Jobs in Fremont, CA
754 positions found — Page 14
Nurse Case Manager - CFHP PRN
✦ New
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
Identifies Community First Health Plan members with specific health care needs and provides case management interventions. Analyzes, approves health care services and monitors outpatient care planning for Community First Health Plans members based on established criteria, plan policies and procedures. Formulates and communicates case management plans that efficiently utilize health care services to move the member along the continuum of care towards optimum outcomes in the safest, most cost effective manner.
EDUCATION/EXPERIENCE
Graduation from an accredited school of professional nursing is required, BSN preferred. Master’s degree is preferred. Minimum three years’ acute care experience or managed care experience is required. Minimum one-year of concurrent review experience is required. Candidate must have utilization management and/or quality assurance experience. Basic knowledge of Medicaid, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD-9 and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current Registered Nurse 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) designation is preferred.
Identifies Community First Health Plan members with specific health care needs and provides case management interventions. Analyzes, approves health care services and monitors outpatient care planning for Community First Health Plans members based on established criteria, plan policies and procedures. Formulates and communicates case management plans that efficiently utilize health care services to move the member along the continuum of care towards optimum outcomes in the safest, most cost effective manner.
EDUCATION/EXPERIENCE
Graduation from an accredited school of professional nursing is required, BSN preferred. Master’s degree is preferred. Minimum three years’ acute care experience or managed care experience is required. Minimum one-year of concurrent review experience is required. Candidate must have utilization management and/or quality assurance experience. Basic knowledge of Medicaid, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD-9 and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current Registered Nurse 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) designation is preferred.
Not Specified
Nurse Case Manager - CFHP
✦ New 🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members.
EDUCATION/EXPERIENCE
Registered Nurse (RN) is required. Bachelor of Science in Nursing (BSN) or Master’s degree is preferred. Minimum three (3) years nursing, acute care, quality management or managed care experience is required. Basic knowledge of Medicaid, Medicare, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. Current certification from an appropriate professional agency, such as Case Management Society, is preferred.
Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members.
EDUCATION/EXPERIENCE
Registered Nurse (RN) is required. Bachelor of Science in Nursing (BSN) or Master’s degree is preferred. Minimum three (3) years nursing, acute care, quality management or managed care experience is required. Basic knowledge of Medicaid, Medicare, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. Current certification from an appropriate professional agency, such as Case Management Society, is preferred.
Not Specified
LVN Ambulatory PRN
✦ New 🏢 University Health
Salary not disclosed
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 System 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
At least one year experience in direct patient care is preferred. Current American Heart Association, Basic Cardiac Life Support and Healthcare Provider card required. ACLS certification may be required based on site location. Various certifications may be required based on location site.
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.
Provides direct and indirect nursing care to patients in the Ambulatory setting in accordance with UH policies and standards. Supports and promotes University Health System 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
At least one year experience in direct patient care is preferred. Current American Heart Association, Basic Cardiac Life Support and Healthcare Provider card required. ACLS certification may be required based on site location. Various certifications may be required based on location site.
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.
Not Specified
Nurse Case Manager CFHP PRN
✦ New 🏢 University Health
Salary not disclosed
POSITION SUMMARY AND RESPONSIBILITIES
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.
EDUCATION/EXPERIENCE
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.
LICENSURE
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.
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.
EDUCATION/EXPERIENCE
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.
LICENSURE
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.
Not Specified
Staff Nurse II
✦ New 🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
Trains patients and care partners on self-care home hemodialysis (HHD) or peritoneal dialysis (PD) techniques, equipment use, infection control, and emergency procedures. Home Dialysis nurses will also conduct home visits to assess the environment and ensure safety and compliance. Home Dialysis nurses will also be required to take on call responsibilities for patient and care partner support during and after office hours, and on holidays. Performs the nursing process in a safe therapeutic manner in a designated clinical setting.
Provides direct patient care (HHD/CAPD/CCPD) and monitoring of renal dialysis patients. Coordinates home dialysis activities within the frame work of the Federal Regulations, State and Local End Stage Renal Disease Network. Supports and adheres to University Health and department specific policies and standards. Receives mentoring from the Patient Care Coordinator and Director of Dialysis Services.
EDUCATION/EXPERIENCE
Registered nurse who has at least 2 years of experience as an RN, and six months experience in the specific home dialysis modality. BSN is highly preferred.
Must meet career ladder Staff Nurse II criteria for specialty area worked. National Certification in Dialysis is preferred.
Must have current American Heart Association, Basic Cardiac Life Support and Healthcare Provider card.
LICENSURE/CERTIFICATION
Must be a Registered Nurse currently licensed in the state of Texas.
Trains patients and care partners on self-care home hemodialysis (HHD) or peritoneal dialysis (PD) techniques, equipment use, infection control, and emergency procedures. Home Dialysis nurses will also conduct home visits to assess the environment and ensure safety and compliance. Home Dialysis nurses will also be required to take on call responsibilities for patient and care partner support during and after office hours, and on holidays. Performs the nursing process in a safe therapeutic manner in a designated clinical setting.
Provides direct patient care (HHD/CAPD/CCPD) and monitoring of renal dialysis patients. Coordinates home dialysis activities within the frame work of the Federal Regulations, State and Local End Stage Renal Disease Network. Supports and adheres to University Health and department specific policies and standards. Receives mentoring from the Patient Care Coordinator and Director of Dialysis Services.
EDUCATION/EXPERIENCE
Registered nurse who has at least 2 years of experience as an RN, and six months experience in the specific home dialysis modality. BSN is highly preferred.
Must meet career ladder Staff Nurse II criteria for specialty area worked. National Certification in Dialysis is preferred.
Must have current American Heart Association, Basic Cardiac Life Support and Healthcare Provider card.
LICENSURE/CERTIFICATION
Must be a Registered Nurse currently licensed in the state of Texas.
Not Specified
Director, Clinical Nursing
✦ New 🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES Maintains management responsibility and accountability for clinical practice of nursing for a nursing unit.
Promotes the University Health System Customer Relation's policy.
EDUCATION/EXPERIENCE Bachelor's Degree in Nursing and current registration with the Board of Nurse Examiners for the State of Texas is required (Magnet).
Master of Science Degree in Nursing with an Administration component is preferred.
Five years experience in nursing with at least two years in a supervisor or managerial position is required.
Experience in a 300+ bed hospital preferred.
Promotes the University Health System Customer Relation's policy.
EDUCATION/EXPERIENCE Bachelor's Degree in Nursing and current registration with the Board of Nurse Examiners for the State of Texas is required (Magnet).
Master of Science Degree in Nursing with an Administration component is preferred.
Five years experience in nursing with at least two years in a supervisor or managerial position is required.
Experience in a 300+ bed hospital preferred.
Not Specified
Nurse Educator
✦ New 🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
Serves as a clinical expert, educator, researcher and mentor for assigned area.
Functions in a team environment to provide support to clinical practice.
EDUCATION/EXPERIENCE
MSNis required plus specialty national certification and Nursing Professional Development Certification or Healthcare Simulation Educator Certification is required or PhD plus specialty national certification is required. Minimum of five years of full-time nursing experience with at least three years in related nursing specialty is required. Demonstration of experience in curriculum development and implementation of adult learning principles is required.
Serves as a clinical expert, educator, researcher and mentor for assigned area.
Functions in a team environment to provide support to clinical practice.
EDUCATION/EXPERIENCE
MSNis required plus specialty national certification and Nursing Professional Development Certification or Healthcare Simulation Educator Certification is required or PhD plus specialty national certification is required. Minimum of five years of full-time nursing experience with at least three years in related nursing specialty is required. Demonstration of experience in curriculum development and implementation of adult learning principles is required.
Not Specified
Staff Nurse - Non-Bedside
✦ New 🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
Assumes the responsibilities of leadership in designated clinic setting to ensure efficient and appropriate administration of care. Supports and maintains the University Health as well as the clinic’s departmental policies and standards.
EDUCATION/EXPERIENCE
BSN preferred, ADN required. Must meet career ladder Staff Nurse II criteria for worked area. Two years or more nursing experience required. American Heart Association, Basic Cardiac Life Support and Healthcare Provider card required.
Assumes the responsibilities of leadership in designated clinic setting to ensure efficient and appropriate administration of care. Supports and maintains the University Health as well as the clinic’s departmental policies and standards.
EDUCATION/EXPERIENCE
BSN preferred, ADN required. Must meet career ladder Staff Nurse II criteria for worked area. Two years or more nursing experience required. American Heart Association, Basic Cardiac Life Support and Healthcare Provider card required.
Not Specified
Staff Nurse
✦ New 🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
Provides clinical nursing leadership and acts as a facilitator, educator, and resource for the Detention Health Care Services team.
Ensures that efficient, appropriate, and therapeutic health care is administered to DHCS patients while also ensuring that established security requirements are maintained (as defined by the Bexar County Adult Detention Center and Central Magistrate’s Office).
Demonstrates patient assessment skills and able to translate knowledge into the planning and interventions required to meet the individual needs of each patient.
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/EXPERIENCE
One year of clinical experience in direct patient care is required.
Experience in correctional health care or nursing within an emergency environment is preferred.
Prior knowledge or experience within the University Health System nursing services and certification as a Certified Correctional Health Care Provider (CCHP) also a plus. BSN is highly preferred.
Trauma Nursing Core Course (TNCC) certification strongly preferred (Central Magistrate)
LICENSURE
Must possess a current Registered Nurse license from the Board of Nurse Examiners of the State of Texas. Must have a current AHA BLS Healthcare Provider or AHA BLS Instructor Provider card
Provides clinical nursing leadership and acts as a facilitator, educator, and resource for the Detention Health Care Services team.
Ensures that efficient, appropriate, and therapeutic health care is administered to DHCS patients while also ensuring that established security requirements are maintained (as defined by the Bexar County Adult Detention Center and Central Magistrate’s Office).
Demonstrates patient assessment skills and able to translate knowledge into the planning and interventions required to meet the individual needs of each patient.
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/EXPERIENCE
One year of clinical experience in direct patient care is required.
Experience in correctional health care or nursing within an emergency environment is preferred.
Prior knowledge or experience within the University Health System nursing services and certification as a Certified Correctional Health Care Provider (CCHP) also a plus. BSN is highly preferred.
Trauma Nursing Core Course (TNCC) certification strongly preferred (Central Magistrate)
LICENSURE
Must possess a current Registered Nurse license from the Board of Nurse Examiners of the State of Texas. Must have a current AHA BLS Healthcare Provider or AHA BLS Instructor Provider card
Not Specified
Nurse Practitioner
✦ New 🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
In collaboration and consultation with physicians and other healthcare professionals, the nurse practitioner provides evidence-based, quality, compassionate, and holistic care to inpatients and their families.
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. Must be a participating Medicare provider or eligible to obtain a Medicare provider number. Three years of nursing experience are required, and two years of advanced practice are preferred.
LICENSURE/CERTIFICATION
Must be currently licensed as a registered nurse in Texas and credentialed by the statee to practice as anadvancedd nurse practitioner. Must maintain current AHA BLS or higher in accordance with medical-dental staff bylaws. Prescriptive authority is required. A valid DEA number must be obtained within 90 days of hire. Certification by a national nursing body is required.
In collaboration and consultation with physicians and other healthcare professionals, the nurse practitioner provides evidence-based, quality, compassionate, and holistic care to inpatients and their families.
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. Must be a participating Medicare provider or eligible to obtain a Medicare provider number. Three years of nursing experience are required, and two years of advanced practice are preferred.
LICENSURE/CERTIFICATION
Must be currently licensed as a registered nurse in Texas and credentialed by the statee to practice as anadvancedd nurse practitioner. Must maintain current AHA BLS or higher in accordance with medical-dental staff bylaws. Prescriptive authority is required. A valid DEA number must be obtained within 90 days of hire. Certification by a national nursing body is required.
Not Specified
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