Centurion Cost Jobs in Usa

Cost Estimator / Bid Specialist

Build What Matters. Win What Counts.

OCG Companies is seeking a detail-driven and analytical Cost Estimator / Bid Specialist to support our continued growth in civil infrastructure construction.

This role is central to our business development strategy and directly impacts our ability to secure complex municipal and utility projects. You will prepare competitive, data-driven bid packages for projects including:

• Concrete flatwork
• Underground utility infrastructure
• Sewer systems
• Water main installations
• Utility restoration (hard and soft surface)

If you thrive in a numbers-driven environment, enjoy research and analytics, and understand the mechanics of civil construction bidding — this is a high-visibility opportunity to grow with an industry leader.

What You’ll Do

Estimating & Data Analysis

• Develop accurate cost estimates using historical data, vendor pricing, and market research
• Analyze production rates, labor costs, material pricing, and subcontractor proposals
• Build and maintain detailed unit rate bid sheets
• Leverage Excel and other tools for advanced cost modeling and scenario analysis

Bid Development & Strategy

• Review RFQs, RFPs, ITBs, drawings, and technical specifications
• Extract scope requirements and identify risk factors
• Coordinate with operations, project management, and field teams for input
• Assemble complete, compliant bid packages for municipal and utility clients
• Track project postings and identify new bidding opportunities

Market Research & Business Intelligence

• Conduct research on potential customers, municipalities, and utility providers
• Analyze competitor trends and historical award data
• Monitor industry pricing shifts and supply chain changes
• Support business development with data-driven insights

Preferred Qualifications

• Experience in civil construction estimating (flatwork, underground utilities, sewer, water main, restoration)
• Strong knowledge of construction bidding processes for municipal or public works projects
• Advanced proficiency in Microsoft Excel (pivot tables, formulas, lookups, cost modeling)
• Strong analytical and data interpretation skills
• Ability to read and interpret civil drawings, specifications, and blueprints
• Familiarity with project posting platforms and solicitation systems
• Exceptional attention to detail and deadline management
• Excellent written and verbal communication skills

Bonus Qualifications:

• Experience with estimating software platforms
• Background in data analytics or business intelligence
• Understanding of production rates and field operations

What Makes This Role Unique

• Direct impact on revenue growth
• High visibility within executive leadership
• Opportunity to shape bidding strategy
• Exposure to large-scale municipal infrastructure projects
• Growth potential within a rapidly expanding organization

About OCG Companies

OCG Companies is a Detroit-based infrastructure services company with over 26 years of experience serving municipalities and utility providers. With more than 250,000 completed jobs, we understand the complexities of underground infrastructure and restoration better than anyone.

We specialize in:

• Hard and soft surface restoration
• Underground utility construction
• Trucking and hauling
• Forestry services
• Municipal infrastructure support

Through strong customer service and strategic growth, we have become one of Michigan’s largest utility servicing companies.

Learn more at:

Warranty & Cost Recovery Analyst

Bergen County, NJ | $60–80K | Onsite

Ready to step into a high visibility role where your Excel skills actually matter? Our client needs someone who can own Cost Recovery and support Warranty—not the other way around. If you love digging into data, finding money on the table, and keeping vendors honest, keep reading.

What You’ll Do

• Drive Cost Recovery efforts (your main focus—about 60–70%).
• Pull, analyze, and present data using pivot tables, VLOOKUPs, charts, and graphs.
• Build and refine reports for leadership.
• Manage vendor and customer follow up to resolve disputes.
• Support the Warranty team as needed on claims, documentation, and coverage decisions.
• Communicate professionally across all levels—from production staff to VPs.

What You Bring

• Strong Excel skills (non negotiable).
• Experience in Cost Recovery, Warranty, Claims, or Customer Service with financial follow up.
• Ability to write clean reports and explain the story behind the numbers.
• Comfortable working independently and jumping into complex issues.
• Microsoft 365 experience.
• Bonus: SAP, aviation or automotive industry experience

Why This Role

• You’ll be joining a department that’s growing—not stagnant.
• Leadership wants someone who’ll make this a long term career move.
• Real room to expand, own processes, and elevate the function.
• OT available case by case.

Schedule

• 8:30 AM–5:00 PM

The client offers medical, dental, vision, HSA, FSA, 401K, 15 days of PTO to start, 6 sick days, and 16 company paid holidays!!!

Equal Opportunity Employer/Veterans/Disabled

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:

• The California Fair Chance Act

• Los Angeles City Fair Chance Ordinance

• Los Angeles County Fair Chance Ordinance for Employers

• San Francisco Fair Chance Ordinance

A growing metal fabrication company based in Newburgh, NY is seeking a full-time employee to fill the position of Controller. The applicant will serve as the financial leader for MetalWyze, responsible for the accuracy of our financial reporting and the strategic forecasting required to guide business growth. This is a hands-on leadership role; you will oversee the daily accounting operations, manage the AR/AP specialists, and utilize our ERP system to provide critical insights into margins, cash flow, and inventory costs.

QUALIFICATIONS

• Bachelor's degree in Accounting or Finance (CPA or CMA preferred).
• Proven experience in a manufacturing, distribution, or inventory-heavy environment.
• Ability to navigate digital MRP/ERP systems (experience with ABIS Adjutant is a major plus).
• Strong understanding of Cost Accounting and inventory valuation methods.
• Leadership experience with the ability to mentor and manage a small accounting team.
• Must have a can-do, customer service-first attitude.
• Advanced proficiency in Excel and financial modeling.
• Commitment to the Company's mission and core values.

MAIN JOB TASKS & REQUIREMENTS

• Oversee all daily accounting functions, including General Ledger, Accounts Payable, and Accounts Receivable.
• Lead the month-end and year-end close process, ensuring timely and accurate financial statements.
• Manage and mentor the Credit/AR Specialist and Accounting/AP Specialist.
• Prepare weekly cash flow forecasts and margin analysis reports to assist ownership in decision-making.
• Serve as the financial \"Super User\" for ABIS Adjutant, ensuring the system is fully utilized for accurate inventory tracking and job costing.
• Coordinate with external tax accountants and auditors as needed.
• Monitor internal controls to safeguard company assets.
• Analyze sales and expense data to identify trends and opportunities for cost reduction.
• You will be expected to perform other duties as assigned.

BENEFITS

• Competitive pay ($120,000 - $150,000)
• Paid vacation and holidays
• 401(k) with discretionary employer match
• Benefits: Medical/Dental/Vision/Life Insurance

***Facility opening in SPRING 2026***

Senior Estimator | Elford Construction | Columbus

Elford Construction is looking for a Senior Estimator (10+ years) to help lead pursuit strategy and pricing across major projects in the Columbus market. This role is about more than takeoffs. Our estimators help shape how projects are pursued, priced, and won — working closely with operations, trade partners, and clients from early concept through final submission.

If you enjoy building accurate budgets, solving complex pricing challenges, and helping teams win meaningful work, this could be a great fit.

At Elford, estimators are trusted partners in the pursuit process — bringing market insight, strong subcontractor relationships, and creative problem-solving to every project.

What You’ll Do

• Lead estimating efforts from conceptual budgeting through final pricing and subcontractor buyout
• Develop conceptual and detailed cost estimates based on schematic, design development, and construction documents
• Perform quantity takeoffs, cost analysis, and pricing evaluations across all major scopes of work
• Build and maintain strong relationships with subcontractors, vendors, and trade partners
• Coordinate with operations, project management, and field leadership to align estimating strategies with project execution
• Evaluate subcontractor proposals, conduct bid reviews, and prepare bid leveling and award recommendations
• Identify opportunities for value engineering, cost efficiencies, and schedule improvements
• Prepare clear and well-organized estimate presentations for leadership and clients
• Participate in project pursuits, proposals, and client presentations
• Track market trends, trade partner capacity, and material pricing that impact project costs

What We’re Looking For

• 10+ years of construction estimating experience, preferably in commercial construction
• Experience estimating negotiated work, GMP projects, and competitive bids
• Strong knowledge of construction means, methods, materials, and labor productivity
• Ability to prepare conceptual budgets and detailed estimates from incomplete design information
• Experience managing the bidding process, subcontractor outreach, and bid evaluations
• Strong communication skills and the ability to work collaboratively with internal teams and external partners
• Proficiency with estimating software and digital takeoff tools
• Experience with Microsoft Office and construction management software
• Bachelor’s degree in Construction Management, Engineering, or related field is a plus

Why Elford

Elford Construction is a trusted builder with deep roots in Central Ohio, known for delivering complex projects while maintaining a strong culture of collaboration and craftsmanship.

Our teams work across a diverse portfolio of commercial construction projects, and we’re committed to providing opportunities for experienced professionals to lead, mentor, and grow their careers while building meaningful projects in the communities we serve.

If you are someone who pays attention to detail, is self-motivated and have the ability to stay on task, don't mind traveling between our Raleigh - Durham locations and you are willing to work the overnight shift this job could be for you!

Our Food Cost Truck Manager is responsible for:

• Checking off food truck items as they arrive at our stores.
• Verifying and reporting errors.
• Communicating daily with your supervisor through phone, email & text.
• Servicing our 13 restaurants across Raleigh - Durham in your personal vehicle - reliable transportation is a must. The North Raleigh area is fairly centrally located to our locations.

We're looking for positive people who like to have fun and who have the desire to work at our famously fast paced McDonald's environments. You must be 18 years or older to be a manager in our restaurants.

Additional Info:

Along with competitive pay, a Food Cost Manager at a 1020 Enterprises owned McDonald's is eligible for benefits including:

• Paid vacation
• Education through Archways to Opportunity including opportunities to earn a High School degree, college tuition assistance and English classes as a second language
• Medical, dental and vision coverage
• Short and Long-Term Disability, life and accident insurance
• You'll also have access to McDperks discounts which include AT&T, Sprint, Verizon, Apple, Target and many others.

By applying to this position, I understand that I am applying to work at a restaurant that is owned and operated by an independent franchisee, not McDonald's USA. I understand that this franchisee is a separate company and a separate employer from McDonald's USA. Any information I provide in this application will be submitted only to the independent franchisee, who is the only company responsible for employment matters at this restaurant. I recognize that the independent franchisee alone will make all decisions concerning employment matters, including hiring, firing, discipline, supervision, staffing and scheduling. By applying for a job at a franchisee operated restaurant, I understand that the information I provide will be forwarded to the franchisee organization in order for that organization to reach out to me and process and evaluate my application. I acknowledge that McDonald's USA will not receive a copy of my employment application and will have no involvement in any employment decisions regarding me, including whether I receive an interview or whether I am hired to work for the franchisee. I understand that I need to contact the franchise organization for information about its privacy practices.

We are seeking experienced Senior Cost Manager based in the UK who are ready to relocate to the United States and take on high-value, technically complex construction projects.

You will join a leading international contractor delivering large-scale builds across rapidly expanding U.S. markets. This role offers significant career acceleration, leadership exposure, and a substantial uplift in earning potential.

The Role

As Senior Cost Manager, you will take full commercial responsibility for major project packages or entire mid-sized schemes, reporting to the Commercial Manager or Project Director.

Key responsibilities include:

• Lead commercial management of large construction projects
• Cost planning, forecasting, and financial reporting
• Procurement strategy and subcontractor negotiation
• Managing variations, claims, and change control
• Risk management and value engineering
• Mentoring and supporting junior QS team members
• Driving commercial performance and protecting margin

What We’re Looking For

• Degree qualified in Quantity Surveying or Commercial Management
• 5+ years’ post-graduate experience (Senior QS level)
• Proven experience managing major construction packages (£20m+ desirable)
• Strong contractual and commercial acumen
• Experience in complex builds (commercial, infrastructure, MEP-heavy, industrial, healthcare, etc.)
• Clear ambition to relocate and develop an international career

What’s on Offer

• Full visa sponsorship (subject to eligibility)
• Comprehensive relocation support (flights, accommodation assistance, relocation allowance)
• Highly competitive U.S. salary (significant uplift vs UK market)
• Performance-based bonus
• Private healthcare

Want to learn more about MercyOne Dubuque? Click here:

Find a Location Dubuque, Iowa (IA), MercyOne Dubuque  

Join the MercyOne Family! We are looking to hire a Registered Nurse!

An Operating Room Registered Nurse at MercyOne provides perioperative patient care, specifically in the intraoperative phase, in both the scrub and circulating roles according to established guidelines. Serves the population from neonate, infant, pediatric, adolescent, adult and geriatric. 

Essential Functions: 

• Scrubs and circulates on cases independently, with minimal direction. 

• Prepares for surgical cases in an efficient manner, anticipating needs of patient, surgeon, anesthesia and other O.R. team members. 

• Provides a safe environment for patient and staff by implementing standards of aseptic technique and by controlling the physical and psychological aspects of that environment. 

• Collects and analyzes data and assesses patient in developing nursing diagnosis. 

• Communicates effectively with the patient, staff, physicians, and families. 

• Maintains knowledge of equipment set-up and function. 

• Initiates and directs room clean up and turnover 

Schedule:  

• 36 hours per week  

• Day shift: 6:30 am – 5:30 pm with flex to evening shift hours.

• On call rotation for weekend, holiday and night hours with a 30-minute response time​​

Minimum Qualifications:  

• Possession of a current or compact state license as a Registered Nurse issued/defined by the State of Iowa.   

• Operating Room experience preferred. 

• Basic Life Support certified within six (6) weeks of hire.  Acceptable credentialing bodies and certifications include American Heart Association Basic Life Support for Healthcare Providers. 

• Proof of completion of Mandatory Reporter abuse training specific to population served within three (3) months of hire.  

• Ability to read, write and speak English language. 

• Ability to maintain a high standard of courtesy and cooperation in dealing with co-workers, patients and visitors, and perform job functions satisfactorily despite the stress of a hospital work environment. 

• Adaptability to perform a variety of duties, often changing from one task to another without loss of composure or efficiency. 

• Ability to perform in situations requiring set limits, standards and strict adherence to established procedures and guidelines. 

• Ability to perform under stress when confronted with emergency, critical or unusual situations. 

• Ability to take direction but also to work independently when appropriate. 

• Adaptability to situations involving the interpretation of feelings, ideas, or facts in terms of personal viewpoint.  

• Ability to influence people in their opinion, attitudes or judgments about ideas or things. 

• Ability to make generalizations, evaluations or decisions based on sensory or judgmental criteria. 

• Ability to make generalizations, evaluations or decisions based on measurable or verifiable criteria. 

• Ability to deal with people beyond giving and receiving instructions.

• Ability to accept responsibility for the direction, control or planning of an activity. 

Colleagues of MercyOne Health System enjoy competitive compensation with a full benefits package and opportunity for growth throughout the system! 

Visit MercyOne Careers to learn more about the benefits, culture, and career development opportunities available to you at MercyOne Health System circle of care.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

RN

Pediatrics

Status: .9/FT (36 hours a week)

Shift: Nights

Hours: 6pm-6:30am

As the only Pediatric inpatient unit in the Dubuque area, pediatric staff provide family centered care to pediatric patients up to the age of 18. This includes conducting physical assessments, monitoring and administration of medications, creating care plans and providing relevant patient education. Pediatric staff work closely with physicians, respiratory therapists and laboratory personnel to fulfill each patient’s plan of care.

Working a primarily night position, staff are assigned every third weekend and have an assigned holiday rotation. Working primarily 1800-0630, schedule is otherwise created utilizing self-scheduling with the guidance of the unit based staffing committee.

Pediatric staff will be cross-trained to the Level 2 NICU to take patients admitted to that unit, in addition to crosstraining to care for postpartum couplets. Opportunities to assist in the Emergency Department with pediatric patients as well, including assessments and cares. All Pediatric staff are certified in NRP and PALS onsite, and are also required to be certified in BLS and mandatory reporter.

Full time position in the Birth Center at MercyOne Dubuque Medical Center. Primarily night position; this position is also required to work every third weekend and every third holiday. Care for the laboring patient in addition to postpartum couplets and surgical patients. Will be cross trained to assist in pediatrics during times of high census. Required to become Electronic Fetal Monitor certified within first year, in addition to ACLS and NRP; Mandatory Reporter and BLS also required.  

POSITION PURPOSE:
Provides and directs safe, effective, and culturally competent care for women, newborns, and pediatric patients. Utilizes evidence-based practice and critical thinking to assess, plan, implement, and evaluate outcome-based care. Manages a diverse patient population across labor and delivery, postpartum, newborn nursery, pediatrics, and/or pediatric intensive care, with varying levels of acuity. Supervises and coordinates care provided by LPNs, Patient Care Technicians/Assistants, and other team members, while ensuring clear communication with physicians, families, and the interdisciplinary team. Adheres to MercyOne’s performance expectations and upholds the Mission, Vision, and Values of MercyOne.

MINIMUM QUALIFICATIONS:

1. Associate degree in nursing required

2. Bachelor of Science in Nursing (BSN) preferred.

3. Current Iowa RN license, (current Illinois (IL) license if working in IL) required.

4. American Heart Association Basic Life Support (BLS) required.

5. Proof of completion of Mandatory Reporter – Child and/or Dependent Adult Abuse training within three (3) months of hire.

6. High language, intermediate to high math, high critical thinking ability.

7. Basic computer skills required.

ESSENTIAL FUNCTIONS:
1. Conducts an initial assessment to gather data.

• Makes an initial assessment of new admissions within 30 minutes of the patient’s arrival to the unit.

• Completes all areas of the admission assessment database within 24 hours of admission.

2. Identifies patient problems and develops them into an outcome/goal-based plan of care.

• Initiates the patient problem list and incorporates relevant obstetric, neonatal, or pediatric history into the plan of care.

• Analyzes and interprets assessment data to identify desired outcomes/goals for mother and child.

• Determines nursing interventions to achieve those outcomes/goals.

• Prioritizes care needs for both mother and infant.

• Identifies and makes appropriate referrals (e.g., Lactation Consultant, Social Services, Nutritional Services, Spiritual Care).

3. Implements the outcome/goal-based plan of care

• Assigns and coordinates patient care based on acuity and team member competencies.

• Organizes and prioritizes care for mothers, newborns, and pediatric patients.

• Delegates tasks appropriately to other team members.

• Implements the plan of care including procedures, treatments, physician orders, nursing orders, education plans, and medications.

• Coordinates implementation with Case Manager, Social Worker, and other disciplines.

• Assists in discharge planning, ensuring families have resources for newborn care, breastfeeding support, and pediatric follow-up.

• Uses nursing judgment to determine frequency and components of reassessment.

• Reassesses at regular intervals to monitor maternal recovery and newborn/pediatric progress.

• Documents discharge instructions for mother, infant, and/or caregiver.

4. Evaluates patient progress and revises the plan as needed

• Evaluates maternal and pediatric response(s) to interventions.

• Updates the plan of care based on ongoing reassessments.

• Revises problem list and outcomes/goals as conditions change.

5. Evaluates patient progress and revises the outcome/goal-based plan as needed.

• Evaluates patient response(s) to interventions.

• Review/modifies/revises the outcome-based plan of care based on ongoing reassessments.

• Updates the problem list and outcomes/goals.

6. Communicates relevant clinical information to optimize outcomes

• Communicates maternal and pediatric status to physicians and team members.

• Reports progress toward outcomes/goals and changes in condition promptly.

• Maintains ongoing communication with interdisciplinary team throughout the shift, at handoff, and during transfers.

• Documents completely and accurately per policy.

7. Demonstrates clinical competence

• Utilizes Women & Children-specific policies and procedures to guide practice.

• Ensures medication safety following the “5 Rights.”

• Demonstrates competency in electronic health record systems.

• Processes and implements physician orders accurately.

• Maintains communication with leadership regarding admissions, acuity, and significant events.

• Completes assigned shift duties and resolves discrepancies.

8. Manages fetal and neonatal monitoring when applicable

• Demonstrates competency in interpreting fetal heart tracings and neonatal vital signs.

• Responds appropriately to changes in maternal or neonatal condition.

• Provides interventions for obstetric or neonatal emergencies.

• Serves as a resource for other hospital services and participates in quality improvement initiatives.

9. Provides age-appropriate care based on principles of growth and development

• Collects, analyzes, and applies age-specific data for newborns, children, and adolescents.

• Performs tasks and uses equipment in an age-appropriate manner.

• Communicates effectively with patients and families at their developmental level.

10. Adheres to safety and infection control standards

• Attends required safety programs.

• Uses appropriate PPE consistently.

• Demonstrates emergency procedures for obstetric and pediatric emergencies.

• Maintains a safe environment for mothers, infants, and staff.

11. Maintains compliance with laws, regulations, and organizational standards

• Upholds Trinity Health’s Integrity Program, Standards of Conduct, and all applicable policies in a professional and ethical manner.

PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS
1. Performs duties that may involve exposure to hazardous substances and is subject to normal risks associated with handling of narcotics. In patient care areas, may perform or demonstrate patient care tasks which may expose the clinical nurse to infectious or communicable disease, or possibility of injury from irrational or confused patients and visitors or from instruments or equipment.

2. Lift/Carry; Push/Pull 76-100% of the time, avg 50-100 lbs.

3. Stand; Walk/Move About 76-100% of the time

4. Must possess the ability to comply with Trinity Health policies and procedures.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orie

Want to learn more about MercyOne Elkader? Click here: Elkader Medical Center

As a Registered Nurse at MercyOne, you will provide and direct safe, effective, and culturally competent care for patients with acute medical and surgical conditions. Through evidence-based practice, utilizes critical thinking to assess, plan, implement, and evaluate outcome-based care. The Acute Care RN manages a diverse patient population with varying levels of acuity, including post-operative, medical, telemetry, and neurologic patients. Supervises and coordinates care provided by LPNs, Patient Care Assistants, and other nursing team members. Facilitates communication with physicians, patients and families, and interdisciplinary team members. Adheres to MercyOne’s performance expectations and upholds the Mission, Vision, and Values of MercyOne.

Essential Functions:

• Conducts assessment

• Identifies patient problems and develops plan of care

• Implements outcome/goal - based plan of care

• Evaluates patient progress and revises the outcome/goal - based plan as needed

• Communicates relevant clinical information to the team to optimize patient outcomes/goals

• Demonstrates clinical competence

• Manages telemetry and cardiac monitoring when applicable

• Provides care appropriate to the age-related needs of the patients served on his/her assigned unit

• Adheres to all safety, infection control and colleague health policies and procedures

• Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.

Schedule: 

• .3 FTE (12 hours per week)

• Night shift

• Day: 5:45 am - 6:15 pm; Night: 5:45 pm - 6:15 am

• Rotating weekend and holiday schedule

Minimum Qualifications:

• Associate degree in nursing required

• Bachelor of Science in Nursing (BSN) preferred

• Possession of a current or compact state licensure as a Registered Nurse issued/defined by the State of Iowa

• American Heart Association Basic Life Support (BLS) required

• American Heart Association Advanced Cardiac Life Support (ACLS) required only if the unit has telemetry monitoring capabilities

• Proof of completion of Mandatory Reporter – Child and/or Dependent Adult Abuse training within three (3) months of hire

Visit MercyOne Careers to learn more about the benefits, culture, and career development opportunities available to you at MercyOne Health System circle of care.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

RN

Pediatrics

Status: .9/FT (36 hours a week)

Shift: Nights

Hours: 6pm-6:30am

As the only Pediatric inpatient unit in the Dubuque area, pediatric staff provide family centered care to pediatric patients up to the age of 18. This includes conducting physical assessments, monitoring and administration of medications, creating care plans and providing relevant patient education. Pediatric staff work closely with physicians, respiratory therapists and laboratory personnel to fulfill each patient’s plan of care.

Working a primarily night position, staff are assigned every third weekend and have an assigned holiday rotation. Working primarily 1800-0630, schedule is otherwise created utilizing self-scheduling with the guidance of the unit based staffing committee.

Pediatric staff will be cross-trained to the Level 2 NICU to take patients admitted to that unit, in addition to crosstraining to care for postpartum couplets. Opportunities to assist in the Emergency Department with pediatric patients as well, including assessments and cares. All Pediatric staff are certified in NRP and PALS onsite, and are also required to be certified in BLS and mandatory reporter.

Full time position in the Birth Center at MercyOne Dubuque Medical Center. Primarily night position; this position is also required to work every third weekend and every third holiday. Care for the laboring patient in addition to postpartum couplets and surgical patients. Will be cross trained to assist in pediatrics during times of high census. Required to become Electronic Fetal Monitor certified within first year, in addition to ACLS and NRP; Mandatory Reporter and BLS also required.  

POSITION PURPOSE:
Provides and directs safe, effective, and culturally competent care for women, newborns, and pediatric patients. Utilizes evidence-based practice and critical thinking to assess, plan, implement, and evaluate outcome-based care. Manages a diverse patient population across labor and delivery, postpartum, newborn nursery, pediatrics, and/or pediatric intensive care, with varying levels of acuity. Supervises and coordinates care provided by LPNs, Patient Care Technicians/Assistants, and other team members, while ensuring clear communication with physicians, families, and the interdisciplinary team. Adheres to MercyOne’s performance expectations and upholds the Mission, Vision, and Values of MercyOne.

MINIMUM QUALIFICATIONS:

1. Associate degree in nursing required

2. Bachelor of Science in Nursing (BSN) preferred.

3. Current Iowa RN license, (current Illinois (IL) license if working in IL) required.

4. American Heart Association Basic Life Support (BLS) required.

5. Proof of completion of Mandatory Reporter – Child and/or Dependent Adult Abuse training within three (3) months of hire.

6. High language, intermediate to high math, high critical thinking ability.

7. Basic computer skills required.

ESSENTIAL FUNCTIONS:
1. Conducts an initial assessment to gather data.

• Makes an initial assessment of new admissions within 30 minutes of the patient’s arrival to the unit.

• Completes all areas of the admission assessment database within 24 hours of admission.

2. Identifies patient problems and develops them into an outcome/goal-based plan of care.

• Initiates the patient problem list and incorporates relevant obstetric, neonatal, or pediatric history into the plan of care.

• Analyzes and interprets assessment data to identify desired outcomes/goals for mother and child.

• Determines nursing interventions to achieve those outcomes/goals.

• Prioritizes care needs for both mother and infant.

• Identifies and makes appropriate referrals (e.g., Lactation Consultant, Social Services, Nutritional Services, Spiritual Care).

3. Implements the outcome/goal-based plan of care

• Assigns and coordinates patient care based on acuity and team member competencies.

• Organizes and prioritizes care for mothers, newborns, and pediatric patients.

• Delegates tasks appropriately to other team members.

• Implements the plan of care including procedures, treatments, physician orders, nursing orders, education plans, and medications.

• Coordinates implementation with Case Manager, Social Worker, and other disciplines.

• Assists in discharge planning, ensuring families have resources for newborn care, breastfeeding support, and pediatric follow-up.

• Uses nursing judgment to determine frequency and components of reassessment.

• Reassesses at regular intervals to monitor maternal recovery and newborn/pediatric progress.

• Documents discharge instructions for mother, infant, and/or caregiver.

4. Evaluates patient progress and revises the plan as needed

• Evaluates maternal and pediatric response(s) to interventions.

• Updates the plan of care based on ongoing reassessments.

• Revises problem list and outcomes/goals as conditions change.

5. Evaluates patient progress and revises the outcome/goal-based plan as needed.

• Evaluates patient response(s) to interventions.

• Review/modifies/revises the outcome-based plan of care based on ongoing reassessments.

• Updates the problem list and outcomes/goals.

6. Communicates relevant clinical information to optimize outcomes

• Communicates maternal and pediatric status to physicians and team members.

• Reports progress toward outcomes/goals and changes in condition promptly.

• Maintains ongoing communication with interdisciplinary team throughout the shift, at handoff, and during transfers.

• Documents completely and accurately per policy.

7. Demonstrates clinical competence

• Utilizes Women & Children-specific policies and procedures to guide practice.

• Ensures medication safety following the “5 Rights.”

• Demonstrates competency in electronic health record systems.

• Processes and implements physician orders accurately.

• Maintains communication with leadership regarding admissions, acuity, and significant events.

• Completes assigned shift duties and resolves discrepancies.

8. Manages fetal and neonatal monitoring when applicable

• Demonstrates competency in interpreting fetal heart tracings and neonatal vital signs.

• Responds appropriately to changes in maternal or neonatal condition.

• Provides interventions for obstetric or neonatal emergencies.

• Serves as a resource for other hospital services and participates in quality improvement initiatives.

9. Provides age-appropriate care based on principles of growth and development

• Collects, analyzes, and applies age-specific data for newborns, children, and adolescents.

• Performs tasks and uses equipment in an age-appropriate manner.

• Communicates effectively with patients and families at their developmental level.

10. Adheres to safety and infection control standards

• Attends required safety programs.

• Uses appropriate PPE consistently.

• Demonstrates emergency procedures for obstetric and pediatric emergencies.

• Maintains a safe environment for mothers, infants, and staff.

11. Maintains compliance with laws, regulations, and organizational standards

• Upholds Trinity Health’s Integrity Program, Standards of Conduct, and all applicable policies in a professional and ethical manner.

PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS
1. Performs duties that may involve exposure to hazardous substances and is subject to normal risks associated with handling of narcotics. In patient care areas, may perform or demonstrate patient care tasks which may expose the clinical nurse to infectious or communicable disease, or possibility of injury from irrational or confused patients and visitors or from instruments or equipment.

2. Lift/Carry; Push/Pull 76-100% of the time, avg 50-100 lbs.

3. Stand; Walk/Move About 76-100% of the time

4. Must possess the ability to comply with Trinity Health policies and procedures.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orie