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<h4>How you will change lives</h4>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.<h4>What you'll be doing</h4>Patient care. 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.Technician Duties. 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.Safety and Quality. 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.PATIENT CARE TECHNICIAN STATE SPECIFIC BOARD OF NURSING REQUIREMENTS California<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>Maryland<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>New Mexico<ul><li>Must have New Mexico dialysis technician certificate at time of hire OR</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 OR</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>OHIO<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>OREGON<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;

U.S. Renal Care

Dialysis Patient Care Technician - Floater - CCHT Required

<h4>Introduction</h4> Are you a Licensed Practical Nurse (LPN) seeking a fulfilling career opportunity? DDS South Region is currently hiring for multiple full-time LPN positions at our Waterford location. We're looking for dedicated individuals who are ready to make a difference in the lives of both children and adults with intellectual/developmental disabilities and autism spectrum disorder. What we can&nbsp;offer&nbsp;you: <ul><li>The opportunity to work for a Forbes top company: 'Forbes'&nbsp;State of Connecticut Ranked One of the Best Employers of 2023&nbsp;- State of CT Receives National Recognition for Offering Job Growth, Competitive Benefits, and Flexible Schedule.</li><li>NEW:&nbsp;A Platinum Healthcare Plan,&nbsp;the nation’s best for state employees and dependents,&nbsp;according to a report by&nbsp;Georgetown’s Center on Health Insurance Reform and article by Ellen Andrews,Ph.D., along with&nbsp;comprehensive benefit offerings</li><li>The State of Connecticut is an eligible Public Service Loan Forgiveness employer, meaning you may be eligible to have qualifying student loans forgiven after 10 years of service.&nbsp; Click&nbsp;here&nbsp;for more information.</li><li>Extensive pension plan and supplemental retirement offerings.</li><li>Generous paid time off, including 13 paid holidays per calendar year.</li><li>Professional growth and development opportunities.</li><li>A healthy work/life balance&nbsp;to all employees.</li><li>FOR SECOND AND THIRD SHIFT POSITIONS - YOU MAY BE APPROVED FOR AN ADDITIONAL COMPENSATION BONUS:&nbsp; Each Licensed Practical Nurse who is permanently assigned to second and third shift shall receive a yearly “retention” bonus of six hundred ($600). This bonus shall be paid in two (2) installments: In July and December. In order to be eligible for this bonus, the Employee must have completed one year of service in the classification.</li></ul> Position Details: <ul><li>Shore Road in Waterford</li><li>Multiple full-time</li><li>All shifts</li><li>70 hours/biweekly positions, with various work schedules.</li><li>However, work schedule flexibility is required in order to meet the demands of the job.&nbsp;&nbsp;</li><li>Must have a valid driver's license.</li><li>Will be required to travel, consistent travel between DDS locations on site and across the state that may need to be done at short notice.&nbsp;</li></ul> About Us:&nbsp; The&nbsp;State of Connecticut, Department of Developmental Services (DDS)&nbsp;is dedicated to partnering with individuals with developmental disabilities and their families to facilitate lifelong planning and promote meaningful participation within their communities. The mission of DDS revolves around collaborating with individuals and their families to support them throughout their lives and working alongside others to create opportunities for full community engagement. Key aspects of DDS's vision include fostering safe, empowering relationships; providing continuous support to families; offering lifelong learning opportunities; promoting informed choice and responsibility; facilitating financial independence; and advocating for rights awareness and self-determination. DDS aims to empower individuals to make informed decisions and take responsibility for their lives while recognizing and embracing the dignity of risk-taking in pursuit of personal growth. If you're passionate about providing compassionate care and meet the qualifications below, we want to hear from you! Apply now and become a valued member of our team at DDS South Region. <h4>Selection Plan</h4> <ul><li>Please visit our 'Applicant Tips on How to Apply' page or view our&nbsp;tutorial.</li><li>The minimum experience and training requirements must be met by the close date on the job opening, unless otherwise specified.</li><li>If you require an accommodation to participate fully and fairly under the provisions of the Americans with Disabilities Act (ADA), please contact Edward&nbsp;Magnano, EEO Manager at (860) 418-6148 or&nbsp;<a href="mailto:Edward.Magnano@ct.gov" target="_blank">Edward.Magnano@ct.gov</a>.</li><li>Although applicants will receive correspondence via email, as a backup they are also encouraged to sign on to their Personal Status Board on a daily basis to monitor their status, view all emailed notices and complete tasks required in the recruitment process.&nbsp;</li><li>In order to comply with Public Act 21-69, the State of Connecticut is no longer asking for resumes during the initial application process.&nbsp;&nbsp;</li><li>This posting may require completion of additional referral questions (RQs). You can access these RQs via an email that will be sent to you after the posting's closing date or by visiting your&nbsp;JobAps&nbsp;Personal Status Board (Certification Questionnaires section). Your responses to these RQs must be submitted by the question's expiration date. Please regularly check your email and&nbsp;JobAps&nbsp;Personal Status Board for notifications. Please check your SPAM and/or Junk folders on a daily basis in the event an email provider places auto-notification emails in a user's spam.&nbsp;</li><li>Note:&nbsp; At any point during the recruitment process, applicants may be required to submit additional documentation which support their qualification(s) for this position.&nbsp; These documents may include:&nbsp; a cover letter, resume, transcripts, diplomas, performance reviews, attendance records, supervisory references, licensure, etc., at the discretion of the hiring agency.&nbsp; Applicants must meet the minimum qualifications as indicated to apply for this position.&nbsp;</li><li>Should you have questions pertaining to this recruitment, please contact Liz&nbsp;Pinette&nbsp;at&nbsp;<a href="mailto:elizabeth.pinette@ct.gov" target="_blank">elizabeth.pinette@ct.gov</a>.</li><li>This position will be filled in accordance with contractual language, reemployment, SEBAC, transfer, promotion and merit employment rules.</li><li>The immediate vacancy is listed above, however, applications to this recruitment may be used for future vacancies in this job class.</li><li>All application materials must be received by the recruiting agency by the time specified on the job opening for the position for which you are applying. Late applications may not be submitted and will not be considered. Exceptions are rare and limited to documented events that incapacitate a candidate during the entire duration of the job posting time period.&nbsp; It is the candidate’s obligation and responsibility to request an exception and provide a legally recognized justification to accommodate such exception.&nbsp; Requests should be made to&nbsp;<a href="mailto:DAS.SHRM@ct.gov" target="_blank">DAS.SHRM@ct.gov</a>.</li><li>For current state employees, salary calculations are not necessarily comparable from one of the three branches of state government (i.e., Executive, Legislative, Judicial) to the other.</li><li>Read through this helpful link to&nbsp;prepare for your interview.</li><li>FOR THOSE WHO HOLD A PRATICAL NURSE LICENSE IN A STATE OTHER THAN CONNECTICUT AND WISH TO APPLY FOR A CONNECTICUT LICENSE, PLEASE:<ul><li>Review the&nbsp;eligibility and documentation requirements for CT&nbsp;license by endorsement of an out-of-state license;</li><li>Complete a&nbsp;CT DPH online application online&nbsp;(expand the ‘Public Health Practitioners’ grouping, select ‘Licensed Practical Nurse’ and then ‘Start’.</li><li>Request verification of your out-of-state license(s) electronically through the National Council of State Boards of Nursing’s:&nbsp;Nursys®&nbsp;System. To send verification of your license(s) to CT, read and agree to the terms, enter your biographic information, select your license type (PN for Practical Nurse) and select ‘SEARCH’. Review the results and select the ‘Next’ button. Check the box next to ‘Connecticut’ and complete the transaction. Once the transaction is completed, you will receive a confirmation email from Nursys and the verification will be available to the DPH. Note that PA and MI verifications are not provided through Nursys. Please contact those state boards for information on obtaining verification.</li></ul></li></ul> <h4>PURPOSE OF JOB CLASS (NATURE OF WORK)</h4> In a state facility this class is accountable for rendering bedside care or mental health services to individuals with physical disabilities and/or an intellectual disability in instances where the services of a registered nurse are not required. <h4>EXAMPLES OF DUTIES</h4> <ul><li>Assists doctors and nurses in the general care and treatment of individuals;</li><li>Measures doses and administers medications including insulin injections;&nbsp;</li><li>Documents medications using appropriate forms;</li><li>Performs narcotic counts;</li><li>Checks and may administer intravenous medications;</li><li>Reports changes in individuals to doctors;</li><li>Ensures that restraints are applied correctly;</li><li>Transcribes doctors medication orders;</li><li>Dispenses certain medications in doctor’s absence;</li><li>Applies topical medication;</li><li>Takes and charts temperatures, pulses and respirations;</li><li>Performs simple nursing treatments;</li><li>Monitors general individual needs including personal hygiene;</li><li>Reports on individual conditions and behavior;</li><li>Keeps the unit safe and healthy;</li><li>Administers enemas or suppositories;</li><li>Performs Foley catheterization care;</li><li>Orients individuals concerning medications and their use;</li><li>May perform emergency first aid;</li><li>May drive individuals to necessary appointments/outings;</li><li>Performs related duties as required.</li></ul>DEPARTMENT OF DEVELOPMENTAL SERVICES: <ul><li>Performs the full range of duties as described in the class specification for the Lead Developmental Services Worker.</li></ul> <h4>KNOWLEDGE, SKILL AND ABILITY</h4> <ul><li>Knowledge of <ul><li>practical nursing specialties and bedside care;</li><li>various medications used in conjunction for the care of individuals who have physical disabilities and/or an intellectual disability;</li><li>infection control practices;</li><li>nutrition and diets;</li><li>medical and lab sciences;</li></ul></li><li>Considerable <ul><li>interpersonal skills;</li><li>oral communication and written skills;</li></ul></li><li>Ability to <ul><li>keep records;</li><li>lead staff.</li></ul></li></ul> <h4>MINIMUM QUALIFICATIONS</h4> License or temporary permit to practice nursing in Connecticut by the State Board of Examiners for Nursing. <h4>PREFERRED QUALIFICATIONS</h4> <ul><li>Experience providing nursing services to both children and adults with intellectual/developmental disabilities and autism spectrum disorder.</li><li>Experience working with individuals with Intellectual and/or Developmental Disabilities.</li><li>Experience communicating with non-verbal individuals.</li><li>Experience with basic nursing skills including, but not limited to: administering medication and nutrition via G-Tube or J-Tube; glucose monitoring, insulin administration; respiratory treatments, colostomy; cecostomy; urostomy care; wound care; and catheterization.</li><li>Experience supporting individuals that may exhibit mild to severe challenging behaviors.</li><li>Experience communicating internally and externally with a diverse population both over the telephone and in written inquiries.</li><li>Experience using Microsoft applications, including Outlook, Excel, Teams, and Word.</li></ul> <h4>SPECIAL REQUIREMENTS</h4> DEPARTMENT OF DEVELOPMENTAL SERVICES: Incumbents in this class may be required to possess and retain a valid Connecticut Motor Vehicle Operator's license, Public Passenger Endorsement or Commercial Driver's license for designated positions. <h4>WORKING CONDITIONS</h4> Incumbents in this class may be required to lift/restrain individuals; may have some exposure to communicable/infectious diseases and to some risk of injury from assaultive/abusive individuals; may be exposed to disagreeable conditions. <h4>Conclusion</h4> AN AFFIRMATIVE ACTION/EQUAL OPPORTUNITY EMPLOYER The State of Connecticut is an equal opportunity/affirmative action employer and strongly encourages the applications of women, minorities, and persons with disabilities. <h4>ACKNOWLEDGEMENT</h4> As defined by Sec. 5-196 of the Connecticut General Statutes, a job class is a position or group of positions that share general characteristics and are categorized under a single title for administrative purposes.&nbsp; As such, a job class is not meant to be all-inclusive of every task and/or responsibility.

State of Connecticut

Licensed Practical Nurse(Full-time (35 hours) - All shifts)

Dialysis Patient Care Technician Floater - PCT Chronic In-center

It’s inspiring to work with a company where people truly BELIEVE in what they’re doing! When you become part of the Chapters Health Team, you’ll realize it’s more than a job. It’s a mission. We’re committed to providing outstanding patient care and a high level of customer service in our communities every day. Our employees make all the difference in our success!Role: The Nurse Practitioner (APRN) provides high quality, comprehensive and efficient direct primary or consultative patient care under protocol with hospice physician staff.Qualifications: • Master’s degree in nursing • APRN certification recognized by CMS for Medicare billing • Licensure by state of Florida to work as APRN • Current DEA license- Current Medicare and Medicaid Numbers• Active BLS for healthcare professionals from the American Heart Association or Red Cross. Employees hired prior to 12/31/2022 must obtain certificate prior to 10/1/2023 • Knowledge and experience in medical practice and symptom management • Advanced clinical skills which allow thorough patient assessments and management for any patient with advanced chronic disease as well as for those near the end of life • Ability to work under protocol with multiple physicians in multiple settings • Basic computer skills including use of email and word processing (Microsoft Outlook and Word or equivalent programs) • Strong interpersonal skills, communication, collaboration, and conflict resolution • Ability to manage multiple priorities simultaneously and effectively handle the emotional stress of the workload • Ability to work independently exercising discretion and independent judgment • Ability to work in collaboration with other disciplines within the Organization • Certified by appropriate hospice nursing organization within two years of hire date • Ability to travel to off-site locations • Mobile Driver - Valid driver's license and automobile insurance per Company policy • Reliable transportation to meet visit schedule • Must be able to physically access any home in any area of Company service area (i.e., navigate stairs and narrow spaces, tolerate heat and lack of air conditioning) Competencies: • Satisfactorily complete competency requirements for this position Responsibilities of all employees: • Represent the Company professionally at all times through care delivered and/or services provided to all clients • Comply with all State, federal and local government regulations, maintaining a strong position against fraud and abuse • Comply with Company policies, procedures and standard practices • Observe the Company's health, safety and security practices • Maintain the confidentiality of patients, families, colleagues and other sensitive situations within the Company • Use resources in a fiscally responsible manner • Promote the company through participation in community and professional organizations • Participate proactively in improving performance at the organizational, departmental and individual levels • Improve own professional knowledge and skill level • Advance electronic media skills • Support the Company’s research and educational activities • Share expertise with co-workers both formally and informally • Participate in Quality Assessment Performance Improvement activities as appropriate for the position Job Responsibilities: • Provides high quality direct primary or consultative patient care visits in accordance with productivity standards in all clinical settings as designated by the Medical Director. • Works directly under protocol with Physicians from the Company’s medical staff and reports clinical care provided to the Physician. • Provides clinical expertise and participates in interdisciplinary team (IDG) decisions regarding diagnosis and medical management of patient/family needs, ensuring that the highest quality of medical care is provided and that continuity and comprehensiveness of care is maintained in a cost-effective manner. • Consults to patients’ primary and attending Physicians regarding integration of patients’ hospice care and primary or other care. • Works cooperatively with the Patient Access Department and other staff to facilitate timely evaluation of eligibility for hospice services and provision of services to potential Company patients. • Participates in after-hour and weekend hospice house rounding and face-to-face coverage for hospice patients. • Reports all administrative activities and completes thorough, accurate and timely medical documentation to support proper CPT and ICD-10 coding on all patients seen at the time of service. • Attends the Company’s Medical Staff meetings regularly (a minimum of 50% of all scheduled monthly staff meetings) and reviews minutes of meetings not attended within 5 days of their being made available. • Prescribes controlled and non-controlled medications, as indicated, to relieve pain and non-pain symptoms associated with the terminal illness. • Provides leadership in the development, implementation, and evaluation of standards of practice within the hospice specialty. • Performs other duties as assigned. Physical Demands for Post Offer/Pre-Placement (The demands described below are representative of those that must be met by an individual to perform the essential functions of the job, with or without reasonable accommodation.): While performing the duties of this job, the following abilities are required: see; hear; talk; walk; use hands to finger, handle or feel. Frequently required to: stand; sit; reach with hands/arms; lift; bend; balance. Occasionally required to: pull; push; stoop/crouch; kneel; climb stairs.This position requires consent to drug and/or alcohol testing after a conditional offer of employment is made, as well as on-going compliance with the Drug-Free Workplace Policy.

Chapters Health System

Nurse Practitioner

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

Dialysis Registered Nurse

It’s inspiring to work with a company where people truly BELIEVE in what they’re doing! When you become part of the Chapters Health Team, you’ll realize it’s more than a job. It’s a mission. We’re committed to providing outstanding patient care and a high level of customer service in our communities every day. Our employees make all the difference in our success!Role: The Thrift Store Assistant is responsible for the day-to-day operational management of the store in the absence of the Thrift Store Manager. Successfully engages customers, donors and volunteers and handles interpersonal and merchandise issues.Qualifications: • High School diploma/GED required; some college preferred • Minimum one (1) year experience preferably in retailing, thrift, consignment and/or used merchandise sales • Experience in supervision of numerous volunteers or supervisory experience with a minimum of 20 employees preferred • Good communication (written and verbal) skills and well-developed interpersonal skills with the ability to work with and manage multiple volunteers and handle varied personalities from diverse backgrounds • Ability to work as a team member with the volunteers, Development Staff and the area’s community • Ability to develop and cultivate strong relationships with volunteer team, Development Staff and the community • Ability to strategically plan ahead and be innovative • Ability to plan and implement marketing and promotional campaigns • Ability to secure financial support from donors and community businesses • Good organizational and administrative skills • Results and goal oriented qualities helpful • Physical requirements: Position involves walking and standing, with occasional lifting of merchandise (with assistance) weighing up to 50 lbs.; ability to climb flights of stairs and move boxes/furniture on an ongoing basis • Ability to use Microsoft Word, Excel and Internet technologies Competencies: • Satisfactorily complete competency requirements for this position Responsibilities of all employees: • Represent the Company professionally at all times through care delivered and/or services provided to all clients. • Comply with all State, federal and local government regulations, maintaining a strong position against fraud and abuse. • Comply with Company policies, procedures and standard practices. • Observe the Company's health, safety and security practices. • Maintain the confidentiality of patients, families, colleagues and other sensitive situations within the Company. • Use resources in a fiscally responsible manner. • Promote the Company through participation in community and professional organizations. • Participate proactively in improving performance at the organizational, departmental and individual levels. • Improve own professional knowledge and skill level. • Advance electronic media skills. • Support Company research and educational activities. • Share expertise with co-workers both formally and informally. • Participate in Quality Assessment and Performance Improvement activities as appropriate for the position. Job Responsibilities: • Assists in the implementation of daily procedures to open and close the store; implements sales strategies to ensure the customer experience is maximized while conflicts are mitigated. • Promotes a positive influence throughout the store including the receiving room, stock room, break room and sales floor. • When necessary, oversees back office functions including, but not limited to, processing cash transactions, creating bank deposits, reporting, and auditing customer transactions. • Collaboratively ensures the timely pick-up and delivery of donations. • Assists in the receiving of merchandise ensuring each item is properly processed and placed in the store. • Working with store staff and volunteers, ensures regular store maintenance is performed to establish a pleasant and safe retail environment to maximize the shopping experience. • Supports volunteers on the sales floor with customer conflicts, pricing issues, etc. • Responsible for effectively managing, training, guiding, communicating with, scheduling and organizing the store’s volunteer work force which may surpass 20 volunteers each day. • Promotes and is knowledgeable about Company programs and services. • Implements strategies, programs and activities as selected by the Foundation Executive Director and/or the Director of Thrift Stores. • Performs other duties as assigned.This position requires consent to drug and/or alcohol testing after a conditional offer of employment is made, as well as on-going compliance with the Drug-Free Workplace Policy.

Thrift Store Assistant-Hope Healthcare Cape Coral

Salary Range:&nbsp;&nbsp;$60,778.00&nbsp;(Min.) -&nbsp;$75,950.00&nbsp;(Mid.) -&nbsp;$91,166.00&nbsp;(Max.)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. 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. <h4>Job Summary</h4>The Customer Solution Center Appeals and Grievances (A&amp;G) Specialist II &nbsp;will receive, investigate and resolve member and provider complaints and appeals exercising strong independent judgment. This position will provide resolution of complaints in compliance with Centers for Medicare and Medicaid Services (CMS), California Department of Health Care Services (DHCS), Department of Managed Health Care (DMHC), Managed Risk Medical Insurance Board (MBMIB) and National Committee for Quality Assurance (NCQA) regulatory requirements. This position reviews pre-service authorizations, concurrent and post-service (retroactive review) medical necessity; benefit coverage appeals and reconsiderations, and complex provider claim disputes. &nbsp;The position is further responsible for tracking, trending and reporting complaints and appeals, as well as participating in internal and external oversight activities.The position is responsible for maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting noncompliance, adhering to company policy and procedures, including accreditation requirements, applicable federal, state and local laws and regulations.<h4>Duties</h4>Identifies, investigates, and resolves administrative complaints, complex provider appeals and State Fair Hearing adhering to CMS, DHCS, DMHC, MRMIB and NCQA standards and regulations.Intakes, acknowledges, prepares case files and routes complaints to appropriate internal department for investigation and resolution, exercising strong independent judgment.&nbsp;Ensures integrity of A&amp;G database by thorough, timely and accurate assignment of cases. &nbsp;Monitors closure of complaints and works with Quality Control Supervisor to resolve all database issues.&nbsp;Prepare and analyze monthly appeal and grievance reports to meet internal and external reporting requirements.Participates in internal and external oversight activities, inter-rater reliability reviews and focused audits. &nbsp;Recommends opportunities for improvementPerform other duties as assigned.<h4>Duties Continued</h4><h4>Education Required</h4>Associate's DegreeIn lieu of degree, equivalent education and/or experience may be considered.<h4>Education Preferred</h4>Bachelor's Degree<h4>Experience</h4>Required:At least 2 years of experience in Managed Care with specific experience in resolving member and provider complaint and appeals issues, including eligibility, access to care, claims, benefit, and quality of care concerns.&nbsp; Experience working with firm deadlines, able to interpret and apply regulations. &nbsp;At least 5 years of experience in Managed Care working with Medicare, Medi-Cal and other State Sponsored programs. &nbsp;Knowledge of Medical terminology and strong advocacy experience.<h4>Skills</h4>Required: Must be organized, detail oriented, able to exercise strong independent judgment; poses conflict resolution and persuasion skills. &nbsp;A team player with excellent communication and presentation skills, able to work effectively with various internal departments/service areas, plan partners, participating provider groups and other external agencies. Proficient in MS Office applications, Word, Excel and Power Point.&nbsp;Requires strong knowledge of regulatory standards and claims processing; strong analytical, oral, written and presentation skills, able to monitor and be compliant with strict regulatory deadlines.&nbsp;Preferred: Proficient in MS Office applications, Access, Visio.<h4>Licenses/Certifications Required</h4><h4>Licenses/Certifications Preferred</h4><h4>Required Training</h4><h4>Physical Requirements</h4>Light<h4>Additional Information</h4>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.L.A. Care offers&nbsp;a wide range of benefits including<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>

L.A. Care Health Plan

Customer Solution Center Appeals and Grievances Specialist II

Full time - evening or day shift!Duties and Responsibilities:<ul><li>Assume the charge nurse role if applicable and/or unit nurse role by:</li><li>Receiving and giving accurate and thorough shift reports</li><li>Keeping the physicians informed of patient’s conditions, change of conditions, LOC and triage information and needs</li><li>Correctly entering and taking off physician orders</li><li>Oversight of the care of patients by auxiliary personnel</li><li>Organizing and delegating patient care activities</li><li>Monitoring and/or performing diagnostic screening tests as ordered by physician</li><li>Providing thorough and accurate patient information during shift exchange for end of shift report</li><li>Assess individual patient care needs, initiate medical treatment plan and competently implement/instruct all care in the appropriate nursing practice to all staff.</li><li>Serve as a resource to treatment team members.</li><li>Perform nursing assessments, LOC, and review patient histories to document all necessary information in the Electronic Medical Record on all patients admitted to Caron.</li><li>Prepare patients for examinations: height/weight, vitals, collect and process lab specimens including UDS, UA, Chem Sticks, etc. following proper infection control procedures.</li><li>Utilize safe and effective practices of medication management as defined by policy including the oversight of self-administration observation of medication.</li><li>Administer and monitor the effects of medications, ensure accurate medication is ordered and administered for controlled substances and conduct accurate med counts.</li><li>Provide appropriate patient education as determined by patient assessments/needs and treatment plans.</li><li>Conduct 14-day, 25-day and PRN meetings with patients for assigned units when in unit nurse role.</li><li>Monitor and/or perform withdrawal assessments and appropriately implement/instruct the necessary nursing interventions.</li><li>Accurately and thoroughly document in the medical record utilizing approved medical record language and abbreviations adhering to the medical record policies and procedures.</li><li>Schedule all patient appointments related to their medical treatment.</li><li>Work a flexible schedule based upon service demands and work mandatory overtime as needed.</li><li>Attend all mandatory trainings as identified by Caron policies.</li><li>Attend multi-disciplinary treatment team meetings when in unit nurse role.</li><li>Maintain the quality control logs.</li><li>Provide support services for patient care issues to staff at other Caron facilities.</li><li>Maintain adequate staffing for each shift.</li><li>Ensure the highest level of professionalism for self and staff and maintain a clean and organized work environment.</li><li>Complete yearly training requirements and mentor new employees.</li><li>This job description reflects management’s assignment of essential functions and does not prescribe or restrict the tasks that may be assigned.</li></ul>Physical Requirements:The physical and mental demands described here are representative of those that must be met to successfully perform the essential functions of this job.&nbsp; Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.<ul><li>Lifting: up to 50 pounds on occasion.</li><li>Standing: up to several hours at a time, this may include walking, climbing steps, and descending steps.</li><li>Walking: must be able to ambulate throughout the assigned facilities on campus or Caron properties.</li><li>Sitting: up to several hours at a time for data entry into the computer or medical record documentation.</li></ul>EDUCATION/EXPERIENCE QUALIFICATIONS:<ul><li>Currently licensed as RN in Pennsylvania.</li><li>Current Certified Addiction Registered Nurse (CARN) certification preferred.</li><li>1-3 years’ experience working as an RN preferably in ER, acute care or mental health setting</li><li>Current CPR/First Aid training/certification.</li><li>21 years of age or older is required</li><li>Requires a current, valid, unrestricted driver’s license</li><li>Two years continuous sobriety preferred if in recovery.</li><li>Previous hospital/chemical dependency rehabilitation treatment program experience desired.</li><li>Possess a working knowledge of addictions with age specific patient populations preferred.</li><li>Working knowledge of electronic medical record and charting.</li></ul>#IND102

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