RN Med-Surg Full-time
The Christ Hospital Health Network

Professional Development Specialist Med Surg-RN - Main Patient Care Support Svcs - Full Time - Varies

Job Description

The Professional Development Specialist (PDS) is a self-directed, professional registered nurse with advanced knowledge and expertise specific to his/her clinical area. The PDS serves as an educator, change agent, researcher, servant leader role model and mentor. The PDS role is developed in relationship to responsibilities and specialty population of practice. The PDS will be centrally based/department based and may have additional responsibilities within the department as the need arises.

Responsibilities

Follows Standards of Practice

Standard 1: Assessment of Practice Gaps

  • The nursing professional development specialist analyzes issues, trends and supporting data to determine the needs of individuals, organizations, and communities in relation to health care.

Standard 2: Identification of Learning Needs

  • The nursing professional development specialist collects data and information to validate an identified gap in professional practice and to determine the specific knowledge, skill, or practice deficit or opportunity.

Standard 3: Outcomes Identification

  • The nursing professional development specialist identifies desired outcomes of the educational plan.

Standard 4: Planning

  • The nursing professional development specialist establishes a plan that prescribes strategies, alternatives, and resources to achieve expected outcomes.

Standard 5: Implementation

  • The nursing professional development specialist implements the identified plan.

Standard 5a: Coordination

  • The nursing professional development specialist coordinates educational initiatives and activities.

Standard 5b: Facilitation of Positive Learning and Practice Environments

  • The nursing professional development specialist employs strategies to facilitate positive learning and practice environments.

Standard 6: Evaluation

  • The nursing professional development specialist evaluates progress toward attainment of outcomes.

Standard 7: Ethics

  • The nursing professional development specialist integrates ethics in all areas of practice.

Standard 8: Education

  • The nursing professional development specialist maintains current knowledge and competency in nursing and professional development practice.

Standard 9: Evidence-based Practice and Research

  • The nursing professional development specialist acts as a champion of scientific inquiry, generating new knowledge and integrating best available evidence into practice.

Standard 10: Quality of Nursing Professional Development Practice

  • The nursing professional development specialist systematically enhances the quality and effectiveness of nursing professional development practice.

Standard 11: Change Management

  • The nursing professional development specialist acts as a change agent within all settings.

Standard 12: Leadership

  • The nursing professional development specialist provides leadership in the professional practice setting and the profession.

Standard 13: Collaboration

  • The nursing professional development specialist collaborates with interprofessional teams, leaders, stakeholders and others to facilitate nursing practice and positive outcomes for consumers.

Standard 14: Professional Practice Evaluation

  • The nursing professional development specialist evaluates personal practice in relation to professional practice standards and guidelines, and relevant statutes, rules, and regulations.

Standard 15: Resource Utilization

  • The nursing professional development specialist considers factors related to quality, safety, effectiveness and cost regarding professional development activities and expected outcomes.

Standard 16: Mentorship/Advancing the Profession

  • The nursing professional development specialist advances the profession and the specialty through mentoring and contributions to the professional development of others.

Duties and Responsibilities: Onboarding:

Assessment

  • Communicates with new employee before start date to make introductions, identify learning style, provides an overview of the orientation process and attempt to alleviate fears and apprehensions.

Diagnosis

  • Collaborates with the Clinical Manager when a new hire is finalized and hire date is established. There will be discussion regarding new employee’s previous work history, clinical background and possible learning needs.

Identification of Educational Outcomes

  • Prepares a competency-based unit orientation for new hires based on objectives and needs of orientee.

Planning

  • Prepares a clinical orientation schedule for each new employee based on the employee’s previous work experience and clinical background.
  • Collaborates with manager to identify a compatible preceptor and determine the anticipated length of orientation.

Implementation

  • Works closely with Orientation Team to ensure new employees have attended all classroom orientation before being oriented to the clinical department.
  • Schedules and facilitates “class day” for a new employee that is scheduled on the unit to acclimate the new staff member to the physical environment, department standards, performance expectations, and requirements and competencies identified in the new employee’s job description.
  • Provides instruction to new employee on infection control, emergency equipment and typical equipment/products used in the department.
  • Review importance of customer service.
  • Provides new employee with a Clinical Performance Record.

Evaluation

  • Has daily conversations with preceptor regarding orientee’s competency-based orientation plan. Follows up to ensure preceptor documents daily progress.
  • Meets with orientee, preceptor and manager (if necessary) during the clinical orientation to discuss progress, set new goals, facilitate conflict resolution strategies and provide feedback.
  • Evaluates and documents orientee’s progress weekly.
  • Provides input into the 90 day evaluation of all new employees.
  • Encourages new hires to evaluate the orientation process and makes revision to orientation content based on this input.

Duties and Responsibilities: On-Going Staff Education:

Assessment

  • Evaluates the learning needs of the staff at least annually.

Diagnosis

  • Maintains current knowledge of nursing practice in the clinical setting.
  • Keeps abreast of educational requirements for all job categories which pertain to clinical care.

Identification of Educational Outcomes

  • Prepares and/or coordinates staff education for new products, medications, equipment, services provided, performance improvement initiatives and/or regulatory requirements

Planning

  • Refers to professional literature and evidence-based practice when preparing educational materials.
  • Maintains Basic Life Support Instructor certification and teaches BLS classes minimally four times in a two year period as deemed necessary.
  • Collaborates with vendors, physicians, other nurses or professional staff to provide staff education.
  • Updates content of Education Day annually in collaboration with other educators or unit council members as deemed appropriate per department.

Implementation

  • Ensures that all staff is scheduled for and attend Education Day annually as deemed appropriate per department.
  • Ensures that staff completes all required, mandatory education.
  • Maintain educational files on all employees.

Evaluation

  • Evaluates staff satisfaction with educational programs
  • Evaluates for improved clinical outcomes as appropriate

Duties and Responsibilities: Leadership

Demonstrates leadership skills such as the ability to motivate, educate, delegate, and mentor peers and other members of the healthcare team while effectively managing the care of patients and family members. Acts as a resource and educator for multidisciplinary team members and students, continuously evaluating and documenting competency.

Duties and Responsibilities: Professional Development:

  • Assumes responsibility and accountability for personal professional growth and development. Contributes to the professional development of peers, colleagues and others.
  • Supports self and peer professional growth and development based on information received in periodic (at least annual) needs assessment.
  • Provides on-going education for individuals in leadership positions such as charge nurse, council chairs or preceptors.
  • Completes all educational requirements to maintain necessary population specific competencies. Submits required test and paperwork in a timely manner.
  • Participates in self and peer review. Uses performance improvement data as a mechanism to positively recognize staff performance.
  • Prepares for certification examination for self and peers in the clinical area through review courses or study groups.
  • Participates in appropriate professional organizations.
  • Evaluates reports of nurse-sensitive outcomes and prepares staff education based on this data.
  • Participates in community services activities.

Duties and Responsibilities: Other :

  • Is available to provide education to employees on all shifts.
  • Participates in councils, task forces, and committee meetings (house wide and unit-based) to improve competencies of the staff members per management’s discretion.

Duties and Responsibilities: UNIT POPULATION SERVED COMPETENCY:

Evidence exists that The Christ Hospital staff considers the special needs and behaviors of the specific patient populations served. Evidence also exists that shows the staff demonstrates those competencies that address the unique characteristics related to developmental, physical, psychosocial, mental, emotional, and social needs of patients across the life span. Associates should also be able to demonstrate those competencies that address the needs of patients with unique cultural norms, religious preferences, language/communication barriers and/or literacy limitations.

Qualifications

RELATIONSHIPS, RESPONSIBILITIES, AND REQUIREMENTS

  • Coordinates preceptor development activities.
  • Coordinates specialized educational events for staff and patients involving high risk/low volume procedures.
  • Sets standards for development of educational materials.
  • Coordinates student experiences for role transition.
  • Develops strong relationships with clinical instructors to ensure enhanced student experiences.
  • Serves as a mentor for RN’s and other care providers.
  • Assists staff in professional advancement application process.

KNOWLEDGE AND SKILLS:

Please describe any specialized knowledge or skills, which are REQUIRED to perform the position duties. Do not personalize the job description, credentials, or knowledge and skills based on the current associate. List any special education required for this position.

EDUCATION:

Graduate of accredited school of nursing. BSN required/ MSN with education focus, or MEd preferred.

YEARS OF EXPERIENCE:

Minimum of five years of applicable clinical nursing experience or three years applicable clinical nursing experience and two years of formal educator experience preferred.

REQUIRED SKILLS AND KNOWLEDGE:

Excellent communication and teaching skills are required. Actively seeks opportunities in area of expertise and /or in education to improve own knowledge by regularly attending continuing education programs.

LICENSES & CERTIFICATIONS:

  • Graduate of an approved School of Nursing, Current RN licensure in the state of employment.
  • The RN holds a current licensure to practice nursing in her/his state of employment. Membership in professional organizations is desirable.
  • Certification in area of specialty is required; certification in Nursing Professional Development (through American Nurses Credential Center [ANCC] or Association for Nursing Professional Development [ANPD] required within two years..
  • BLS certification is required.
  • ACLS certification required for all critical care areas.
  • NRP certification is required for all perinatal areas.

Share this job

Share to FB Share to LinkedIn Share to Twitter

Related Jobs

RN Per Diem
IntelyCare

Registered Nurse (RN)

$38 - $68 / HOUR
Free yourself with truly flexible schedules and earn up to $68 as a Registered Nurse (RN) in the Cincinnati suburb of Monroe, Ohio, and surrounding areas. IntelyCare was founded by nurses, for nurses, so we understand just how valuable work-life balance is for nursing professionals. Our staff have the freedom to choose the shifts at our partner facilities that best fit their unique lives — and to take time off whenever they like. Maybe you need some flexibility so you can attend classes at Galen College while still earning an income. Perhaps you enjoy meeting friends at the Traders World Flea Market, followed by lunch, every Saturday. Don't like working night shifts? No problem. Whatever makes your life full, we've got your back. Take a look at our other perks and benefits and consider applying with us today. Benefits RN hourly rate between $38 and $68 Get paid rates that are up to 25% higher on average, with weekly and daily pay options Opportunities for overtime as well as boosted rates for holidays Quickly find shifts in all states where you're authorized to practice Set your own schedule by selecting only your preferred shifts at any of our partner facilities Choose from weekday/weekend shifts, day/evening/overnight shifts, and more 401k retirement plan Upskilling opportunities with a dedicated team of quality assurance nursing professionals Eligibility for medical, dental, and vision insurance for you and qualifying family members Employer tax withholding each pay period Employer coverage for workers' comp and malpractice insurance Undergraduate and graduate tuition discounts at Excelsior University (up to 34%) Manage your shifts and access workplace perks like free continuing education courses through an all-in-one app At IntelyCare, you get a job and a schedule that you manage, but also a supportive community that has your back. Here's how some of our own nursing professionals have described the experience: "I love working with IntelyCare because of all the perks and benefits it provides. There are a variety of facilities to choose from in the app. At first I was going to multiple facilities until I found my two favorites, where I now work full time. I love it!" "I love how flexible this job is! I am a busy mom, so accepting last minute ‘hero’ shifts typically works out better than scheduling shifts in advance. I appreciate the pay and the additional bonuses." "IntelyCare has exceptionally high rates, a variety of facilities, and an easy and fun app to use. The staff here are all very personable and knowledgeable as well, which makes things so much easier. This is truly a 5-star agency." "I love IntelyCare because everything has been easy from the application process until now. There has never been a question unanswered, and everyone is always happy to help with whatever I needed. They always advocate on our behalf. I am so grateful to be an IntelyPro." Job Responsibilities Providing high-quality RN care in post-acute facilities Reviewing various care options with the medical team, residents, and their family members Coordinating with clinical teams to develop individualized care plans Being accountable to follow and adhere to resident care plans Administering appropriate medications and treatments to residents Drawing fluids as needed for labs and testing Using and monitoring medical equipment and devices to ensure effectiveness Training and supervising nursing professionals and other care staff consistent with scope of practice guidelines Promoting staff compliance with all applicable laws, regulations, facility policies, and nursing standards of care Documenting all relevant data to include vital signs, nursing interventions and responses, and resident histories Assisting staff members with incident investigations and the development of care best practices Qualifications and Skills Current Ohio state license to practice as a Registered Nurse (RN) 6 months of experience (in an RN or related role) Completion of an approved nursing program High level of organizational skills Demonstrated ability to effectively communicate across medical and nursing teams Ability to lift at least 50 lbs Ready for a Job That Puts Your Needs First? As you search for Registered Nurse (RN) jobs in your area, you don't have to settle for the work-life imbalance that you may be used to. If you're ready for something better, we're ready for you. Take the next step today by applying to the team ranked #1 in quality. We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Location: Monroe, Ohio 45050
Cincinnati Children's

Registered Nurse (Rn) - Liberty Med/Surg - Full-time, Night Shift - Prefer previous ICU/ED experience

JOB RESPONSIBILITIES Clinical Inquiry - Follows professional practice standards and guidelines. Questions appropriateness of policies and guidelines; questions current practice; seeks advice, resources, or information to improve patient care; begins to compare and contrast possible alternatives. Assists with development of competence in peers; formally, by precepting new employees, and informally, by sharing knowledge at the point-of-care. Uses self-appraisal performance review and peer review, including annual goal setting, for assurance of competence and professional development to promote safe and ethical practice using the nursing process. Coaches and mentors others. Precepts nursing peers and students. Facilitates learning for members of the healthcare team. Actively works with department managers, nurse council and magnet representatives to identify, share, implement and evaluate safety best practices. Mitigate actual or potential risks to patient and staff safety. Utilize current research findings and other evidence to expand professional knowledge, enhance role performance, and increase knowledge of nursing professional issues. Support clinical nursing, health care, and health system research studies conducted by professional, credentialed researchers. Systems Thinking - Is able to recognize systems and processes within the healthcare environment that affect the patient experience; anticipates needs of patients and families as they move through the healthcare system; utilizes untapped and alternative resources as necessary. Inclusion - Considers patient values and incorporates in care, when differing from personal values; supports colleagues in ethical and clinical issues; moral decision-making can deviate from rules; engages the patient's family, encouraging them to speak/represent themselves; protects patient and family rights. Inquires about cultural differences and considers their impact on care accommodates personal and professional differences in the plan of care; helps patient/family understand the culture of the healthcare system. Clinical Judgment - Collects & interprets complex patient data; makes clinical judgments based on an immediate grasp of the whole picture; recognizes patterns & trends by focusing on key elements while eliminating extraneous details. Documents & teaches others to document the plan of care, care delivered, & patient/family outcomes. Responds to subtle patient/family changes; engages with each unique patient/family in a compassionate manner; tailors caring practices to the individuality of patient/family; recognizes the importance of a healing environment & tailors the environment to meet the needs of the patient/family; promotes safety throughout patient/family transitions along the healthcare continuum; recognizes that death may be an acceptable outcome. Proficiently integrates age specific concepts into patient care, taking into consideration both the patient's chronological age & developmental functioning. Using self-management support, develops care goals & actions through partnerships with patients. Uses teach back strategies to evaluate effectiveness. Coordinates education with other members of the health care team. Integrates strategies in the plan of care that support the patient/family adaptation to the home environment. JOB QUALIFICATIONS Associate/Diploma prepared RNs from ACEN, CCNE or NLN CNEA accredited institution requires 2+ years of experience. If hired without a BSN or MSN, must enroll in a BSN or MSN program within 1 year of hire date/RN job date and complete program within 5 years of hire/RN job date. Preferred: BSN from ACEN, CCNE or NLN CNEA accredited institution or MSN are preferred. Active Ohio RN License. May be required to obtain other state licensure. 2 years of work experience in a related job discipline. Foreign graduates must have license validated through TruMeritTM per Ohio Board of Nursing code for Foreign Graduates. Primary Location Liberty LA Schedule Full time Shift Night (United States of America) Department LA4-2 Employee Status Regular FTE 0.9 Weekly Hours 36 Market Leading Benefits Including*: Medical coverage starting day one of employment. View employee benefits here. Competitive retirement plans Tuition reimbursement for continuing education Expansive employee discount programs through our many community partners Shift Differential, Weekend Differential, and Weekend Option Pay Programs for qualified positions Support through Employee Resource Groups such as African American Professionals Advisory Council, Asian Cultural and Professional Group, EQUAL - LGBTQA Resource Group, Juntos - Hispanic/Latin Resource Group, Veterans and Military Family Advocacy Network, and Young Professionals (YP) Resource Group Physical and mental health wellness programs Relocation assistance available for qualified positions * Benefits may vary based on FTE Status and Position Type About Us At Cincinnati Children’s, we come to work with one goal: to make children’s health better. We believe in a holistic team approach, both in caring for patients and their families, and in advancing science and discovery. We strive to do better and find energy and inspiration in our shared purpose. If you want to be the best you can be, you can do it at Cincinnati Children’s. Cincinnati Children's is: Recognized by U.S. News & World Report as a top 10 best Children's Hospitals in the nation for more than 15 years Consistently among the top 3 Children's Hospitals for National Institutes of Health (NIH) Funding Recognized as one of America’s Best Large Employers (2025) , America’s Best Employers for New Grads (2025) One of the nation's America’s Most Innovative Companies as noted by Fortune Consistently certified as great place to work A Leading Disability Employer as noted by the National Organization on Disability Magnet® designated for the fourth consecutive time by the American Nurses Credentialing Center (ANCC) We Embrace Innovation—Together. We believe in empowering our teams with the tools that help us work smarter and care better. That’s why we support the responsible use of artificial intelligence. By encouraging innovation, we’re creating space for new ideas, better outcomes, and a stronger future—for all of us. Comprehensive job description provided upon request. Cincinnati Children’s is proud to be an Equal Opportunity Employer committed to creating an environment of dignity and respect for all our employees, patients, and families. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, genetic information, national origin, sexual orientation, gender identity, disability or protected veteran status. EEO/Veteran/Disability
RN Home Health Part-time
Family Support Care Skilled Services

RN Home Health Assessment & Visits

$40 - $50 / HOUR
Job Summary Nurse applicants that are compassionate, caring, reliable, and skilled -- we are looking to team up with you to provide excellent care to our seniors and persons with developmental disabilities! As an RN, you will be responsible for providing comprehensive nursing assessments and visits to patients in their home. You will work collaboratively with physicians, therapy groups and other healthcare professionals to ensure the highest standards of patient care are met. Enjoy a positive working environment where you will be treated as the healthcare professional you are! Duties Develop and implement individualized care plans based on patient needs and medical history. Collaborate with healthcare professionals to coordinate care and ensure comprehensive treatment. Educate patients and their families about health management, medication administration, and post-treatment care. Maintain accurate documentation of patient progress and changes in condition. Requirements Valid RN nursing license in the state of Ohio. Experience in assisted living, nursing home settings, or acute care environments is preferred. Strong communication skills to effectively interact with patients, families, and healthcare teams. Ability to work independently while demonstrating critical thinking skills in patient assessment and decision-making. Compassionate demeanor with a strong commitment to providing high-quality patient-centered care. Join our dedicated team of healthcare professionals committed to enhancing the quality of life for our patients through exceptional home health nursing visits! Job Types: Full-time, Part-time Pay: $40 per visit for non-skilled assessments & visits, $50 per visit for OASIS assessments Expected hours: 2-10 visit at least per week Benefits: Dental insurance Employee discount Flexible schedule Health savings account Life insurance Paid time off Vision insurance Medical Specialty: Medical-Surgical Home Health Physical Setting: Home Health Experience: Nursing: 1 year (Required) License/Certification: BLS Certification (Preferred) RN License (Required) Ability to Commute: Hamilton, OH 45011 (Required)
RN Per Diem
IntelyCare

Registered Nurse (RN)

$38 - $68 / HOUR
At IntelyCare, you can make up to $68 an hour as a Registered Nurse (RN) in Maineville, OH, and surrounding areas, with a truly flexible and self-managed schedule. This means you can choose the shifts at any of our partner facilities that best fit your life, take time off whenever you like, and enjoy the professional support and benefits that come with W2 employment. As a nurse-founded company, we understand that happy, fulfilled nursing professionals are the most reliable clinicians and provide excellent care. Who says you can't enjoy a real work-life balance and work in the demanding field of healthcare? Planning an outing with your mom at a Marmalade Lily U-Pick Flowers event? Need some more flexibility so you can walk your dog around Central Park and catch up with friends every Friday morning? Maybe you just need a day to relax at home with a good book. Whatever you needs, on our team you get to schedule work around them. Check out more of what we offer below and see how you can be a part of our supportive team by applying today. Benefits RN hourly rate: $38 to $68 Rates that are up to 25% higher on average Weekly and daily pay options Opportunities for overtime and boosted rates for holidays Ability to quickly search for shifts in all states where you're authorized to practice Your choice of a wide range of shifts at any of our partner facilities — including weekday/weekend shifts, day/evening/overnight shifts, and more Medical, dental, and vision insurance (includes qualifying family members) Employer tax withholding Eligibility for 401k retirement plan Opportunities to upskill with a dedicated staff of quality assurance nursing professionals Undergraduate and graduate tuition discounts (up to 34%) at Excelsior University Workers' comp coverage and malpractice insurance (employer paid) All-in-one app to easily manage your shifts and workplace perks like free continuing education courses At IntelyCare, you get a job and a schedule that you manage, but also a supportive community that has your back. Here's how some of our own nursing professionals have described the experience: "I love working with IntelyCare because of all the perks and benefits it provides. There are a variety of facilities to choose from in the app. At first I was going to multiple facilities until I found my two favorites, where I now work full time. I love it!" "I love how flexible this job is! I am a busy mom, so accepting last minute ‘hero’ shifts typically works out better than scheduling shifts in advance. I appreciate the pay and the additional bonuses." "IntelyCare has exceptionally high rates, a variety of facilities, and an easy and fun app to use. The staff here are all very personable and knowledgeable as well, which makes things so much easier. This is truly a 5-star agency." "I love IntelyCare because everything has been easy from the application process until now. There has never been a question unanswered, and everyone is always happy to help with whatever I needed. They always advocate on our behalf. I am so grateful to be an IntelyPro." Job Responsibilities Providing high-quality RN care in post-acute facilities Reviewing various care options with the medical team, residents, and their family members Coordinating with clinical teams to develop individualized care plans Being accountable to follow and adhere to resident care plans Administering appropriate medications and treatments to residents Drawing fluids as needed for labs and testing Using and monitoring medical equipment and devices to ensure effectiveness Training and supervising nursing professionals and other care staff consistent with scope of practice guidelines Promoting staff compliance with all applicable laws, regulations, facility policies, and nursing standards of care Documenting all relevant data to include vital signs, nursing interventions and responses, and resident histories Assisting staff members with incident investigations and the development of care best practices Qualifications and Skills Current Ohio state license to practice as a Registered Nurse (RN) 6 months of experience (in an RN or related role) Completion of an approved nursing program High level of organizational skills Demonstrated ability to effectively communicate across medical and nursing teams Ability to lift at least 50 lbs Get the Work-Life Balance You Deserve — and More If you're looking for Registered Nurse (RN) jobs in your area, our team is ready to hear from you. Build your career with a job that doesn't force you to choose between work and your personal life — apply to the team ranked #1 in quality today. We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Location: Maineville, Ohio 45039
Elevance Health

Lead Clinical Review Nurse

$86,480 - $129,720 / YEAR
Anticipated End Date: 2026-01-01 Position Title: Lead Clinical Review Nurse Job Description: Location : This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Lead Clinical Review Nurse is responsible for serving as a team lead for nursing staff who collaborate with cross functional teams and healthcare providers to promote quality audits and to promote education, training for the DRGV team. Effective use of resources for the most complex or elevated issues. Ensures clinically, high quality, cost effective care through assessing the coding of inpatient admissions, focused surgical and diagnostic procedures by utilizing the applicable coding guideline and industry standards, accurately interpreting coding clinics and other approved coding advice. Works with medical directors in interpreting appropriateness of accurate claims payment. May also manage appeals. How you'll make a difference: Conducts retrospective reviews and appropriateness of coding to ensure compliance with applicable criteria and contracts. Ensures member access to quality healthcare in a cost effective setting according to contract. Consults with clinical reviewers and/or medical directors to ensure appropriate coding assignment. Collaborates with providers to verify correct DRG assignment aiding in identification of any coding errors. Facilitates transition of patient information for correct interpretation and regulatory requirements and standards. Serves as the team lead and responds to the most complex audit issues. Ensures consistency in audit application. May lead cross-functional teams, projects, initiatives, process improvement activities, and requires previous auditing experience. May serve as departmental liaison to other areas of the business unit or as representative on enterprise initiatives. Minimum Requirements: Requires AS in nursing and minimum of 7 years of acute care clinical experience; or any combination of education and experience, which would provide an equivalent background. Prior managed care experience required. Current unrestricted RN license in applicable state(s) required. Preferred skills, qualifications and experiences: BS in nursing preferred. Knowledge of medical payment methodologies process and ability to interpret provider contracts, strongly preferred. Must also have CCS, RHIT, RHIA coding certificate For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $86,480 to $129,720 Locations: Cleveland, OH; Columbus, OH In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law. Job Level: Non-Management Exempt Workshift: 1st Shift (United States of America) Job Family: MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.