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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.<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. &nbsp; ESSENTIAL DUTIES AND RESPONSIBILITIES include the following.&nbsp; Other duties and tasks may be assigned.</li><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>Salary / Compensation StatementCompensation for the role will depend on several factors, including a candidate's experience, qualifications and skills. U.S. Renal Care offers a comprehensive total rewards package, which includes a 401k match, healthcare coverage, and a broad range of other benefits.

U.S. Renal Care

Dialysis Registered Nurse - Peritoneal RN - We Will Train!

<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

Position SummaryThe role of the Certified Nurse Assistant (CNA) is to work collaboratively with physicians, providers, nurses, and patients through a variety of tasks related to patient care with a focus on patient experience, safety, quality and efficiency.&nbsp; The CAN directly assists nurses with patient care, operating under the direction and supervision of the Registered Nurse in charge of the team and/or unit.The CNA acts as a patient care coordinator and advocate, monitors patient status, ensures proper documentation and an optimal patient flow and experience, following OSHA/WISHA/other compliance and regulatory guidelines.Location: Candidate must be able to go between Bellevue and Issaquah clinic locations&nbsp;Key Duties and ResponsibilitiesThe Certified Nurse Assistant is expected to perform position-related duties including, but not limited to:<ul><li>Provide basic nursing care to non-acutely ill patients within the ASC</li><li>Provide general care that meet psychosocial or physical needs or both simultaneously</li><li>Assist in admission, transfer and discharge of patient.</li><li>Perform basic care responsibilities considering needs specific to the standard of care</li><li>Demonstrate ability to communicate to the RN any observed changes in patient status</li><li>Maintain awareness of the needs of the pediatric, geriatric and patient population</li><li>Demonstrate ability to perform treatments and provide services within scope of practice.</li><li>Communicate appropriately and clearly to team leader, co-workers and physicians.</li><li>Demonstrate an ability to be flexible, organized and function under stressful situations.</li><li>Respond to patient in emergency or physically distressful situations.</li><li>Treat patients and their families with respect and dignity; ensures patient confidentiality.</li><li>Meet current documentation standards and policies and completes within shift.</li><li>Manage and operates equipment safely and correctly.</li></ul>Education/Experience<ul><li>High school graduate or the equivalent is required</li><li>Completion of supervisory course, and course work in a related field preferred. </li><li>Graduate from an accredited Certified Nursing Assistant program. </li><li>Current Basic Life Support certification required. </li><li>Advanced Cardiac Life Support certification and Pediatric Advanced Life Support certification preferred.</li><li>1-2 years’ experience in a medical office a plus</li></ul>Knowledge, Skills and Abilities<ul><li>Basic knowledge of medical terminology and medications</li><li>Familiarity with or working knowledge of Electronic Medical Records a plus</li><li>Basic computer knowledge and skills, including data entry</li><li>Superior customer service skills</li><li>Impeccable integrity</li><li>Great interpersonal skills; demonstrating patience, compassion, empathy and the ability to work well with all types of people</li><li>Adherence to all safety, risk management and precautionary procedures, including the consistent respect for confidentiality (HIPAA) </li><li>Use time efficiently, with attention to quality, detail, accuracy and completion</li><li>Consistency, timeliness and dependability</li><li>Effective team membership, supporting and working with others to achieve common goals</li><li>Ability to adapt to continuous change/flexibility </li><li>Demonstrated ability to continuously learn</li><li>Self-motivated; able to work with increasing independence, overcome obstacles and challenges with little supervision</li><li>Clear oral and written communication skills</li><li>Demonstrated aptitude to organize and prioritize work </li><li>Critical thinking and problem-solving skills</li><li>Skilled in coping with fast paced often stressful situations with unpredictable circumstances in a professional, safe, and efficient manner</li><li>Self-motivated; able to work following specific guidelines and in accordance with detailed instructions; measure self against standard of excellence, overcome obstacles and challenges with little supervision</li></ul>Work Environment/Physical DemandsThe work environment/physical demands described here are representative of those that must be met by an associate to successfully perform the essential functions of this job.&nbsp; Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Proliance Surgeons

Certified Nurse Assistant (CNA)

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>

Dialysis Licensed Vocational Nurse - LVN Chronic In-center

Dialysis Registered Nurse - Floater

Position SummaryThe role of the Licensed Practical Nurse (LPN) is to work collaboratively with physicians, providers, nurses, and patients through a variety of tasks related to patient care with a focus on patient experience, safety, quality and efficiency.&nbsp; The LPN acts as a patient care coordinator and advocate, maintains clinical supplies, proper documentation and an optimal patient flow and experience, following OSHA/WISHA/other compliance and regulatory guidelines.Key Duties and ResponsibilitiesThe key duties and responsibilities of the Licensed Practical Nurse include, but are not limited to:<ul><li>Assist in providing direct patient care for office visit patients may involve </li><ul><li>Arranging the exam room instruments and equipment and maintaining supplies</li><li>The disposal of contaminated supplies and sterilizing medical instruments</li><li>Positioning patients for exams and procedures</li><li>Collecting and preparing laboratory specimens</li><li>Obtaining vitals, patient history and chief complaints</li><li>Other patient care related duties as necessary</li></ul><li>Assist provider with in clinic procedures may involve </li><ul><li>Preparing patient exam, dressing and/or surgical areas by using vigorous aseptic technique.</li><li>Holding patients in position for extended periods of time, manipulating body parts, using instruments to hold surgical or imaging areas immobile, or positioning patients on tables</li><li>Handing provider instruments while standing for long periods of time</li></ul><li>Report test results to patients as indicated by physician in a timely manner</li><li>Chart all vital information in electronic record as well as check to be sure all information related to medication, health history and reason for visit is obtained and documented</li><li>Perform phone triage, post-op calls and respond to voicemail messages directed to them preferably within same business day, but no later than 24 business hours, and perform action required. Documents all encounters.</li><li>Maintain patient documentation for visit and communications in person or over the phone</li><li>Coordinate care and diagnostic testing at other facilities as indicated by physician</li><li>Obtain CT authorization and other prior authorization as needed and requested</li><li>Assist provider in e-scribing, maintaining medication list</li><li>Assist provider in maintaining communication with referring doctors</li><li>Maintain equipment and ensure supplies are stocked and in place</li><li>Follow all other daily team duties and special tasks as assigned</li></ul>Education/Experience<ul><li>High school graduate or equivalent</li><li>Graduate of an accredited LPN Program required</li><li>Current Washington State LPN license required</li><li>1-2 years’ experience in a medical office a plus</li></ul>Knowledge, Skills and Abilities<ul><li>Problem solving skills</li><li>Skill in using a computer</li><li>Knowledge of applicable specialties</li><li>Outpatient clinical organizational ability</li><li>Ability to remove oneself personally from given situations, remaining objective</li><li>Ability to exhibit cooperation, flexibility, and provide assistance when interfacing with patients, physician and staff</li><li>Ability to multi-task</li><li>Skill in organizing and reporting information that is accurate and complete</li><li>Understanding of the need for and evidence of consistent respect for confidentiality/HIPAA </li><li>Ability to maintain composure in stressful situations</li><li>Skill in establishing and maintaining effective working relationships with all staff</li><li>Ability to prepare records in accordance with detailed instructions</li><li>Ability to communicate clearly</li><li>Consistency and timeliness in attendance</li></ul>Work Environment/Physical DemandsThe work environment/physical demands described here are representative of those that must be met by a teammate to successfully perform the essential functions of this job.&nbsp; Reasonable accommodations may be made to enable differently abled persons to perform the essential functions.

Licensed Practical Nurse (LPN)

<h4>Thank you for your interest in a career at NeighborHealth, formerly East Boston Neighborhood Health Center!</h4>Everywhere you turn, you can feel the immeasurable level of enthusiasm here at NeighborHealth! We are one of the largest community health centers in the country, supporting the greater Boston area and focusing on the well-being of our patients and local community. From the nurses and physicians on the front line of patient care, to the managers who lead and guide our staff, to the many support roles that keep our facilities running smoothly - everyone plays a vital role in improving medicine for our patients.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: The Nurse Practitioner may approach patients between the age of 0 to 20 and with all types of conditions; elicit histories; perform examinations; order, perform and interpret diagnostic studies; order and perform therapeutic procedures; instruct and counsel patients regarding physical and mental health issues; respond to life threatening situations; and facilitate the appropriate referral of patients; consistent with his or her supervising physician’s scope of expertise and responsibility delegated to him or her by the supervising physician.Essential Duties &amp; Responsibilities:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Obtains comprehensive and problem focused health history&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Performs a comprehensive and problem focused physical exam&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Orders and interprets screening and diagnostic tests&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Demonstrates critical thinking and diagnostic reasoning skills in clinical decision making.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Communicates with patients re: clinical findings&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Initiates appropriate and timely consultations (NP, PA &amp; MD)Qualifications and Requirements:MA License as Nurse PractitionerBLS/ALS/PALS Certification as required by deptWill require one evening a week and 1 weekend day a month.

Nurse Practitioner

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;<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.&nbsp;</li></ul> 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>

Dialysis Registered Nurse, Home Hemo & Peritoneal RN

Position SummaryWashington isn’t a sit-down kind of state, and the team at Proliance Orthopedic Associates understands this better than anyone. Our orthopedic specialists have a true passion for the active Washington lifestyle, and it fuels our approach to help each patient achieve their personal best.&nbsp;We are currently seeking dynamic, experienced professionals as well as new aspiring graduates, to join our treatment team located in the southeast region of Seattle. Are you a leader, can you share your knowledge to grow an even stronger team? If so, we want you! If you want to be a part of a team where bi-directional feedback, innovation, and patient outcomes are paramount, join us today!&nbsp;“Exceptional Outcomes, Personally Delivered” &nbsp;Benefits of joining the Proliance Orthopedic Associates Physical Therapy:&nbsp;<ul><li>Proliance is the most prestigious and comprehensive, integrated approach to orthopedic care in Washington.&nbsp;</li><li>Enjoy a collaborative learning environment that fosters personal and professional growth.&nbsp;</li><li>Available opportunities to engage in mentorship and/or leadership programs.&nbsp;</li><li>You and your family will enjoy all the benefits of the multi-season, Washington lifestyle.&nbsp;</li><li>Our excellent benefits package includes: a competitive base salary, a productivity bonus plan, and annual stipend for continuing education and paid days.</li></ul>We are proud to offer a comprehensive and competitive benefit and pay package including health coverage, 401k with match and profit share, PTO and more! Check out our main career site for more details at <a href="http://www.proliancesurgeons.com/careers" target="_blank">www.proliancesurgeons.com/careers</a> &nbsp;Be Part of Who We Are!&nbsp;Position SummaryThe Physical Therapist is responsible for delivering exceptional patient care while performing evaluations as well as developing and administering treatment plans for a wide variety of outpatient conditions.Key Duties and ResponsibilitiesThe key duties and responsibilities of the Physical Therapist include, but are not limited to:<ul><li>Routinely evaluate and treat outpatient conditions in consultation with physician&nbsp;</li><li>Occasionally evaluate and treat outpatient conditions under direct access&nbsp;</li><li>Effectively determine and apply a wide variety of therapeutic exercises, modalities, manual therapy, and other treatments in accordance with state practice act&nbsp;</li><li>Apply lawful and ethical use of therapy services in daily treatments&nbsp;</li><li>Document patient care services according to regulatory and department guidelines&nbsp;</li><li>Direct supervision of a Physical Therapist Assistant (PTA) may be required&nbsp;</li><li>Collaborate with physicians, managers and staff across the organization&nbsp;</li><li>Ability to work in a fast-paced outpatient orthopedic setting&nbsp;</li><li>Ability to work a flexible schedule based on clinic needs including but not limited to variable shifts, multiple clinic locations, etc.&nbsp;</li><li>Maintain safe environment for self, staff and patients&nbsp;</li><li>Participate in continuing education in order to maintain state license&nbsp;</li><li>Routinely participate and share knowledge obtained from continuing education courses with staff and the community at the direction of the department or organization.&nbsp;</li><li>Occasionally participate in community functions relating to outreach events throughout the yea&nbsp;</li><li>Any and all other duties as assigned&nbsp;</li></ul>Education/Experience<ul><li>Graduate from an accredited Physical Therapy program; Bachelor’s Degree required, Master’s or Doctorate Degree preferred</li><li>Active Washington state license in Physical Therapy or&nbsp;application in process.&nbsp;</li></ul>Key Duties and Responsibilities<ul><li>Comply with company policies, procedures, practices and business ethics guidelines.&nbsp;</li></ul><ul><li>Complete job required training.&nbsp;</li></ul><ul><li>Comply with all applicable laws and regulations, (e.g. HIPAA, Stark, OSHA, employment laws, etc.)&nbsp;</li></ul><ul><li>Demonstrate prompt and reliable attendance&nbsp;</li></ul><ul><li>Work in the clinic, office or surgery center during business hours &nbsp;</li></ul><ul><li>Travel independently throughout the clinic, office or surgery center (which may include movement from floor to floor); frequent bending, lifting, standing, stooping or sitting for long periods of time may be required&nbsp;</li></ul><ul><li>Work at an efficient and productive pace, handle interruptions appropriately and meet deadlines&nbsp;</li></ul><ul><li>Communicate and interact in a respectful and professional manner&nbsp;</li></ul><ul><li>Prioritize workload while being flexible to meet the expectations of the daily operations&nbsp;</li></ul><ul><li>Apply principles of logical thinking to define problems, establish facts, and draw valid conclusions&nbsp;</li></ul><ul><li>Understand and execute a variety of instructions&nbsp;</li></ul><ul><li>Effectively operate equipment and communicate on and operate the phone system&nbsp;</li></ul><ul><li>Work independently with minimal supervision&nbsp;</li></ul>Work Environment/Physical DemandsThe work environment/physical demands described here are representative of those that must be met by an associate to successfully perform the essential functions of this job.&nbsp; Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Work may be performed in an office and clinical environment.&nbsp; Requires corrected vision and hearing to normal range.&nbsp; While performing the duties of this job, the associate is regularly required to talk or hear.&nbsp; The associate is required to sit for long periods of time, stand and walk, bend and stretch.&nbsp; Use of telephone and computer is required.&nbsp; Manual dexterity required for use of computer keyboard. Occasionally lifts and carries items weighing up to 40 pounds. May requires working under stressful conditions or working irregular hours.CommentsThis description is intended to describe the essential job functions, the general supplemental functions and the essential requirements for the performance of this job.  It is not an exhaustive list of all duties, responsibilities and requirements of a person so classified.  Other functions may be assigned, and management retains the right to add or change the duties at any time.&nbsp;

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