4325 clinical nurse ii jobs found

Atrius Health is a nonprofit healthcare leader delivering a system of connected care that enables us to know our patients better so that we can serve them well. Across 32 clinical locations, more than 50 specialties and 825 physicians, we provide proactive, customized care to more than 720,000 adult and pediatric patients across eastern Massachusetts. The Atrius Health practices including Dedham Medical Associates, Granite Medical Group, Harvard Vanguard Medical Associates and PMG Physician Associates - together with VNA Care - work in collaboration with hospital partners, community specialists and skilled nursing facilities, to develop innovative and effective ways of delivering care in the most appropriate setting, making it easier for patients to be healthy. We believe that by establishing a solid foundation of knowledge, understanding and trust with each of our patients, we enrich their health and enhance their lives. SUMMARY Responsible for the management and...

Job description to be created Atrius Health is an equal opportunity/affirmative action employer and does not discriminate in recruiting, hiring, training, promoting or any other employment practices on the basis of race, color, religion, sex, marital status, age, sexual orientation, gender identity, national origin, military service or application for military service, veteran or disability status.Applicants have rights under Federal Employment Laws: Family and Medical Leave Act (FMLA);Equal Employment Opportunity (EEO); and Employee Polygraph Protection Act (EPPA).VEVRAA Federal ContractorRequest Priority Protected Veteran & Disabled Referrals for all of our locations within the statePDN-96e3caa9-1389-4f93-86ce-8d263ea36e41

TBD Atrius Health is an equal opportunity/affirmative action employer and does not discriminate in recruiting, hiring, training, promoting or any other employment practices on the basis of race, color, religion, sex, marital status, age, sexual orientation, gender identity, national origin, military service or application for military service, veteran or disability status.Applicants have rights under Federal Employment Laws: Family and Medical Leave Act (FMLA);Equal Employment Opportunity (EEO); and Employee Polygraph Protection Act (EPPA).VEVRAA Federal ContractorRequest Priority Protected Veteran & Disabled Referrals for all of our locations within the statePDN-970e0949-fc02-4069-83bc-dbf971070b52

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Conduct screening and risk assessment interventions per program guidelines. Act as primary liaison for members and staff. Assist with aspects of the member’s care, including referrals to community resources. • Identify special needs members through the completion of health screens and other resources • Work with community outreach/member advocates to coordinate member care • Educate providers and community resources on program components and available support services • Educate members with special needs to foster compliance with program and positively impact outcomes • Conduct site visits as appropriate for programs and provide support to other special programs • Develop and modify...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Conduct screening and risk assessment interventions per program guidelines. Act as primary liaison for members and staff. Assist with aspects of the member’s care, including referrals to community resources. • Identify special needs members through the completion of health screens and other resources • Work with community outreach/member advocates to coordinate member care • Educate providers and community resources on program components and available support services • Educate members with special needs to foster compliance with program and positively impact outcomes • Conduct site visits as appropriate for programs and provide support to other special programs • Develop and modify...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. This is a hybrid role and LVN are needed. Service Coordinators will do member visits 2-3 days a week for assessments. Mileage reimbursement is available. The remaining 2-3 days of the work week are fully remote from home doing documentation and outreach. Applicants must reside in San Antonio. Position Purpose: Determine needs and eligibility of members for various services through field-based collaboration with medical, behavioral, and social support staff. Conduct screening and risk assessment interventions per program guidelines. Conduct in-home face to face member assessments and telephonic outreach Document assessments and contacts, develop and approve service plans, and ensure authorizations...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Promote the quality and cost effectiveness of medical care by applying clinical acumen and the appropriate application of policies and guidelines to emergent/urgent and continued stay reviews. • Perform onsite review of emergent/urgent and continued stay requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other determinations • Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings • Collaborate with various staff within provider...

You could be the one who changes everything for our 26 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. • Review medical records to determine if bills submitted by providers match the supporting documentation • Assist the health plans with preventative measures including educational materials, payment holds, new/changed payment policies, etc. • Meet with Medical Director(s) to validate medical decisions and track cost savings based on clinical denials • Identify billing isssues that can be resolved through claim system editing • Use antifraud detection software to create reports that identify potential high dollar cases and provide medical guidance for potential abuse and fraud cases • Providing medical guidance for potential waste, abuse, and fraud cases ****Position is REMOTE****...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Care Manager II (RN) - Remote - Florida Position Purpose: Remote Position, South Florida Region. 5% travel to in person office meetings. Seeking an RN with LTC Case Management Experience. Bilingual (Spanish/English). Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care. • Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options • Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care. • Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options • Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes • Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Provides Case Management services to a specific clientele. Systematically identify and addresses fragmentation of care, and fill gaps in are using proactive initiatives. Assesses medical records for appropriateness, level of care provided and criteria determination. Identifies appropriate care for patients by evaluating high-risk cases, intensity and complexity of services, health care costs and non-compliance issues. Coordinates care between multiple providers. Develops care plans in coordination with providers, patients, families as appropriate and assess the effectiveness. Organizes and schedules training for all new Case Management employees. May conduct periodic quality assurance...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Responsible for members gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation, care plan development, assessment, and care coordination. Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services for care plan development Monitor delivery of services and follow-up with members, caregivers, or providers through in person visits and telephonic contact Authorize and coordinate referral for services Ensure provider services are delivered without gaps and identify functional deficiencies in plans of care Assist in...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Conduct screening and risk assessment interventions per program guidelines. Act as primary liaison for members and staff. Assist with aspects of the member’s care, including referrals to community resources. • Identify special needs members through the completion of health screens and other resources • Work with community outreach/member advocates to coordinate member care • Educate providers and community resources on program components and available support services • Educate members with special needs to foster compliance with program and positively impact outcomes • Conduct site visits as appropriate for programs and provide support to other special programs • Develop and modify...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care. • Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options • Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes • Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care. ** This role requires between 25% - 50% local travel in Eau Claire / Northern Wisconsin area. Candidates will have flexibility to work remotely from their home during the remaining time ** • Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options • Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Responsible for members gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation, care plan development, assessment, and care coordination. Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services for care plan development Monitor delivery of services and follow-up with members, caregivers, or providers through in person visits and telephonic contact Authorize and coordinate referral for services Ensure provider services are delivered without gaps and identify functional deficiencies in plans of care Assist in...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care. • Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options • Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes • Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Care Manager II (RN) - Field - Home Health - Bexar SDA/ San Antonio and surroundings areas/counties. 100% remote with the ability to complete face-to-face visits with members within Bexar service delivery area. Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care. • Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options • Utilize assessment skills and discretionary judgment to develop plan of care based upon...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Determine needs and eligibility of members for various services through field-based collaboration with medical, behavioral, and social support staff. Conduct screening and risk assessment interventions per program guidelines. Conduct in-home face to face member assessments and telephonic outreach Document assessments and contacts, develop and approve service plans, and ensure authorizations are completed Conduct follow-up contacts or in-person visits to determine if services meet member’s needs Assess member’s medical, safety and support service needs and coordinate the delivery of services Provide education related to member’s health condition and care Assist with modification and...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Determine needs and eligibility of members for various services through field-based collaboration with medical, behavioral, and social support staff. Conduct screening and risk assessment interventions per program guidelines. Conduct in-home face to face member assessments and telephonic outreach Document assessments and contacts, develop and approve service plans, and ensure authorizations are completed Conduct follow-up contacts or in-person visits to determine if services meet member’s needs Assess member’s medical, safety and support service needs and coordinate the delivery of services Provide education related to member’s health condition and care Assist with modification and...