This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Utilization Review (UR) Specialist is a Registered Nurse responsible for conducting thorough medical necessity reviews to assist with determining appropriate patient class designation. The UR Specialist will perform timely and comprehensive reviews of the patient chart utilizing InterQual Criteria accurately in conjunction with the UR Department workflows/processes, clinical nursing judgement, and when necessary, discussions with the provider team and/or Medical Director of UR. - Operational Support: - Conducts thorough medical necessity reviews to assist with determining appropriate patient class designation. - Performs timely and comprehensive reviews of the patient chart utilizing InterQual Criteria accurately in conjunction with the UR Department workflows/processes, clinical nursing judgement, and when necessary, discussions with the provider team and/or Medical Director of UR. - Performs appropriate and accurate initial, admission (episode day one) and concurrent utilization reviews as guided by InterQual Criteria and UR Department workflows on all observation, inpatient, and extended recovery admissions as required based on Emory Healthcare's Utilization Management Plan and the UR Department’s processes. - Ensures that all InterQual reviews are supported with provider team documentation and/or clinical data. - When appropriate, utilizes the UR Department's Severity of Illness/Intensity of Service template to document the medical necessity of the admission or continued stay. - Identifies any Avoidable Delays and accurately documents the delay(s) based on the workflow. - Follows the UR Department’s denial workflows as appropriate. - Prioritizes work with minimal guidance for optimal reimbursement and to avoid financial risk to both patient and hospital. - Compliance: - Identifies and completes Medicare Outpatient Observation Notices (MOON), Medicare Change of Status Notice (MCSN), Condition Code 44s and Medicare Hospital Issued Notices of Non-Coverage (HINNs) for Medicare beneficiaries as appropriate. - Ensures compliance with all state of Georgia and Federal regulatory requirements as designated in Emory Healthcare's Utilization Management Plan. - Maintains all required annual competencies, metrics, and fully participates and engages in department process improvements. - Collaboration: - Responsible for timely communication to the provider team and interdisciplinary team as it relates to patient class designation and medical necessity of an admission or continued stay on individual patient basis based on UR Department workflows. - Works closely with the UR Department's Case Management Authorization Specialist IP to ensure that authorized days and patient actual LOS are reconciled to ensure appropriate reimbursement for services provided. - Communicates medical necessity denials for in-house patients to the Medical Director of UR, and when designated to the provider team. - Serves as a resource to the provider team, Interdisciplinary Care Team, and patient to explain external UR regulations. - Provides effective and efficient proactive communication to internal and external customers. - Assists in collaborative efforts with the Case Management Department, Revenue Cycle, Physician Advisors, and other required departments. - Additional Responsibilities: - Ability to multi-task in a fast-paced environment while efficiently handling multiple priorities and ensuring deadlines are met. - Performs other duties and tasks as assigned. Travel: Less than 10% of the time may be required. Work Type: This position is a remote position outside traditional office, often from home or another remote setting. Qualifications - Education: Associate degree in nursing. - Experience: Minimum of 5 years of recent acute hospital experience or a minimum of two years of previous utilization review experience. - Licensure: Must have a valid, active unencumbered Registered Nurse license approved by the Georgia Licensing Board. - Skills: Must meet all quality and productivity expectations and successfully complete yearly competencies. Requirements - Education: Bachelor's degree in Nursing strongly preferred. - Certification: Case Management certification preferred. - Skills: InterQual Level of Care Criteria experience. Previous utilization review experience strongly preferred. Benefits - Comprehensive health benefits that start day 1. - Student Loan Repayment Assistance & Reimbursement Programs. - Family-focused benefits. - Wellness incentives. - Ongoing mentorship, development, and leadership programs. - And more. Company Description Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law. Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare’s Human Resources at careers@emoryhealthcare.org. Please note that one week's advance notice is preferred.

Overview Answer with Care. Guide with Compassion. Support Every Step. We are seeking a dedicated Telephonic Triage RN to join our clinical call center team. This position is responsible for providing high-quality triage and nursing support over the phone for hospice patients and families during after-hours, holidays, and peak volume times. If you're an experienced, compassionate RN with strong clinical judgment and excellent communication skills, we invite you to bring your expertise home—literally. We have two shifts available: 1st shift: Mon: 6pm-2am Tues: 6pm-2am Sat: 9am-9pm Sun: 9am-9pm 2nd shift: Wed: 2am-10am Thur: 2am-10am Fri: 2am-10am Sat: 6pm-2am Sun: 6pm-2am About the Role:The Telephonic Triage Nurse provides timely, expert guidance and support over the phone to hospice patients and families. This critical nursing role includes assessing symptoms, prioritizing calls, managing urgent care needs, and determining when an in-person visit is necessary. Key Responsibilities: - Receive and respond to calls for assigned hospice service areas - Prioritize urgent needs and assess callers’ symptoms to guide care decisions - Assign on-call staff or provide treatment guidance per Plan of Care - Provide education, emotional support, and continuity of care - Collaborate with the interdisciplinary team to manage symptoms and avoid crises - Document all calls accurately in electronic medical record systems - Promote patient/family choices and quality of life at end of life - Participate in Quality Assessment and Performance Improvement programs - Maintain professional and compassionate communication with all stakeholders - Provide triage coverage for multi-state/multi-agency network About You Qualifications: - Graduate of an accredited nursing program - Current Registered Nurse (RN) license in a NLC Compact State - Three (3) years of clinical nursing experience - At least two (2) years of experience in hospice, oncology, long-term care, or home health - Bachelor’s degree in nursing (BSN) preferred - Prior experience in telephone triage strongly preferred - Proficiency in EMR systems and Microsoft Office Suite - Current CPR certification, valid driver’s license, and automobile insurance Work From Home Requirements: - Reliable high-speed internet (minimum 10 MBPS download / 5 MBPS upload) - Dedicated, quiet workspace - Comfortable wearing a headset up to 12 hours - Ability to navigate multiple computer screens (dual monitors + laptop) - Ability to report to nearest Gentiva branch if needed due to equipment issues Skills and Traits for Success: - Deep knowledge of hospice care and end-of-life needs - Strong patient assessment and communication skills - Ability to remain calm, clear, and compassionate in emotional or urgent situations - Adaptable, dependable, and solutions-focused - Strong documentation and time management capabilities - Sensitivity to diverse backgrounds and experiences We Offer Benefits for All Associates (Full-Time, Part-Time & Per Diem): - Competitive Pay - 401(k) with Company Match - Career Advancement Opportunities - National & Local Recognition Programs - Teammate Assistance Fund Additional Full-Time Benefits: - Medical, Dental, Vision Insurance - Mileage Reimbursement or Fleet Vehicle Program - Generous Paid Time Off + 7 Paid Holidays - Wellness Programs (Telemedicine, Diabetes Management, Joint & Spine Concierge Care) - Education Support & Tuition Assistance (ASN to BSN, BSN to MSN) - Free Continuing Education Units (CEUs) - Company-paid Life & Long-Term Disability Insurance - Voluntary Benefits (Pet, Critical Illness, Accident, LTC) Ready to support patients when it matters most?Apply now and bring your nursing skills home. Make every call count. Legalese - This is a safety-sensitive position - Employee must meet minimum requirements to be eligible for benefits - Where applicable, employee must meet state specific requirements - We are proud to be an EEO employer - We maintain a drug-free workplace Location Gentiva Hospice Our Company At Gentiva, it is our privilege to offer compassionate care in the comfort of wherever our patients call home. We are a national leader in hospice care, palliative care, home health care, and advanced illness management, with nearly 600 locations and thousands of dedicated clinicians across 38 states. Our place is by the side of those who need us – from helping people recover from illness, injury, or surgery in the comfort of their homes to guiding patients and their families through the physical, emotional, and spiritual effects of a serious illness or terminal diagnosis. Our nationwide reach is powered by a family of trusted brands that include: - Hospice care: Gentiva Hospice, Emerald Coast Hospice Care, Heartland Hospice, Hospice Plus, New Century Hospice, Regency SouthernCare, SouthernCare Hospice Services, SouthernCare New Beacon - Palliative care: Empatia Palliative Care, Emerald Coast Palliative Care - Home health care: Heartland Home Health - Advanced illness management: Illumia Health With corporate headquarters in Atlanta, Georgia, and providers delivering care across the U.S., we are proud to offer rewarding careers in a collaborative environment where inspiring achievements are recognized – and kindness is celebrated.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Impact Recruiting Solutions is currently seeking a RN Health Care Facility Surveyor to fill an opening with a Quality Improvement Consulting Company and will work in a technically exciting environment supporting internal and external customers nationwide. - The position is 100% remote with up to 75% travel. - The Surveyor will serve as a team member or team leader on various types of surveys (i.e. re-certification, comparative, complaint investigation, and revisits) for long-term care and non-long-term care surveys, which can include: - ambulatory surgical centers (ASC) - Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID) - end-stage renal disease (ESRD) - Psychiatric Residential Treatment Facility (PRTF) - hospital - critical access hospital - hospice facilities - Surveyors travel to healthcare facilities nationally conducting surveys to assess compliance with requirements and regulations guiding the quality of care for residents/customers of the facilities. - The responsibility of the Surveyor is to apply approved survey protocols for conducting on-site surveys. - Specific activities include: - Conduct on-site surveys of Medicare-Medicaid certified health care facilities to determine compliance with Federal regulations. - Surveys require preparations such as off-site preparation, tour of the facility, observation of care, record review, interviews of staff and families, etc. - Determine if care, treatment, and services are consistent with Federal requirements. - Evaluate many aspects of the healthcare facility system from the quality of care to the consumers’ rights and physical plant. - Communicate the non-compliance issues with key personnel throughout the site review and during the exit conference to assure an understanding of the deficiencies cited. - Determine if a plan of correction is acceptable. - Conduct follow-up visits and monitoring surveys to ascertain if facilities’ plans of correction to resolve the deficient practice have been implemented. - Assist with facility and bureau training. Participate in work groups as needed. Qualifications - Must have an Associate or Bachelor’s degree in nursing. - Must have successfully completed CMS’s Long-Term Care Basic Training and passed the Surveyor Minimum Qualifications Test (SMQT). - Must have at least two (2) years of recent experience working as a surveyor accrediting or certifying facilities that serve the residents of long-term care facilities. - Must maintain current licensure to practice as a Registered Nurse (RN). - Demonstrated a history of independent decision-making skills to direct and effectively manage the survey process. - Ability to set priorities independently and collectively in performing survey tasks. - Ability to openly discuss conflicts/controversy, and to seek assistance when appropriate to make decisions and resolve conflicts. - Ability to travel up to 75% of the time on a regular basis is required. Benefits - The salary for this position is $75,000 - 90,000 / yr. - This is a Full-time position (Monday - Friday). - Flexible paid vacation days. - Paid holidays. - Company-issued and company-paid Amex card for travel. - All travel expenses paid directly by the company. - Airline and hotel points accumulate for employee's personal use. - Employee discounts. - Employee retirement plan (401k) with a generous match and immediate vesting. - Company-paid tax-free Health Savings Account (HSA). - Health insurance. - Dental insurance. - Vision insurance. - Company-paid life insurance. - Company-paid disability insurance. - Extensive training opportunity. - Predictable work schedule.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Join a cardiology team where you manage telehealth workflows and work fully remote. Role: Remote Medical Assistant – Cardiology Telehealth Location/Type: Remote • Eastern Time Zone preferred (Hybrid option in Columbia, MD) Pay: $18–$20 per hour Schedule: Monday–Friday • 7:30am–4:00pm EST Our client operates a structured virtual cardiology care model supporting patients through telehealth visits. This is not a hands-on clinical Medical Assistant role. You will not room patients, take vitals, or assist with injections. Instead, you will support cardiology providers by managing telehealth workflows, patient coordination, and real-time EMR documentation. This role is best for MAs who enjoy organization, documentation, and keeping provider workflows moving in a high-volume environment. What You'll Do - Support cardiology providers during live telehealth visits - Document patient encounters in real time within the EMR - Manage provider inbox and patient portal messages - Coordinate labs, referrals, and follow-up scheduling - Prioritize multiple patient coordination tasks independently - Maintain efficient telehealth workflows across providers - Guide patients through telehealth visit workflows during live video appointments - Communicate clearly with patients and providers during virtual visits - Maintain a professional and confident video presence when interacting with patients Qualifications - Active Medical Assistant certification - 3+ years outpatient Medical Assistant experience - Direct telehealth visit support experience - Cardiology or cardiac-focused internal medicine exposure - Experience in high-volume or high-acuity specialty clinics - Strong EMR documentation and workflow management skills - Ability to work independently in a remote environment - Reliable high-speed internet and dedicated workspace - Availability during 7:30am–4:00pm EST - Clear verbal communication skills when supporting patients and providers during telehealth visits - Comfortable appearing on video while assisting with virtual patient appointments Requirements - Epic, Cerner, Athena, or similar EMR systems - Experience managing provider inbox or task lists - Experience supporting multiple providers Benefits - Pay: $18–$20 per hour - Medical, dental, vision benefits - 401(k) - PTO + paid holidays - Opportunity to grow into Lead Medical Assistant Schedule & Setup - Monday–Friday schedule - 7:30am–4:00pm EST - Fully remote role - Hybrid option available for candidates near Columbia, MD (1 day remote per week) - Modern office located in a luxury high-rise building in Columbia, MD - No hands-on patient contact Impact & Growth Your work keeps cardiology providers focused on patient care while telehealth workflows stay organized and efficient. High-performing Medical Assistants can grow into Lead MA roles within their site. Many team members pursue nursing school, and the organization hires nurses internally. This creates a potential pathway for MAs who later transition into future nursing roles within the organization. The company is a fast-growing virtual cardiology organization backed by leading healthcare investors, supporting continued expansion of its telehealth care model. You like pace and ownership. You start, finish, follow through. At Urrly, fairness matters. We use AI to review every application against the same clear requirements for the role. This means every candidate is evaluated on job-related factors like skills, certifications, and experience—not on personal attributes such as gender, race, age, or background. Our goal is to create a more objective, consistent, and equal opportunity hiring process for all applicants. Apply Today to work remotely while supporting cardiology telehealth care.