clinical partner sites.&nbsp;</li><li>Clinicals are scheduled at healthcare facilities within a 50-mile radius of the Ontario campus, in any direction.</li></ul>#LI-CM1Do 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.

Nursing Clinical Faculty - Med/Surg

Dialysis Registered Nurse

undefinedDo 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.

Pediatrics Simulation Instructor

At American Career College, we share a&nbsp;passion for students and transforming healthcare education!&nbsp;As an associate for a certified Great Place to Work, you will join a collaborative, student-centric culture valuing academic integrity, mutual respect, student learning, service, responsiveness, innovation, diversity, and stewardship.&nbsp; As a part of this team, you will guide students to do more than change their own lives – you will help change the lives of every patient they care for throughout their career. At American Career College, you will have the opportunity to share your expertise and passion with the next generation of nurses.You will make an impact by:&nbsp;<ul><li>Providing leadership in managing and implementing a comprehensive post-secondary program for delivery in support of American Career College, Ontario.&nbsp;</li><li>Participating in budget preparation and fiscal administration, curriculum development and coordination, determination of teaching assignments, supervision and evaluation of faculty, and selection/coordination of program specific external clinical facilities, teaching responsibilities in the classroom and facilitating strategies for passing of the certification/licensure examination</li><li>Providing professional leadership and support for teaching faculty; serves as a mentor and facilitator for faculty assigned; and enables an environment which fosters creativity, responsiveness, and self-responsibility.</li></ul>Your Experience Includes:<ul><li>Two (2) years' experience teaching in pre- or post-licensure registered nursing programs.</li><li>Meet one of the two following requirements:<ul><li>One (1) year's continuous, full-time or its equivalent experience in direct patient care as a registered nurse; or</li><li>Equivalent experience and/or education, as determined by the board.</li></ul></li></ul>Education:<ul><li>A minimum of a master's degree from an academic institution accredited by a regional or national accrediting agency that is recognized by the U.S. Department of Education which includes course work in nursing, education or administration required.</li><li>Current unencumbered Registered Nurse License in California required.</li><li>Current CPR Card.</li><li>American Heart Basic Life Support (BLS) Certification.</li><li>Must have approval by the Board of Registered Nursing (BRN) prior to assuming the role of Director of Nursing.</li></ul>

29 Nursing Jobs in California