Jobs in Lincoln, NM
59 positions found — Page 5
Nurse Case Manager - CFHP
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
Nurse Case Manager CFHP PRN
🏢 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
Nurse Case Manager - CFHP PRN
🏢 University Health
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
Service Coordinator RN
🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
The RN Service Coordinator-RN (RN-SC) contributes to the Long Term Services and Supports (LTSS) service coordination process by performing activities within the scope of licensure; provides supervision and direction to staff participating in Member’s cases following applicable state law and contract; develops, monitors, evaluates, and revises the Members’ care plans to meet Member’s needs, to optimize health care across the care continuum to enhance the Member's well-being, independence, integration in the community, and potential for productivity.
The RN-SC conducts a holistic assessment of the Member's dynamics, needs, and preferences while providing education and health-related information to the Member, the Member’s Legal Authorized Representative (LAR), and the Member’s Support Network. Responsible for the coordination of STAR+PLUS Members' covered and non-capitated services, including acute and LTSS, while meeting the Member's physical, behavioral, functional, and psychosocial needs. Complies with policies, procedures, and protocols for establishing and maintaining good working relationships with co-workers, employees, patients, and guests.
EDUCATION/EXPERIENCE
Graduation from an accredited school of professional nursing or social work is required. BSN is preferred. Four (4) recent years of clinical experience preferred, which may include service coordination, case management, quality management, or managed care experience. Working knowledge of HMO standards, LTSS, and NCQA standards is preferred. Knowledge of Medicare and Medicaid HMO experience is preferred. Experience in meeting the needs of vulnerable populations who have chronic or complex conditions is required. Bilingual, English/Spanish, is preferred.
LICENSURE/ CERTIFICATION
A current, unrestricted license to practice professional nursing issued by the State of Texas is required. RUG Certification is required and must be obtained within 30 days of employment for all RN candidates.
The RN Service Coordinator-RN (RN-SC) contributes to the Long Term Services and Supports (LTSS) service coordination process by performing activities within the scope of licensure; provides supervision and direction to staff participating in Member’s cases following applicable state law and contract; develops, monitors, evaluates, and revises the Members’ care plans to meet Member’s needs, to optimize health care across the care continuum to enhance the Member's well-being, independence, integration in the community, and potential for productivity.
The RN-SC conducts a holistic assessment of the Member's dynamics, needs, and preferences while providing education and health-related information to the Member, the Member’s Legal Authorized Representative (LAR), and the Member’s Support Network. Responsible for the coordination of STAR+PLUS Members' covered and non-capitated services, including acute and LTSS, while meeting the Member's physical, behavioral, functional, and psychosocial needs. Complies with policies, procedures, and protocols for establishing and maintaining good working relationships with co-workers, employees, patients, and guests.
EDUCATION/EXPERIENCE
Graduation from an accredited school of professional nursing or social work is required. BSN is preferred. Four (4) recent years of clinical experience preferred, which may include service coordination, case management, quality management, or managed care experience. Working knowledge of HMO standards, LTSS, and NCQA standards is preferred. Knowledge of Medicare and Medicaid HMO experience is preferred. Experience in meeting the needs of vulnerable populations who have chronic or complex conditions is required. Bilingual, English/Spanish, is preferred.
LICENSURE/ CERTIFICATION
A current, unrestricted license to practice professional nursing issued by the State of Texas is required. RUG Certification is required and must be obtained within 30 days of employment for all RN candidates.
Not Specified
Infection Preventionist RN
🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
Supports the Director, Infection Control, in providing a robust, comprehensive health system wide infection control program in accordance with current standards of practice and in compliance with regulatory agencies and governmental policies and procedures.
The principle goals of the infection control program include protecting patients, healthcare workers, volunteers, students, visitors, and others in the healthcare environment; and accomplishing the goals in a cost-effective manner
EDUCATION/EXPERIENCE
Minimum of five years of infection prevention experience within a hospital setting required with a Baccalaureate degree in nursing or higher required. Three years of recent infection prevention experience in an acute care hospital setting is required. Preferred: post-graduate courses in epidemiology, infection prevention or disease control, completion of CDC or APIC sponsored infection prevention training is desirable. Supervisory and managerial experience is desirable. Working knowledge of statistics and epidemiological principles is required. Computer skills required include proficiency in the following Microsoft Office applications: Word, Excel, PowerPoint; graphics display programs such as QI Macros, as well as a level of comfort with learning and adapting to new programs
LICENSURE/CERTIFICATION
Current certification in Infection Prevention and Control by the Certification Board of Infection Control and Epidemiology is required. Must have current State of Texas professional nursing licensure
Supports the Director, Infection Control, in providing a robust, comprehensive health system wide infection control program in accordance with current standards of practice and in compliance with regulatory agencies and governmental policies and procedures.
The principle goals of the infection control program include protecting patients, healthcare workers, volunteers, students, visitors, and others in the healthcare environment; and accomplishing the goals in a cost-effective manner
EDUCATION/EXPERIENCE
Minimum of five years of infection prevention experience within a hospital setting required with a Baccalaureate degree in nursing or higher required. Three years of recent infection prevention experience in an acute care hospital setting is required. Preferred: post-graduate courses in epidemiology, infection prevention or disease control, completion of CDC or APIC sponsored infection prevention training is desirable. Supervisory and managerial experience is desirable. Working knowledge of statistics and epidemiological principles is required. Computer skills required include proficiency in the following Microsoft Office applications: Word, Excel, PowerPoint; graphics display programs such as QI Macros, as well as a level of comfort with learning and adapting to new programs
LICENSURE/CERTIFICATION
Current certification in Infection Prevention and Control by the Certification Board of Infection Control and Epidemiology is required. Must have current State of Texas professional nursing licensure
Not Specified
Nurse Practitioner - Inpatient Services
🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES
In collaboration and consultation with physicians and other health care professionals, the nurse practitioner provides evidence-based, quality, compassionate and holistic care to in-patients 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 is required and two years of advanced practice is preferred.
LICENSURE/CERTIFICATION
Must be currently licensed as a Registered Nurse in Texas and credentialed by the State to practice as an Advanced 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 health care professionals, the nurse practitioner provides evidence-based, quality, compassionate and holistic care to in-patients 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 is required and two years of advanced practice is preferred.
LICENSURE/CERTIFICATION
Must be currently licensed as a Registered Nurse in Texas and credentialed by the State to practice as an Advanced 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
Staff Nurse II
🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIESTrains 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/EXPERIENCERegistered 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/CERTIFICATIONMust be a Registered Nurse currently licensed in the state of Texas.
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/EXPERIENCERegistered 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/CERTIFICATIONMust be a Registered Nurse currently licensed in the state of Texas.
Not Specified
Nurse Clinical Transplant Coordinator
🏢 University Health
Salary not disclosed
POSITION SUMMARY/RESPONSIBILITIES Under general supervision, the Clinical Transplant Coordinator I will use clinical management, consultation, education and research to promote quality care for the specific transplant patient populations.
Supports and maintains the University Health System's policies, protocols, values and guest relations.
Directly accountable to the Director and the Supervisor, Clinical Transplant Nurse.
May direct activities and services provided by personnel in assigned area, such as Licensed Vocational Nurses, non-licensed nursing and secretarial support staff.EDUCATION/EXPERIENCE Graduation from an accredited school of nursing with an RN and one year of nursing experience required.
Will develop a plan to attain a Bachelor's Degree in Nursing.
Knowledge of transplant, health care trends, community and regional resources.
An ability to establish cooperative working relationships with diverse groups and individuals, medical staff and other health care disciplines and understanding of the consultative process.LICENSURE Current RN licensure in the State of Texas.
Current American Heart Association, Basic Cardiac Life Support Healthcare Provider certification required.
Attain CITI research certification within six months from date of hire.
(CITI certification is not required for coordinators in lung transplant, post-transplant, live donor transplant or disease management nurses).
Supports and maintains the University Health System's policies, protocols, values and guest relations.
Directly accountable to the Director and the Supervisor, Clinical Transplant Nurse.
May direct activities and services provided by personnel in assigned area, such as Licensed Vocational Nurses, non-licensed nursing and secretarial support staff.EDUCATION/EXPERIENCE Graduation from an accredited school of nursing with an RN and one year of nursing experience required.
Will develop a plan to attain a Bachelor's Degree in Nursing.
Knowledge of transplant, health care trends, community and regional resources.
An ability to establish cooperative working relationships with diverse groups and individuals, medical staff and other health care disciplines and understanding of the consultative process.LICENSURE Current RN licensure in the State of Texas.
Current American Heart Association, Basic Cardiac Life Support Healthcare Provider certification required.
Attain CITI research certification within six months from date of hire.
(CITI certification is not required for coordinators in lung transplant, post-transplant, live donor transplant or disease management nurses).
Not Specified
Staff Nurse PRN
🏢 University Health
Salary not disclosed
University Health is Bexar County and South Texas' first health system to earn Magnet status from the American Nurses Credentialing Center (ANCC). Magnet hospitals and health systems offer patients reassurance that they are being cared for by a team with a proven track record for providing excellent care and positive outcomes for their patients.\
What sets us apart?
Most up-to-date advancements in nursing
Level I Trauma Center
Teaching Hospital
Nurse Residency Program
RN Loan Repayment Program
Nationally certified nursing staff
Regionally, nationally and internationally recognized
Requirements:
Current RN license from the Texas Board of Nursing
BSN highly preferred
American Heart Association Healthcare Provider card
What sets us apart?
Most up-to-date advancements in nursing
Level I Trauma Center
Teaching Hospital
Nurse Residency Program
RN Loan Repayment Program
Nationally certified nursing staff
Regionally, nationally and internationally recognized
Requirements:
Current RN license from the Texas Board of Nursing
BSN highly preferred
American Heart Association Healthcare Provider card
Not Specified
Home Care Aide
Salary not disclosed
Caregivers can now make BONUS PAY!! Apply now for additional details!!
DAILY PAY available for select positions!
Take advantage of this unique opportunity to learn the fundamentals of quality home care and deliver life-changing service to your clients. As an Ambercare Home Health Aide, you’ll play a vital role in supporting seniors and people with disabilities living independently. This rewarding position provides consistent, flexible hours to accommodate your personal needs, while providing a great career with a growing, innovative industry leader.
If you have a genuine passion for helping others, and you are looking for a meaningful, fulfilling career with a dynamic, values-driven organization that recognizes and supports your contribution, we invite you to join our team.
Essential Duties:
- Follow specific care plans for clients and report on completed tasks.
- Assist with personal care needs of the client (bathing, dressing, etc.).
- Provide or assist in routine house cleaning, meal preparation, and laundry.
- Transport client to doctor's office, grocery store and other essential errands.
- Assist client with the self-administration of medications.
- Observe and report any changes in client's condition.
- Maintain a high degree of confidentiality at all times due to access to sensitive information.
- Maintain regular, predictable, consistent attendance and is flexible to meet the needs of the department.
- Follow all Medicare, Medicaid, and HIPAA regulations and requirements.
- Abide by all regulations, policies, procedures and standards.
- Perform other duties as assigned.
Position Requirements & Competencies:
- Must be 18 years of age
- Must be a Certified Nursing Asistant
- Pre-employment physical examination/PPD prior to patient contact
- Must be able to pass a criminal background check.
- Must have reliable transportation; if by car, a valid driver's license and proof of insurance is required
- Nurturing and compassionate nature with the desire to care for others
- Ability to work with limited supervision
- Ability to follow written and verbal instructions
- Good communication and interpersonal skills
With over 20 years of experience, Ambercare provides Home Health Care and Personal Care Services for individuals and their families in the comfort of their own homes. Despite challenging economic conditions caused by COVID-19 Ambercare is still hiring in New Mexico. Ambercare has implemented comprehensive safety policies based on CDC guidelines designed to promote workplace safety. We are providing Personal Protective Equipment (PPE) including gloves, face masks, hand sanitizer and anti-bacterial soap to our employees.
We are offering virtual job interviews as a safety measure against COVID-19. Apply today and learn more about our current opportunities.
Ambercare provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
#NMARPA
Employee wellbeing is top priority at Addus Homecare, and we're thrilled to announce our recognition as the top healthcare company on Indeed's 2024 Top 100 Work Wellbeing Index. View the full rankings here:
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