Jobs in Florence Ky Remote
2,307 positions found — Page 11
Hire Type: Direct Hire
Benefits: Benefits from day 1 with almost 100% coverage! In addition to 11 paid holidays, 2-3 weeks vacation, 401K, etc.
Target Salary:$120,000-150,000
Bonus/ Incentives/ Stock Options: up to 20% annual bonus
Job Summary: Plan, organize, and direct the design engineering staff to develop specialized structures for North American Class 1 and Transit applications. Lead the development and standardization of the design engineering processes for the production and assembly of products across seven facilities within the US. Responsible for implementing and championing new methodologies to improve the consistency and timeliness of the design engineering activities, as well as streamline and clarify projects to reduce completion time.
Job Duties:
- Manage engineering personnel (including direct reports) to ensure projects are completed and released according to specifications and schedules
- Champion the continuous improvement efforts of design engineering
- Identify opportunities to improve or mitigate risk through data driven process approach
- Develop designs with consideration of interested parties, manufacturability, and cost implications
- Create training programs to develop new hires, expand roles of existing employees, and empower the Design team as a whole
- Communicate with Customers and outside agencies to prioritize submittals and approvals
- Forecast team workload and schedules, develop strategies to address resources constraints; promote teamwork and shared workload
- Implement and review check sheets to monitor progress and quality of design work
- Assign and prioritize staff projects
- Manage overall design engineering backlog
- Lead product strategy vision and development requirements to achieve strategy goals, market share, cost, and OPACC objectives
Qualifications:
- Master’s degree in Engineering (PE desirable) or bachelor’s degree with equivalent required experience
- Familiarity with international standards and regulations (FRA, AAR, EN, AS/RISSB) preferred
- Experience in structural steel design, metallurgy, steel machining, and processing
- Demonstrated experience in leading product development and design processes
- Knowledge of ISO (AREMA & AAR a plus) standards and specifications related to product design and application, product development, engineering principles, and testing, to include theory, design and manufacture, project management, and data analysis
- Proven experience with design software including various 2D and 3D modeling and drawing platforms (AutoDesk-AutoCAD, Inventor, Visual Basic, LISP)
- Experience with ASME Y14.5, AIAG Core Tools (DFMEA) and Root Cause are a plus
- Strong proficiency with MS Office tools (Outlook, Excel, Word, PowerPoint) and Blueprint reading
Qualified applicants will receive consideration for employment without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or genetic information.
North - Field Remote
Let’s go North, together.
Join our mission to build the largest suite of credit card processing and merchant services. It’s one simple payment platform backed by the most diverse payment companies. From credit card processing to back-office management, North points the way to smarter, faster, and just plain better payment solutions.
Sales Professional – SaaS, Software & Payment Processing
At North, we’re on a mission to be the easiest payments company to do business with - because let’s face it, running a restaurant or shop is already enough of a juggling act! That’s why we created the North Direct Field Sales (NDFS) team: to swoop in and save the day (or at least the checkout process).
North is shaking up how restaurants and retailers thrive, and we want you to be part of this revolution! As an NDFS Sales Professional, you’ll bring North’s state-of-the-art SaaS platform to life for local businesses—like a techy superhero, minus the cape.
We're building something BIG and we can not do it without top sales talent. Are you a passionate sales whiz who loves building connections and sealing deals? You’ll be using your consultative superpowers to help businesses find the perfect fit for their payment needs—all while working from home, with a flexible schedule that lets you be the boss of your calendar.
Oh, and about that green stuff. Sure, money can’t buy happiness—but it can definitely buy pizza, vacations, and the occasional inflatable flamingo for your pool. That’s why our top sales pros earn the most lucrative compensation in the SaaS & Payments space – we call it North ’25. Which includes sky-high weekly commissions, residuals for the life of their accounts, and even a slice of portfolio equity.
So if you’re ready to rock your neighborhood (or at least your sales territory), come join North and help us create a future where payments are the least of a business owner’s worries!
What you’ll do:
- Put together your ultimate playlist of local businesses and guide them through the entire sales cycle—first call to final high-five. Bonus points if you’re a lead-generation wizard.
- Forge rock-solid partnerships with local POS dealers, web designers, and BNI folks to build an unstoppable referral network.
- Perform demos so dazzling, prospects will feel like they’re front-row at a magic show.
- Team up with our awesome colleagues across North to make sure your promises turn into real results.
- Use Salesforce like a pro—think Jedi-level control over all your sales activities.
- Get to know the competition like it’s your favorite soap opera—and find ways to make North shine like polaris.
What we need from you:
- You’re at least 18 and have a valid driver’s license.
- Charisma that could charm the socks off anyone (plus strong communication, organizational, and presentation skills).
- Thrives in a fast-paced, startup vibe—where every day’s an adventure and “boring” doesn’t exist.
- A self-starter who can pivot on a dime and still shine brighter than the Vegas strip.
- Cold-calling and local canvassing experience? Even better.
- Knowledge of restaurants is a plus (because who doesn’t love good food?).
- Sales experience preferred, especially if you’re the type who loves the thrill of the chase and the rush of the close.
- This is a remote field sales role, but you’ve gotta live in the area—no teleportation allowed (yet).
Career path and perks:
- We’re big fans of promoting from within. Sales leadership, business development, revenue operations—the sky’s the limit.
- W2 status with medical, dental, life, and disability insurance—so you can stay healthy and happy.
- First-year pros in the top 25% can expect $90,000–$105,000+ with uncapped weekly commissions, lifetime residuals, and portfolio equity. Show us the money!
- We’ve got shout-outs galore, with peer and company recognition programs to keep you feeling like the rockstar you are.
- A 401(k) with matching to help you save up for that future yacht (or that future hammock).
Ready to start a fun and rewarding sales career? Apply now to join our rockstar sales team!
Who we are:
North, and our family of companies, are committed to helping entrepreneurs grow their businesses. As an end-to-end payment solutions company, we provide everything business owners need to get paid, whether they serve customers in a physical storefront, online, or both. We pride ourselves on being large enough to offer customized solutions to our enterprise-level clients while remaining agile enough to take an award-winning, hands-on approach to personal service that our merchants won’t find anywhere else.
What we offer:
We offer a comprehensive benefits package that enables our teams to live a life well lived, both personally and professionally. Some of our perks include:
- Medical, Dental, & Vision Coverage
- 401(k) + Match
- Education Assistance
- Mental Health Support & Well-Being Program
- Company-funded Lifestyle Spending Account
Let’s go North, together! Our most important resource is our people. Join our diverse team of innovators and do-ers and make your mark on the future of payments technology. We're proud to offer benefits that help our team members further their overall well-being through unique initiatives that are both personally and professionally fulfilling.
At North, we celebrate diversity and create an inclusive environment for everyone. We are an equal opportunity employer.
To learn more about North, and our family of companies, visit our website:
POSITION OVERVIEW
The Senior Estimator plays a critical role within the preconstruction team. This position is responsible for leading complex estimating efforts, developing accurate and competitive project budgets, and collaborating closely with internal teams, subcontractors, and clients. The Senior Estimator also supports continuous improvement initiatives and mentors junior estimating staff to ensure consistency, accuracy, and efficiency across estimating operations.
KEY RESPONSIBILITIES
Preconstruction & Estimating Leadership
- Lead preconstruction and estimating efforts for large-scale, complex, or high-priority commercial construction projects.
- Develop detailed conceptual, schematic, design development, and GMP estimates.
- Analyze drawings, specifications, and project documents to prepare comprehensive and accurate cost estimates.
- Identify project risks, assumptions, and contingencies and communicate them clearly to stakeholders.
Subcontractor & Supplier Coordination
- Solicit, review, and evaluate subcontractor and supplier bids for scope completeness and pricing accuracy.
- Coordinate bid leveling and ensure alignment with project scope and schedule.
- Develop strong working relationships with trade partners and suppliers.
Client & Internal Collaboration
- Collaborate with project management, operations, architects, engineers, and consultants to define scope and pricing strategies.
- Present estimates, budgets, and value engineering options to clients and executive leadership.
- Support business development efforts by assisting with pricing strategies and proposal development.
Value Engineering & Cost Control
- Develop value engineering options and cost-saving recommendations while maintaining quality and performance.
- Utilize historical cost data and market trends to enhance estimate accuracy.
- Participate in post-bid and post-project reviews to evaluate estimating performance and identify improvement opportunities.
Leadership & Mentorship
- Mentor and support junior estimators and preconstruction team members.
- Assist leadership with developing and maintaining standardized estimating procedures and best practices.
- Promote collaboration, accountability, and continuous improvement within the estimating team.
QUALIFICATIONS AND EXPERIENCE
- Bachelor’s degree in Construction Management, Engineering, or a related field preferred.
- 7+ years of experience in commercial construction estimating, including experience leading complex projects.
- Strong understanding of construction methods, materials, and cost drivers.
- Proficiency with estimating software, digital takeoff tools, and Microsoft Office applications.
- Excellent analytical, organizational, and communication skills.
KEY COMPETENCIES
- Advanced estimating and cost analysis expertise.
- Strong leadership and mentorship capabilities.
- Strategic thinking and problem-solving skills.
- High attention to detail and accuracy.
- Ability to communicate effectively with clients, trade partners, and executive leadership.
We’re unique. You should be, too.
We’re changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?
We’re different than most primary care providers. We’re rapidly expanding and we need great people to join our team.
ChenMed, a physician-led and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to be America’s leading primary care provider, transforming care of the neediest population. Our mission is to honor seniors with affordable VIP care that delivers better health. In order to achieve our vision and deliver our mission, we need the best primary care providers that are seeking to fulfill purpose and personal opportunity and join the ChenMed family. The Primary Care Physician (PCP) in our organization demonstrates: • Accountability for outcomes: The PCP demonstrates accountability for outcomes, strong clinical care, and cost-effectiveness for each patient in their panel of up to 450 patients. They understand that they can strongly influence the patient’s outcomes by building a trusting relationship and helping them change behaviors.• Coaching for health: The PCP acts as a health coach, rather than just a consultant for sickness, by helping patients set short and long-term health goals, partners with the patient to work toward the goals, and frequently follows up on those goals on the path to improved health for their patients.
• Simplifying for action: The PCP simplifies and prioritizes appropriately so that behavior change is more actionable, both for the patient in helping them achieve their goals, and when leading their care teams towards their performance goals. We are an outcomes-focused, value-based organization and for their panel of patients, the following metrics are regularly measured to help PCP’s become successful and reach partnership status: patient admissions/thousand, using between 18-21 appointment slots per day (each new patient count for 2 slots, follow-up patients 1 slot), CGCAHPS (patient experience), clinical gaps closures, and medical cost measures. Each PCP will have goals for these metrics and will be expected to work towards those targets with their center and market leadership as well as their care teams. Culture is very important in the medical centers and because PCP’s are leaders in our organization and centers, they are expected to help champion a positive culture of love, accountability, and passion along with center leadership.
The PCP will be required to demonstrate the ability to function both independently and in collaboration with other health care professionals. The PCP will work closely with the applicable managers and medical directors to ensure compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as required that promote patient health and company goals.
The PCP will adhere to strict departmental goals/objectives, standards of performance, regulatory compliance, quality patient care compliance, and policies and procedures.
ESSENTIAL JOB DUTIES/RESPONSIBILITIES:
- The PCP independently provides care for patients with acute and chronic illnesses encountered in the older adult patient.
- The PCP will take full accountability for patient care and outcomes and will appropriately seek consultation from specialists when needed, though will still stay involved in, and be responsible for, the detailed care of the patient.
- It is expected that the PCP will engage with the hospitalist whenever one of their patients is in the hospital (regardless of whether the hospitalist works for ChenMed or not).
- The PCP is responsible for assessment, diagnosis, treatment, management, education, health promotion and care coordination and documentation for patients with acute and complex chronic health needs.
- The PCP leads their care team consisting of care promoter (medical assistant), care facilitator, and care coordinator for patients able to come to the office.
- For patients that are unable to come to the office—in hospital, SNF, LTC or homebound, PCP will engage with the transitional care team and others including case managers, acute and transitional-care physicians, and other resources that may be available depending on the market.
- PCP will have an active role in the management of their center and will help cover for other providers who may be out for various reasons. It is also expected that each PCP will take an active role as needed in recruiting patients for the center and additional providers for the company.
- Supervises, collaborates with, participates with, or functions within a practice or collaborative agreement with an Advanced Practice Practitioner (APP) and remains accountable for the actions of the APP while employed with the company.
- Performs other duties as assigned and modified at manager’s discretion.
KNOWLEDGE, SKILLS & ABILITIES:
Competencies for Success
- Availability and Accessibility for patients to build trust from their patients. It is expected that PCP’s will make themselves as available to their patients as possible by being open and available for walk-in visits and answering phone calls and messages in a timely manner.
- Service Orientation — PCP’s provide care that they would want for a family member or for themselves to each patient at every interaction.
- Evidence Based Medicine — The PCP remains updated on evidence-based medicine, but also recognizes that factors outside of traditional medicine, like lifestyle and nutrition, have a large impact on patient health outcomes. The PCP stays up to date on clinical, nutritional, and lifestyle-based interventions to improve outcomes.
- Physician Leadership is integral to good healthcare, so the PCP must be willing to continuously work to develop and improve leadership skills for the benefit of one’s patients, their team, their center and the company .
- Quality — Our patients deserve the highest quality of care. This requires a willingness to work with the care teams towards achieving high quality outcomes and quality measures. At the same time, PCPs will always be looking for ways to continuously and systematically improve their practice of medicine and the operations of their center.
- Influence — PCP’s must competently and compassionately influence their patients, their teams, and themselves to achieve the best outcomes.
- Self-Care — A PCP can take the best care for their patients when they are adequately caring for themselves. That means physically, mentally, socially and spiritually. Physician wellness is important for sustainability and promoting the health of physicians, staff, and patients.
- Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, plus a variety of other word-processing, spreadsheet, database, e-mail and presentation software as used in the company
- Ability and willingness to travel locally as needed in their market, if applicable, nationally for initial training (2 weeks) and then occasionally regionally and nationally for recruiting or training purposes.
- Fluency in English, verbal and written. There may be jobs in some centers that require fluency in other languages, and this will be made known at the time of application.
- This job requires use and exercise of independent judgment
PAY RANGE:
$214,700 - $306,714 SalaryEMPLOYEE BENEFITS
We’re ChenMed and we’re transforming healthcare for seniors and changing America’s healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We’re growing rapidly as we seek to rescue more and more seniors from inadequate health care.
ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people’s lives every single day.
Current Employee apply HERE
Current Contingent Worker please see job aid HERE to apply
#LI-Onsite
Your initial post of duty will be determined at the time of the final job offer and will be based on the operational needs of the U.S. Secret Service.
Recruitment Incentive: Applicants may be eligible for a $40,000 recruitment incentive in accordance with regulatory requirements. Click apply for complete details on the recruitment incentive details and eligibility.
At their core, those who join the Secret Service are courageous, intelligent, strong and determined. A diverse team capable of balancing our investigative mission and fulfilling our protective legacy. Proven to be worthy of trust and confidence. Be tomorrow's Secret Service.
During the course of their careers, special agents carry out assignments in both investigations and protection and may be assigned to multiple duty stations throughout the U.S. and abroad. Duties include:
- Providing protection for various protectees.
- Conducting criminal investigations pertaining to financial obligations of the United States.
- Planning and implementing security designs for National Special Security Events.
This is no ordinary job, and our special agents are no ordinary individuals. Show us you have the talent and background we need, and we'll show you the rewards that come with being a special agent in the U.S. Secret Service. We invite you to become part of our elite team. Explore a career that will take you to new heights while you serve your country with honor, distinction and pride.
Requirements
- U.S. citizenship is required
- Possess a current valid driver's license
- Carry and use a firearm. Maintaining firearm proficiency is mandatory.
- Must be at least 21 years old at the time of application and under 40 at referral. Exceptions may apply for those with current or prior service in federal law enforcement positions covered by special retirement provisions. The Secret Service has determined that age is essential to the performance of this position.
- You must obtain a Top Secret Clearance and retain it during your career.
- Possess uncorrected visual acuity of no worse than 20/100 binocular, possess corrected visual acuity of 20/20 or better in each eye.
- Hearing loss, as measured by an audiometer, must not exceed 25 decibels (A.S.A. or equivalent I.S.O.) in either ear in the 500,1000 and 2000Hz ranges.
- Submit to a drug test prior to your appointment and random drug testing while you occupy the position.
- Complete 13 weeks of intensive training at the Federal Law Enforcement Training Center(FLETC) in Glynco, GA and 18 weeks of specialized training at the James J. Rowley Training Center in Laurel, MD.
- Sign a mobility agreement stating your willingness to accept assignments anywhere within the United States and overseas.
- Certify that you have registered with the Selective Service System or are exempt from having to do so, if you are a male applicant born after December 31, 1959.
Citizen, U.Person, or Immigration Status Requirements:
S. government issued security clearance is required. S. citizens are eligible for a security clearance Security Clearance Type:
Secret Security Clearance Status:
Active and existing security clearance required after day 1
At Raytheon, the foundation of everything we do is rooted in our values and a higher calling – to help our nation and allies defend freedoms and deter aggression. Raytheon Engineering designs, produces, and builds new technologies and enhances existing capabilities to solve our customers’ most complex challenges. The Airborne Antenna Design Department is a team of engineers responsible for electrical design and development of RF products within Raytheon. Our charter is to provide expertise in sub-systems engineering, RF and radome design, digital apertures, antenna ranges and module test.
We are looking to add to our team and desire a Senior Technical Support Engineer to be part of a team that provides the most advanced end-to-end solutions that detect, track, engage and neutralize a broad range of threats. The role includes knowledge of RF product testing and associated RF test equipment, typically obtained through a University Degree program, or through work experience. May have practical knowledge of projects, programs and systems with the ability to make enhancements in daily work.
Perform electrical engineering functions involving the layout, building, testing, troubleshooting, repairing and modification of electronic or electro-mechanical devices, assemblies, subsystems, and systems.
Perform analysis on production data, to determine root cause analysis of failures.
Be involved in planning and executing rework of production assemblies.
This 1st shift role will be 100% on-site and based in McKinney, TX.
Typically requires a degree in Science, Technology, Engineering or Mathematics (STEM) and a minimum of 5 years of prior work experience to include any combination of the following:
S. government issued security clearance is required. S. citizens are eligible for a security clearance.
Active DoD Secret clearance with investigation within last five years.
Our values drive our actions, behaviors, and performance with a vision for a safer, more connected world. This position offers relocation based on candidate eligibility.
Clearance Information: This position requires a security clearance. DCSA Consolidated Adjudication Services (DCSA CAS), an agency of the Department of Defense, handles and adjudicates the security clearance process. More information about Security Clearances can be found on the US Department of State government website here:
As part of our commitment to maintaining a secure hiring process, candidates may be asked to attend select steps of the interview process in-person at one of our office locations, regardless of whether the role is designated as on-site, hybrid or remote.
RTX considers several factors when extending an offer, including but not limited to, the role, function and associated responsibilities, a candidate’s work experience, location, education/training, and key skills.
Hired applicants may be eligible for benefits, including but not limited to, medical, dental, vision, life insurance, short-term disability, long-term disability, 401(k) match, flexible spending accounts, flexible work schedules, employee assistance program, Employee Scholar Program, parental leave, paid time off, and holidays. Specific benefits are dependent upon the specific business unit as well as whether or not the position is covered by a collective-bargaining agreement.
Hired applicants may be eligible for annual short-term and/or long-term incentive compensation programs depending on the level of the position and whether or not it is covered by a collective-bargaining agreement. Payments under these annual programs are not guaranteed and are dependent upon a variety of factors including, but not limited to, individual performance, business unit performance, and/or the company’s performance.
S. territory, the appropriate pay structure and benefits will apply.
RTX anticipates the application window closing approximately 40 days from the date the notice was posted. However, factors such as candidate flow and business necessity may require RTX to shorten or extend the application window.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or veteran status, or any other applicable state or federal protected class. RTX provides affirmative action in employment for qualified Individuals with a Disability and Protected Veterans in compliance with Section 503 of the Rehabilitation Act and the Vietnam Era Veterans’ Readjustment Assistance Act.
Privacy Policy and Terms:
Click on this link to read the Policy and Terms
Remote working/work at home options are available for this role.
Join a mission-driven team making a lasting difference in kidney care.
University Health is seeking a passionate, board-certified Nurse Practitioner or Physician Assistant to join our dynamic Nephrology team. In this hybrid role—split between inpatient and outpatient settings—you'll provide compassionate, patient-centered care while helping advance our commitment to excellence in nephrology.
The ideal candidate is a dedicated clinician who thrives in a collaborative environment, values lifelong learning, and is eager to support a diverse patient community. Two or more years of direct nephrology experience are preferred.
Why You'll Love This Role
- Balanced Schedule: Monday–Friday hybrid model—1 week in clinic, 1 week rounding in the hospital
- Impactful Work: Manage and follow patients with acute and chronic kidney disease, ensuring continuity and quality of care
- Collaboration: Work side-by-side with nephrologists and multidisciplinary teams to create personalized treatment plans
- Guidance and mentorship from a dedicated academic nephrologist
- Education & Empowerment: Help patients and families understand disease management, medications, and lifestyle changes
- Professional Growth: Participate in quality improvement initiatives and contribute to the continued growth of our Nephrology program
What We Offer
- Competitive compensation package
- Annual Professional Business Expense Allowance and Paid CME days
- Internal Loan Repayment program
- Comprehensive benefits with affordable medical insurance
- Generous paid time off and retirement plan options with employer match
- Mentoring programs and regular provider meetings that foster teamwork and growth
Education & Experience
Graduate of an accredited Nurse Practitioner (NP) or Physician Assistant (PA) program.
- At least 3 years of nursing experience with 2 years of advanced practice preferred.
Licensure & Certifications
Current Texas RN and APRN license (for NPs) or Texas PA license. Must hold national certification, prescriptive authority, and AHA BLS (or higher) certification as required by Medical-Dental Staff Bylaws. A valid DEA number is required within 90 days of hire.
Life in San Antonio, Texas
Experience the perfect blend of big-city amenities and small-town charm in San Antonio—a vibrant, culturally rich community known for its friendly people, diverse neighborhoods, and affordable cost of living. Enjoy world-class dining, outdoor recreation, and a thriving arts scene, all while benefiting from no state income tax. With excellent public and private schools, San Antonio offers an exceptional quality of life for professionals and families alike.
Top of Form
Bottom of Form
Join us at University Health and UMA—where your skills, compassion, and expertise will make a meaningful impact every day.
Remote working/work at home options are available for this role.
POSITION SUMMARY/RESPONSIBILITIES
Provides direct and indirect nursing care to patients in the ambulatory setting in accordance with UH policies and standards. Supports and promotes University Health values to ensure patient/guest relations. Performs the nursing process in a safe therapeutic manner in a designated clinic setting. Maintains, facilitates and promotes department policies and standards.
EDUCATION/EXPERIENCE
Graduation from an accredited school of vocational nursing is required. Starting pay varies based on experience; entry up to 2 years, 2–3 years and 4 years or more experience in health care delivery as an LVN. PALS and ACLS certification may be required based on site location.
LICENSURE
Must possess a current license to practice Vocational Nursing in the State of Texas. Must have a current AHA BLS Healthcare Provider or AHA BLS Instructor Provider card.
Remote working/work at home options are available for this role.
POSITION SUMMARY/RESPONSIBILITIES Serves as a member of the mental health care team that provides specialized health care for selected groups of patients in the Adult Detention Center.
Participates as a part of a multidisciplinary team that includes medical and mental health.
Actively supports and adheres to the University Health policies and procedures.
Ensures efficient, appropriate and adequate mental health care is administered to incarcerated individuals in the Bexar County Adult Detention Center.
Supports and adheres to University Health (UH) and Detention Health Care Services (DHCS) – policies and procedures.
Demonstrates behaviors consistent with UH mission, vision, and values.
Promotes excellent internal and external customer relations.
EDUCATION A Registered Professional Nurse who is prepared for advanced nursing practice by virtue of knowledge and skills obtained through an accredited post basic or advanced educational program of study acceptable to the Board of Nurse Examiners.
A Master's degree in nursing is preferred.
Three years of nursing experience is required and two years of advanced practice is preferred.
Certification by a national nursing body is recommended.
LICENSURE Must be currently licensed as a Registered Nurse in Texas and credentialed by the State to practice as a Nurse Practitioner.
Prescriptive authority is required.
Remote working/work at home options are available for this role.
Conducts comprehensive clinical reviews of adverse determinations related to medical necessity.
Initiates outreach to providers to obtain clarification or additional documentation in alignment with established clinical criteria and organizational policies, to support Medical Director decision making.
Provides support for claim appeals in relation to medical necessity.
Ensures the timely and accurate resolution of appeal cases and supports organizational adherence to all state, federal, and accreditation standards.
Facilitates member second level appeal process.
Graduate from an accredited school of professional nursing is required.
BSN preferred.
Minimum 2 years acute care experience or managed care experience is required.
Basic knowledge of Medicaid, Medicare preferred.
Knowledge of InterQual screening criteria, ICD-10, CPT coding preferred.
Current Registered Nurse (RN) license to practice professional nursing issued by the Board of Nurse Examiners for the State of Texas is required.
Active Certification in Case Management (CCM) is preferred.
Remote working/work at home options are available for this role.