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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.&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>

U.S. Renal Care

Dialysis Registered Nurse, Home Hemo & Peritoneal RN

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.

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 - RN Chronic In-center **$10,000.00 Sign-on Bonus**

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.&nbsp;</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>

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.&nbsp;</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; &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>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.

Dialysis Registered Nurse, Peritoneal RN - We Will Train!

Dialysis Registered Nurse Part-time - RN Chronic In-center

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.The work location is McAllen, TX but the nurse will also cover patients at Harlingen, San Benito, and Weslaco as needed.<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>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>

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>

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

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