Title: Nurse Practitioner - National After-Hours Team - part time - Licensed in NC or SC Location: Remote, United States Department: Provider Job Description: At Curana Health, we’re on a mission to radically improve the health, happiness, and dignity of older adults—and we’re looking for passionate people to help us do it. As a national leader in value-based care, we offer senior living communities and skilled nursing facilities a wide range of solutions (including on-site primary care services, Accountable Care Organizations, and Medicare Advantage Special Needs Plans) proven to enhance health outcomes, streamline operations, and create new financial opportunities. Founded in 2021, we’ve grown quickly—now serving 200,000+ seniors in 1,500+ communities across 32 states. Our team includes more than 1,000 clinicians alongside care coordinators, analysts, operators, and professionals from all backgrounds, all working together to deliver high-quality, proactive solutions for senior living operators and those they care for. If you’re looking to make a meaningful impact on the senior healthcare landscape, you’re in the right place—and we look forward to working with you. For more information about our company, visit CuranaHealth.com. Summary At Curana Health, we are committed to supporting the health, dignity, and comfort of residents in senior living communities. Our National After-Hours Call Team plays a vital role by providing compassionate telephonic care and clinical direction during evenings, nights, weekends, and holidays—ensuring that residents receive timely, high-quality support without unnecessary transfers. In this work-from-home role, you’ll deliver after-hours care virtually (primarily by phone) to aging residents across multiple states. This position offers both autonomy and purpose—you’ll be the trusted voice and clinical partner helping residents and facility staff during critical times, making an immediate impact in the lives of older adults. In this position the provider must be comfortable managing high call volumes and performing at least 30% telehealth visits, including evaluation of acute changes, falls, and controlled substance visits. Providers must be able to manage multiple calls independently while providing care across several states. Essential Duties & Responsibilities - Serve as the first line of support for residents and facility staff after-hours, providing direction and medical care over the phone. - Use Curana’s telephonic platform to take and place calls, coordinating care between facilities, hospitals, and clinics. - Deliver high-quality, cost-effective care to patients—addressing acute, chronic, and behavioral health needs in collaboration with physicians and specialty providers. - Perform comprehensive assessments and document encounters accurately and thoroughly in the EMR, ensuring compliance with CMS requirements. - Apply Curana’s clinical protocols and practice guidelines to support safe, effective treatment in place whenever possible. - Participate in mandatory education and training to stay current with standards of care. Scheduling & Hours: While shift times can vary, we provide coverage to skilled nursing and senior living facilities on weeknights from 5pm- 8am local time, continuous coverage from Friday at 5pm to Monday at 8am. Holiday coverage is also provided beginning at 5pm of the end of the last business day to 8am of the resumption of business hours. - Availability and Coverage expectations for this role - Weeknight shifts between 5pm and 8am - Every other weekend coverage for 12 hour shifts covering day shifts both Saturday and Sunday - Overnight and holidays are required for all After Hours Call Team Members, 2 holidays per year required for part time - Holiday scheduling is completed at the beginning of the year for advanced planning Qualifications Education and Experience: - Master's Degree as a Nurse Practitioner - Current unrestricted NP license in North Carolina or South Carolina required. Additional active licenses in Florida and Georgia are strongly preferred. - Nurse Practitioner national certification as ANP, FNP, or GNP - Ability to obtain DEA licensure / Prescriptive Authority - Background in acute and chronic disease management - Clinical background in adult, family, or geriatrics - 3+ years of experience as a NP - Ability to gain a collaborative practice agreement, if applicable in your state(s) - Ability to work scheduled shifts in accordance with scheduling policies - Proficient computer skills including the ability to document medical information with written and electronic medical records Preferred Qualifications: - Experience working in a nursing home, or with seniors in an acute care facility - Understanding of Geriatrics, Chronic Illness, and acute disease management - Understanding of Advanced Illness and end of life discussions - Ability to develop and maintain positive customer relationships - Adaptability to change We’re thrilled to announce that Curana Health has been named the 147th fastest growing, privately owned company in the nation on Inc. magazine’s prestigious Inc. 5000 list. Curana also ranked 16th in the “Healthcare & Medical” industry category and 21st in Texas. This recognition underscores Curana Health’s impact in transforming senior housing by supporting operator stability and ensuring seniors receive the high-quality care they deserve.

Role Description Join our award winning culture as we serve members in your area! Under the general supervision of the Service Utilization Supervisor, this position manages service authorizations in the Lakeland Care electronic member record system. This position supports Interdisciplinary Teams (IDT) by ensuring authorizations are accurately completed based on IDT Resources Allocation Decision (RAD) determinations, maintaining compliance with policy and documentation requirements. As a subject matter expert, this position reviews service guidelines, verifies provider information, monitors quality and compliance, coordinates with claims as needed, and provides resources to IDT staff on best practices to ensure accurate authorizations, documentation, and claims processing. - Timely and accurately enter and modify service authorizations into the electronic member record system, thereby reducing risk for duplicate claims, missing claims, or incorrectly coded claims. - Review service guidelines, coordinate with claims on payment accuracy, and ensure authorizations align with policy requirements. - Conduct routine authorization audits and remediate any findings to ensure accuracy of service authorizations and appropriate payment of claims. - Contribute to ongoing quality improvement within the service authorization entry process, including auditing and analysis. - Conduct quality reviews of required documentation and provider information (e.g., SNF HIPPS codes, TIN changes) to prevent delays in member services. - Respond constructively to emotional situations, high pressure, and conflict. - Demonstrate emotions appropriate to the situation and continue to perform steadily and effectively. - Convey messages concisely and advise others regarding an appropriate course of action. - Teamwork is essential at all times. - Identify obstacles and address problems cooperatively as they occur. - Utilize and apply relevant Standard Practice Codes (SPCs) to ensure appropriate and accurate claims processing. - Provide guidance and share resources to ensure consistent adherence to policies, correct coding practices, and best practice standards for designated services. - Review organizational data and analyze utilization trends to bring forward for Care Management practice review. Qualifications - Associate Degree or specialized training in Medical Records, Medical Coding, other related field preferred, or equivalent combination of education and experience (includes knowledge, skills, and abilities). - One (1) year of experience in medical billing or insurance authorization preferably in Family Care or health care setting. - Strong understanding of service authorization guidelines, policies and procedures. - A strong understanding of Lakeland Care’s electronic member records system is necessary to ensure that all authorizations are correctly entered. - Knowledge of medical terminology and/or experience with CPT, ICD-9 and ICD-10 coding. - Knowledge of Medicare, Medicaid, Family Care preferred. - Excellent verbal and written communication; ability to respectfully and effectively communicate with internal and external partners. - Attention to detail and the ability to critically think in a fast-paced environment. - Computer literate including experience with spreadsheets, MS Word, e-mail, and the internet. - Current driver’s license, acceptable driving record and proof of adequate insurance required. Company Description Lakeland Care is a Wisconsin-based non-profit organization that focuses on creating a world we all want to live in. With long-standing roots as a managed care organization (MCO), we provide long-term care services to eligible elders and individuals with physical and intellectual or developmental disabilities. Currently we serve members in 22 counties and have 11 offices throughout the Central to North East region of Wisconsin. - Our Mission: Empowering individuals. Strengthening communities. Inspiring futures. - Our Vision: To create a world we all want to live in. - Our Core Values: - Kindness – We believe kindness is always possible and that no compassionate act is ever wasted. - Inclusion – We believe that open hearts and open minds are the only path to a brighter future. - Trust – We believe that honesty is still in style and that promises still have power. We are an equal employment opportunity employer functioning under an Affirmative Action Plan. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law. We are an organization that participates in E-Verify.

• Apply specialized, clinical knowledge of hospital partners: categorize, code, summarize, interpret and calculate registry/case information from nuanced, patient medical records. • Ensure quality submission of all data in specified registries or measure data repositories, maintaining a high accuracy threshold. • Prioritize, organize, and meet tight deadlines for multiple concurrent tasks and team requests; uses tact and judgment to manage expectations, flag obstacles, and propose solutions in a timely manner. • Navigate new technical systems: electronic medical records (EMR) and registry/case entry tools; use team resources to troubleshoot technical issues with systems and applications with a focus on solutions. • Contribute to team best practices, data dictionaries, abstraction guidelines, and other business rule documents; identifies process improvement opportunities to help streamline tasks and processes. • Keeps up to date on mandated regulatory/publicly reported data requirements as specified by federal, state, payer, and other agencies. • Any or other additional responsibilities as assigned

Role Description Performs medical reviews using clinical/medical information provided by physicians/providers and established criteria/protocol sets or clinical guidelines. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization practices. Location: This position is full-time (40 hours/week) Monday through Friday in a typical office environment. This role is remote position for South Carolina, Georgia, North Carolina or Alabama. What You'll Do: - Perform medical claim reviews for one or more of the following: - Claims for medically complex services - Services that require preauthorization/predetermination - Requests for appeal or reconsideration - Referrals for potential fraud and/or abuse - Correct coding for claims/operations - Make reasonable charge payment determinations based on clinical/medical information and established criteria/protocol sets or clinical guidelines. - Determine medical necessity and appropriateness and/or reasonableness and necessity for coverage and reimbursement. - Monitor process’s timeliness in accordance with contractor standards. - Document medical rationale to justify payment or denial of services and/or supplies. - Educate internal/external staff regarding medical reviews, medical terminology, coverage determinations, coding procedures, etc. in accordance with contractor guidelines. - Participate in quality control activities in support of the corporate and team-based objectives. - Provide guidance, direction, and input as needed to LPN team members. - Provide education to non-medical staff through discussions, team meetings, classroom participation, and feedback. - Assist with special projects and specialty duties/responsibilities as assigned by management. Qualifications - Associate's in a job related field - Graduate of Accredited School of Nursing. - Active RN licensure in state hired, OR, active compact multistate RN license as defined by the Nurse Licensure Compact (NLC). - 2 years clinical experience. - Working knowledge of word processing software. - Ability to work independently, prioritize effectively, and make sound decisions. - Good judgment skills. - Demonstrated customer service and organizational skills. - Demonstrated oral and written communication skills. - Analytical or critical thinking skills. - Ability to handle confidential or sensitive information with discretion. - Microsoft Office. Benefits - 401(k) retirement savings plan with company match - Subsidized health plans, dental and vision coverage - Life insurance - Paid Time Off (PTO) - Nine paid holidays - On-site cafeterias and fitness centers in significant locations - Wellness programs and a healthy lifestyle premium discount - Tuition assistance - Service Recognition Company Description We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.