Overview Johns Hopkins Intrastaff is the internal staffing agency for the Johns Hopkins Health System and partner hospitals, providing temporary support to a variety of Johns Hopkins locations. Our employees are the strength of our service. Intrastaff is unique because it's one of the very few agencies where a person has the benefit of being a temporary employee and also feels like a member of a large organization. Working at Hopkins means joining a culturally diverse team that includes some of the best nurses, physicians, and allied health professionals in the world. Directly or indirectly, you'll have exposure to cutting-edge technology and groundbreaking medical research. Shift: Mon – Fri, 8:00am-5:00pm EST Work Location- REMOTE No call, holiday, or weekend There is no direct patient care; this is a medical review position only. $55/hr Responsibilities Facilitating and coordinating programs that may include hospital inpatients, outpatients, families, community, and employees of both the hospital and the university by providing evidence-based care based on the nursing process, policies, procedures, and protocols of the Johns Hopkins Hospital. Providing direction to/management of other team members to promote quality, safety, and excellence in care. Working collaboratively with and providing leadership for a multidisciplinary health care team to support program initiatives that support quality, safety, and excellence in care. Participating in promoting and identifying quality improvement initiatives (clinical, financial, operational) that support, protects and promotes area of specialty. Initiating and participating in the research activities relevant to the specialty area. Implementing initiatives in the area of specialty as directed by nursing and medical leadership. Fostering a clinical environment of service excellence. Duties: Responsible for the day-to-day management of health confined plan members in acute care and/or rehabilitative facilities. The Utilization Nurse (UN) actively monitors the appropriateness of care received by plan members in a variety of settings, such as acute hospitals, sub-acute hospitals, and acute rehabilitation facilities. The Utilization Nurse applies member benefits and medical criteria to determine authorization of services in coordination with the Medical Directors. The Utilization Nurse proactively initiates discharge planning for members, including identification of post-discharge needs and coordination of post discharge referrals/services. The UN communicates verbally and in writing authorization and/or denial of covered services with providers, facilities, and members. The UN is a member of the administrative and clinical teams in the area of assignment. Clinical knowledge is maintained and updated, and UN must maintain acceptable documentation and quality standards. Skills: Excellent verbal and written communication skills to effectively interact and work correctly with enrollees, Physicians facility staff, and management staff. Work requires excellent interpersonal skills and an attitude to effectively project a positive image of our Managed Care Program. Computer skills working with a variety of applications and online systems. Knowledge of Enterprise and utilizing various criteria sets, i.e., InterQual. Ability to negotiate and resolve conflicts with external customers. Qualifications Required: Active RN License, (5) years RN experience, Current UR experience; EPIC and referral platforms such as NaviHealth or AllScripts. Knowledge and use of Proficiency using InterQual and/or Milliman criteria software systems, and managed care experience in utilization review for at least 1 year preferred. BLS certification. Johns Hopkins Health System and its affiliates are Equal Opportunity / Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.

It’s an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances. Job Summary: The Inpatient Utilization Management Clinician is responsible for evaluating all inpatient medical treatments for medical necessity, monitoring ongoing treatment, facilitating discharge planning to ensure smooth and successful transitions of care, and collaborating with care management and medical directors to support members in achieving optimal health outcomes. Our Investment in You: · Full-time remote work · Competitive salaries · Excellent benefits Key Functions/Responsibilities: · Performs utilization review activities, including concurrent, and retrospective reviews of inpatient cases applying evidenced-based InterQual® criteria and Medical Policy. · Obtains clinical information using facility EMR, where accessible, to assess and expedite timely decisions. · Determines medical appropriateness of inpatient services following evaluation of medical and contractual guidelines. · Utilizes decision-making and critical-thinking skills in the review and determination of coverage for medically necessary health care services. · Reviews, documents, and communicates all utilization review activities and outcomes including, but not limited to, all inquiries made and received regarding case communication. · Refers cases to Physician Reviewer when the treatment request does not meet medical necessity per guidelines, or when guidelines are not available. · Referrals must be made in a timely manner, allowing the Physician Reviewer time to make appropriate contact with the requesting provider in accordance with departmental policy and within each Medicaid, ACA, CMS or NCQA mandated turnaround times (TAT). · Monitors inpatient cases for compliance with contractual obligations and regulatory requirements, ensuring timely reviews and authorizations. · Demonstrates strong interpersonal and communication skills when conducting reviews, interacting with physicians and staff, and ensures compliance with training on related policies and procedures. · Sends appropriate system-generated letters to provider and member · Provides guidance and coaching to other utilization review nurses and participate in the orientation of newly hired utilization nurses · Participates in discussions with the facility discharge planning team to improve the progression of care to the most appropriate level of care. · Identify delays in care or services and manage with MD. · Consults with the Medical Director, as needed, for complex cases. · Follows all departmental policies and workflows in end-to-end management of cases. · Participates in team meetings, education, discussions, and related activities · Maintains compliance with Federal, State and accreditation organizations. · Identifies opportunities for improved communication or processes · May participate in audit activities and meetings · Documents rate negotiation accurately for proper claims adjudication · Identify and refer potential cases to Care Management · Performs all other related duties as assigned Qualifications: · Active, unrestricted RN license in state of residence. Education: · Nursing degree or diploma required, bachelor’s degree in nursing Preferred/Desirable: · Bachelor’s degree · RN license in state of MA, NH or compact license · Medicare and Medicaid knowledge Experience: · 2+ years utilization review experience and evidence-based guidelines (InterQual Guidelines) · Managed care experience · Experience performing discharge planning · All employees working remotely will be required to adhere to Wellenses’ Telecommuter Policy Licensure, Certification or Conditions of Employment: · Active, unrestricted RN license in state of residence · Pre-employment background check · Ability to take after hours call, including evening/nights/weekends Competencies, Skills, and Attributes: · Strong oral and. written communication skills. · Strong clinical judgement and critical thinking skills to assess complex cases and determine appropriate levels of care. · Excellent communication and interpersonal skills to engage effectively with internal and external stakeholders · Ability to work independently in a remote environment while maintaining adherence to timeliness and regulatory requirements. · Proficiency in Microsoft Office applications and data management systems. · Demonstrated organizational and time management skills · Strong analytical and clinical problem-solving abilities with focus on quality improvement initiatives Working Conditions and Physical Effort: · Fully remote position with possible travel to the Charlestown, MA office for team meetings and training sessions. · Fast paced and dynamic work environment requiring adaptability and focus. · Minimal physical effort required; primarily desk-based tasks such as documentation and virtual meetings. · Regular and reliable attendance is essential. Compensation Range $35.58 - $51.68 This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensure as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, WellSense offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family wellbeing. Note: This range is based on Boston-area data, and is subject to modification based on geographic location. About WellSense WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees

We are seeking a dynamic Travel Registered Nurse (RN) or Travel Licensed Practical Nurse (LPN) to join our Skyview At Bridgeport (Bridgeport, NE) location. At Skyview At Bridgeport we talk about culture, and we want to grow our employees into a culture of grace and compassion, leading with integrity, and the ability to have a say in how your job fulfills you! We are dedicated to the provision of quality healthcare and living accommodations for our residents. We are looking for candidates who want to serve the vulnerable population with care, compassion, and integrity. We "see" our residents, and we consider their physical, mental, and emotional well-being daily, so we can consistently individualize our care for them. This isn't just a job. This is a human, servant leader-based position. Come...grow with us! Day Shift /Night Shift/Holiday - 6am-6pm/6pm-6am 8-13 week assignment Housing is free- we provided (hotel, but we prefer to put you up in an apartment) Mileage : reimbursed at .40cents per mile! $27/day per-deim while you travel to and from the facility - daily if the housing we provide does not have a kitchen/kitchenette Full-time with OT available The RN/LPN is responsible for supporting the Nursing Department in the entire operation of nursing services. The essential duties include, but are not limited to: - Have a working knowledge of, and access to state regulations and federal standards and act according to those regulations and standards. - Supervise nursing staff. - Ensure that all nursing equipment is in safe and usable condition and all supplies are available. - Ensure that established policies and procedures are followed. - Be aware of all residents’ conditions and to report to the DON pertinent data on residents and staff. - Report changes in resident’s condition to physicians and families. - Make daily rounds on all condition changes, all critical residents, and all residents exhibiting unusual behavior and/or problems. - Coordinate resident services within the facility. - Must be able to assume charge nurse duties if needed in an emergency. - Audit charts periodically, checking for omissions and/or errors. - Investigates all incident reports. - Assist staff nurses with admissions, discharges, and transfers. Educational Requirements: Candidate Must be certified in the state of Nebraska as a RN/LPN. The competitive pay range for this position is $45.00 to $55.00. Consideration will be made commensurate with experience.

Role Description Ambulante Neurologie mit maximaler Flexibilität: In diesem MVZ für Psychiatrie und Neurologie bei Braunschweig profitieren Sie von verlässlichen Arbeitszeiten ohne Dienste, einem individuell gestaltbaren Therapieraum sowie der Option, einen Teil Ihrer Tätigkeit im Homeoffice zu erledigen oder anteilig telemedizinisch zu arbeiten. So kombinieren Sie eine professionelle Umgebung mit modernen Arbeitsbedingungen – und gestalten Ihren Arbeitsalltag, wie er zu Ihnen passt. - Position: Facharzt für Neurologie (m/w) - Fachrichtung: Neurologie - Einrichtungstyp: MVZ - Arbeitszeit: Vollzeit, Teilzeit - Beginn: Zum nächstmöglichen Zeitpunkt - Arbeitsort: Großraum Braunschweig Stellendetails: Sie betreuen ein breites neurologisches Behandlungsspektrum in einem sehr gut ausgestatteten MVZ. Neben der eigenverantwortlichen Diagnostik und Therapie setzen Sie auf Wunsch individuelle Schwerpunkte und gestalten Ihren Therapieraum nach Ihren Vorstellungen. Sie profitieren von einer klaren Entlastung in der Administration und verlässlichen Arbeitszeiten ohne Dienste. Die Dokumentation (ca. 20 % der Arbeitszeit) kann flexibel aus dem Homeoffice erfolgen. Auf Wunsch ist zudem eine anteilige telemedizinische Versorgung möglich. Benefits - Attraktive Vergütung + leistungsbezogene Vergütungsbestandteile - Betriebliche Altersvorsorge - Eigener Therapieraum, der individuell gestaltet werden kann - Keine Dienste, auch keine KV-Dienste - Flexible Arbeitszeiten – individuell gestaltbar - Vereinbarkeit von Beruf und Privatleben - Die Dokumentation (ca. 20% der Arbeitszeit) kann aus dem Home-Office erledigt werden. Firmen-Laptop wird gestellt. - Auf Wunsch bis zu 30% Telemedizin möglich - Entlastung von bürokratischen Aufgaben - Strukturierte Einarbeitung in den ambulanten Praxisalltag - Gruppeninterne Fortbildungsformate für die Fortbildungspunkte angerechnet werden. - Förderung auch externer Fortbildungen - Jobrad-Leasing möglich Qualifications - Deutsche Approbation - Facharzttitel in Neurologie - Fachliche Kompetenz und eigenverantwortliches Arbeiten Your Application Sie fühlen sich angesprochen? Dann bewerben Sie sich jetzt bequem über den „Bewerben-Button“. Ihre Daten werden bei uns selbstverständlich streng vertraulich behandelt. Diese Stelle passt nicht ganz zu Ihren Vorstellungen? Sprechen Sie uns an und teilen Sie uns ihre Anforderungen mit oder bewerben Sie sich initiativ. Wir erhalten täglich bundesweit neue Anfragen von Krankenhäusern, MVZ, Praxen und sonstigen medizinischen Einrichtungen. Gerne beraten wir Sie kostenfrei bei der Suche nach Ihrer Wunschstelle. Wir freuen uns auf Sie! Contact - tw.con. GmbH - Friedrich-Ebert-Str. 75 - 51429 Bergisch Gladbach - +49-2204-9843580 - jobs@twcon.de