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<h4><em><strong>How you'll change lives</strong></em></h4><p>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.</p><h4><em><strong>What you'll be doing</strong></em></h4><p><strong>Patient care.</strong> 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. </p><p><strong>Teamwork.</strong> 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.</p><p><strong>Safety &amp; Quality.</strong> 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.</p>

U.S. Renal Care

Dialysis Registered Nurse

<p>Salary Range:&nbsp;&nbsp;$88,854.00&nbsp;(Min.) -&nbsp;$115,509.00&nbsp;(Mid.) -&nbsp;$142,166.00&nbsp;(Max.)</p><p>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.<br><br>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.<br></p><h4>Job Summary</h4><p>The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves medically necessary referrals that meet established criteria. Assures timely and accurate determination and notification of referrals and reconsiderations based on the referral determination status. Generates approval, modification and denial communications, to include member and provider notification of referral determination. Actively monitors for admissions in any inpatient setting. Performs telephonic and/or onsite admission and concurrent review, and collaborates with onsite staff, physicians, providers, member/family interaction to develop and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service and retrospective claims medical review. Monitors and oversees the collection and transfer of data (medical records) and referral requests by Providers. Acts as a department resource for medical service requests /referral management and processes. Receives incoming calls from providers, professionally handles complex calls, researches to identify timely and accurate resolution steps. Follows up with caller to provide response or resolution steps. Answers all inquiries in a professional and courteous manner.</p><h4>Duties</h4><p>Promote and support team engagements, programs and activities to create and ensure a positive and productive workplace environment.</p><p>Perform telephonic and/or onsite admission and concurrent review, and collaborates with onsite staff, physicians, providers, the member and significant others to develop and implement a successful discharge plan. Process, finalize and facilitate inbound requests that are received from providers. </p><p>Generate appropriate member and provider communication for all determinations within the required timelines as defined by the most current department policy.</p><p>Facilitate/review requests for Higher level of care or skilled nursing/discharge planning needs. Research for appropriate facilities, specialty providers and ancillary providers to utilize for all lines of business. Identification of potential areas of improvement within the provider network.</p><p>Identify and initiate referrals for appropriate members to the various L.A. Care programs/processes and external community based programs or Linked and Carve Out Services (e.g. DDS/CCS/MH). Potential quality of care/potential fraud issues are identified and documented per L.A. Care policy. High risk/high cost cases and reports are maintained and referred to the Physician Advisor/UM Director. Document in platform/system of record. Utilize designated software system to document reviews and/or notes. </p><p>Receive incoming calls from providers, professionally handle complex calls, research to identify timely and accurate resolution steps. Follow up with caller to provide response or resolution steps. Answer all inquiries in a professional and courteous manner.</p><h4>Perform other duties as assigned. </h4><h4>Duties Continued</h4><h4>Education Required</h4>Associate's Degree in Nursing<h4>Education Preferred</h4>Bachelor's Degree in Nursing<h4>Experience</h4><p>Required:<br>At least 5 years of varied clinical experience in an acute hospital setting. At least 2 years of Utilization Management/Case Management experience in a hospital or HMO setting .&nbsp;</p><p>Preferred:<br>Managed Care experience performing UM and CM at a medical group or management services organization.</p><p>Experience with Managed Medi-Cal, Medicare, and commercial lines of business.</p><h4>Skills</h4><p>Required:<br>Must be computer literate, with expertise in Outlook, Word, Excel, PowerPoint. &nbsp;Effectively utilizes computer and appropriate software and interacts as needed with L.A. Care Information System. Knowledge of personal computer, keyboarding, and appropriate &nbsp;software to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment. Prepare clear, comprehensive written and oral reports and materials.&nbsp;</p><p>Provision of excellent customer service required due to frequent communication with providers and other members of the interdisciplinary team &nbsp;<br><br>Excellent time management and priority-setting skills.</p><p>Maintains strict member confidentiality and complies with all HIPAA requirements.</p><p>Strong verbal and written communication skills. &nbsp; &nbsp;</p><p>Preferred:<br>Knowledge of National Committee for Quality Assurance (NCQA) requirements for Utilization Management or Care Management (CM).&nbsp;</p><p>Knowledge of Department of Health Care Services (DHCS) or Centers for Medicare and Medicaid Services(CMS) requirements for health plan compliance with UM or CM.</p><h4>Licenses/Certifications Required</h4>Registered Nurse (RN) - Active, current and unrestricted California License<h4>Licenses/Certifications Preferred</h4>Certified Case Manager (CCM)<h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4><p>May work on occasional weekends and some holidays depending on business needs.</p><p>Salary 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.</p><p>L.A. Care offers&nbsp;a wide range of benefits including</p><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><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Nursing, Registered Nurse, Medicare, Medicaid, Claims, Healthcare, Insurance                                                    </p>

L.A. Care Health Plan

Utilization Management Nurse Specialist RN II

<p>Come care with us at West Coast University! As a Physician Assistant Faculty member for a certified Great Place to Work, you will guide students to do more than change their own lives – you will help change the lives of every patient they treat throughout their career in healthcare.&nbsp; At West Coast University you will have the opportunity to share your success story with the next generation of Physician Assistant as a key member of our student-centered, innovative community!</p><p><strong>You will make an impact by:</strong></p><ul><li>Provides professional leadership and support, and serves as an educator, role model, mentor and facilitator.&nbsp;&nbsp;</li><li>Create an educational environment which fosters innovation, responsiveness, and accountability&nbsp;</li><li>Regularly contributes to improvement or upgrading of class materials and syllabi utilizing identified University processes&nbsp;&nbsp;</li><li>Utilizes a variety of teaching methodologies to instruct students, always with intent to facilitate observable evidence of student fulfillment of prescribed learning outcomes.&nbsp;</li><li>Demonstrates enthusiasm for teaching and the teaching/learning process and for individual students.&nbsp;</li><li>Assists with assessment, critique and evaluation of overall curriculum and may lead the process of revisions to program and syllabi (if necessary) while ensuring quality.</li></ul><p><strong>Your Experience Includes:</strong></p><ul><li>0-4 years of teaching in a University (or College) setting or previous rank of assistant professor awarded by a regionally accredited institution.&nbsp;&nbsp;</li><li>Teaching experience in Physician Assistant courses and initiated research interest focused on evidence-based clinical research is strongly preferred.&nbsp;&nbsp;</li><li>Working with online learning management systems to further engage the student learning process desirable.&nbsp;&nbsp;</li><li>Documented experience or certification(s) in area(s) of specialization (neuro-rehabilitation, or mental health, or orthopedic/hand rehabilitation, or pediatrics) required.</li></ul><p><strong>Education:</strong></p><ul><li>Must provide a documented background in educational methodology consistent with teaching assignments including but not limited to education theory and practice, or current concepts relative to specific subjects he or she will be teaching, or current clinical practice experience, or distance education techniques and delivery.&nbsp;&nbsp;</li><li>Terminal academic degree required, Master’s degree or in health related field</li></ul><p><strong>LICENSES/CERTIFICATIONS:</strong></p><ul><li>NCCPA certified Physician Assistant</li></ul><p>West Coast University is proud to be an equal opportunity employer. We celebrate diversity and are dedicated to creating an inclusive environment for all associates. If you feel that this role could make you excited to come to work and you can envision yourself working at our organization, please apply! West Coast University is a place where everyone can grow.&nbsp;</p><p>#HEJ</p><p>#LI-AM1</p><p><strong>Do you want a career that allows you to make a difference in other people’s lives? Discover what it means to truly believe in the work that you do at West Coast University.</strong></p><p>At West Coast University, we have the privilege of educating students seeking careers in healthcare and guide them through their transformational journey from student to caregiver. Our associates are united behind that purpose and share a deep commitment to our values of teamwork, collegiality, transparency, and a student-centric approach to all we do. This focus creates an aligned, nimble, and consensus-driven culture that is solution-oriented and supports our associates’ professional growth.</p><p><em>West Coast University is proud to be an equal opportunity employer. We embrace diversity and are dedicated to creating an inclusive environment for all associates.</em></p>

West Coast University

Adjunct Faculty, Physician Assistant

<h4><em>How you will change lives</em></h4><p>As a Patient Care Technician (PCT) at US Renal Care, you will be an integral part of a cross-functional team providing care and delegated activities of treatment to patients. The PCT will work under the supervision of a Registered Nurse (RN) or Charge Nurse (CN) for patients with renal failure.</p><h4><em>What you'll be doing</em></h4><p><strong>Patient care.</strong> You will work directly with patients to provide safe, comfortable, and high-quality dialysis treatment. Responsibilities include gathering patient stats before and after treatment, initiating treatment, monitoring patients during treatment, terminating treatment, and collecting patient blood samples per physician orders.</p><p><strong>Technician Duties. </strong> You will ensure quality comes first by preparing machines for hemodialysis treatments, cleaning and disinfecting machines after treatment, and conducting machine safety checks and logging results for quality control, ensuring all protocols and regulations are followed.</p><p><strong>Safety and Quality. </strong> You will use appropriate safety measures, including personal protective equipment. Working under the supervision of a Charge Nurse, you will adhere to all company policies, procedures, and state/federal laws and regulations. You will participate in all required staff meetings and continuing education offerings.</p><p><strong>PATIENT CARE TECHNICIAN<br>STATE SPECIFIC BOARD OF NURSING REQUIREMENTS </strong></p><strong>California</strong><ul><li>Must possess current Certified Hemodialysis Technician (CHT) certificate from California Department of Public Health (CDPH) at time of hire OR</li><li>Hired at USRC location recognized by state of California as an approved dialysis technician training program and obtain California state certification (CHT) within six (6) weeks of successful completion of training program. </li></ul><strong>Maryland</strong><ul><li>Must possess current Certified Nursing Assistants -- Dialysis Technicians (CNA-DT) certificate from Maryland Board of Nursing OR</li><li>Hired at USRC location recognized by state of Maryland as an approved dialysis technician training program and obtain Maryland CNA-DT certificate within three (3) months from date of hire OR</li><li>Out-of-state applicant must have active BONENT certification and provide proof of initial application for CNA-DT certification.</li></ul><strong>New Mexico</strong><ul><li>Must have New Mexico dialysis technician certificate at time of hire <strong>OR</strong></li><li>Hired at USRC location recognized by state of New Mexico as an approved dialysis technician training program and obtain New Mexico state certification within six (6) months of successful completion of training program <strong>OR</strong></li><li>New Mexico certification of hemodialysis technician is required for out of state applicant with active state or national hemodialysis certification; must obtain New Mexico state certification prior to working as a Certified Hemodialysis Technician. </li><li>After January 1st, 2024, all initial applications for the certified hemodialysis technician will require a national hemodialysis technician certificate.</li><li>The applicant must submit proof of a valid national hemodialysis technician certificate from a recognized organization.</li><li>Hemodialysis technician students must have a current basic life support credential prior to and while the student has contact with patients</li></ul><strong>OHIO</strong><ul><li>Must have Ohio dialysis technician intern certificate at time of hire OR</li><li>Hired at USRC location recognized by state of Ohio as an approved dialysis technician training program and submit application for Ohio dialysis technician intern certificate to board no later than four (4) weeks prior to completion of the approved training program.</li><li>Must obtain Ohio Board of Nursing Certificate (OCDT) not less than twelve (12) months and not later than eighteen (18) months of enrolling in the USRC OCDT program.</li></ul><strong>OREGON</strong><ul><li>Must possess current Certified Hemodialysis Technician (CHDT) certificate from Oregon Public Health Division at time of hire OR</li><li>Must obtain Oregon dialysis technician provisional certificate within three (3) weeks of successful completion of training program and obtain Certified Hemodialysis Technician (CHDT) certificate from Oregon Public Health Division within eighteen (18) months. An Oregon Provisional Certification is valid for six months and can be renewed for one additional six month period.</li></ul>&nbsp;<br>

Dialysis Patient Care Technician

<br><h4><em><strong>How you'll change lives</strong></em></h4><p>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.</p><h4><em><strong>What you'll be doing</strong></em></h4><p><strong>Patient care.</strong> 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. </p><p><strong>Teamwork.</strong> 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.</p><p><strong>Safety &amp; Quality.</strong> 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.</p>

Dialysis Registered Nurse PRN

Dialysis Patient Care Technician TTS

<p>At West Coast University, we share a passion for students and transforming healthcare education! As a faculty member for a certified Great Place to Work, you willjoin a collaborative, student-centric culture valuing academic integrity, mutual respect, student learning, service, responsiveness, innovation, diversity, and stewardship. As a part of this team, you will guide students to do more than change their own lives – you will help change the lives of every patient they care for throughout their career.&nbsp;</p><p><strong>You will make an impact by:</strong></p><ul><li>Providing program-specific expertise and is actively engaged in relevant department initiatives. Supporting University, Campus, and/or departmental goals to assure compliance with programmatic accreditation and/or licensure, internal consistency, and graduate outcomes that meet student learning, workplace, and placement expectations. </li><li>Providing professional leadership and support, and serving as an educator, role model, mentor and facilitator. </li><li>Creating an educational environment which fosters innovation, responsiveness, and accountability. Focuses extensively on facilitating student learning associated with prescribed course and program learning outcomes. </li><li>Actively and substantively participating in assessment of student learning activities to maximize the potential for students to learn what is necessary to meet prescribed outcomes. </li><li>Vigorously upholding a culture of academic integrity.</li></ul><p><strong>Your Experience Includes:</strong></p><ul><li>Greater than 3 years of clinical experience</li><li>Experience teaching in a PA program or Medical School preferred.</li><li>Experience with ARC-PA accreditation in provisional and/or maintenance phase preferred. </li><li>Non-doctoral faculty: doctoral degree or willingness to enter and complete a doctoral program.</li></ul><p><strong>Education:</strong></p><ul><li>Master’s degree, Physician Assistant; or</li><li>Master’s degree, or higher, in health-related field</li></ul><p>If a non-clinician scientist (Scientist Position):</p><ul><li>Doctorate degree in health- or social-science related field.</li><li>Minimum of three years teaching/research/clinical experience.</li></ul><p>Preferred:</p><ul><li>NCCPA certified Physician Assistant or Board certified allopathic or osteopathic physician</li><li>PA license (or eligible) or MD / DO license or eligible for licensure&nbsp;</li></ul><p>West Coast University is proud to be an equal opportunity employer. We celebrate diversity and are dedicated to creating an inclusive environment for all associates. If you feel that this role could make you excited to come to work and you can envision yourself working at our organization, please apply! West Coast University is a place where everyone can grow.</p><p>#LI-AM1</p><p>#HEJ</p><p><strong>Do you want a career that allows you to make a difference in other people’s lives? Discover what it means to truly believe in the work that you do at West Coast University.</strong></p><p>At West Coast University, we have the privilege of educating students seeking careers in healthcare and guide them through their transformational journey from student to caregiver. Our associates are united behind that purpose and share a deep commitment to our values of teamwork, collegiality, transparency, and a student-centric approach to all we do. This focus creates an aligned, nimble, and consensus-driven culture that is solution-oriented and supports our associates’ professional growth.</p><p><em>West Coast University is proud to be an equal opportunity employer. We embrace diversity and are dedicated to creating an inclusive environment for all associates.</em></p>

Faculty, Physician Assistant (Hybrid)

Dialysis Registered Nurse - PRN

Dialysis Patient Care Technician MWF

<p>Salary Range:&nbsp;&nbsp;$88,854.00&nbsp;(Min.) -&nbsp;$115,509.00&nbsp;(Mid.) -&nbsp;$142,166.00&nbsp;(Max.)</p><p>PLEASE NOTE:&nbsp; This position will work&nbsp;Monday - Friday, 8 a.m. to 5 p.m. PST, with rotating holidays.</p><p>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.<br><br>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.</p><h4>Job Summary</h4><p><br>The Customer Solution Center Appeals and Grievances (A&amp;G) Nurse Specialist Registered Nurse (RN) II provides direct assistance to member's with health care access or benefit coordination issues, ensuring that clinical grievances, complaints and complex issues are investigated and resolved to the member's satisfaction in a manner consistent with L.A. Care, Centers of Medicare and Medicaid Services (CMS) and regulatory guidelines. Benefit coordination may involve coordinating multiple L.A. Care products, Fee for services (FFS )Medi-Cal/Medicare, or commercial insurance.&nbsp;</p><h4>Duties</h4><p>Conducts intake/triage and appropriate classification of Clinical A&amp;G, and Pharmacy requests and makes accurate judgment on appeal, grievance, Provider Claim Disputes, medical records or other issues and follows procedures on how to handle each type of request and route to the appropriate area within the department.</p><p>Investigation, and resolution of clinical member complaints (grievances/appeals) utilizing all regulatory requirements.&nbsp; Investigation, and resolution of clinical Provider Complaints/ Provider Data Resolution (PDR) (grievances/appeals) utilizing regulatory and internal guidelines and Service Level Agreement (SLA). Identification of Expedited Cases and resolution within 72 hours.</p><p>Works with the external providers and Participating Physician Group's (PPG) representatives to obtain relevant medical records and communication documentation.</p><p>Prepares resolved complaint files for Centers for Medicare and Medicaid Services (CMS), DMHC, and external review organization (QIO or IRE).&nbsp; Process the case thru to effectuation and final case documentation in the A&amp;G system of record.</p><p>Investigation and preparation of State Fair Hearing cases as assigned. Prepares resolved complaint files for CMS external review organization - Quality Improvement Organization (QIO) or Independent Review Entity (IRE).</p><p>Conducts reviews and presents to physicians, provider disputes which would be based on medical necessity reviews. Prepares authorizations, after approval by the Medical Director.</p><p>When necessary, outreaches to providers, vendors, hospitals, and members to request necessary information or to provide case status and/or next steps.&nbsp; In instances where necessary, sends written notifications to appropriate parties. All interactions including verbal outreach and written communication will be documented in the A&amp;G system of record. </p><p>Participates inter-rater reliability training and assessments.</p><h4>Perform other duties as assigned.</h4><h4>Duties Continued</h4><h4>Education Required</h4>Associate's Degree in Nursing<h4>Education Preferred</h4>Bachelor's Degree in Nursing<h4>Experience</h4><p>Required:</p><p>At least 5 years of experience in Clinical Nursing and 2 years in Medicare/ Medicaid in a managed care/ health plan environment. </p><h4>Skills</h4><p><br>Required:</p><p>Excellent interpersonal and communication skills. </p><p>Computer literacy and adaptability to computer learning. </p><p>Time management and priority setting skills.</p><p>Must be organized and a team player </p><p>Able to work effectively with various internal departments/service areas, L.A. Care's plan partners, participating provider groups, and other external agencies.</p><p>Good working knowledge of regulatory requirements/standards.</p><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><p>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.</p><p>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 assigned</p><p>Salary 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.</p><p>L.A. Care offers&nbsp;a wide range of benefits including</p><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><p><br><strong>Nearest Major Market: </strong>Los Angeles                                                                            <br><strong>Job Segment: </strong>                    Nursing, Registered Nurse, Medicare, Medicaid, Pharmacy, Healthcare                                                    </p>

24 Healthcare Jobs in Brea, CA, USA