Now Hiring: Director of Clinical Reimbursement Education Type: Full-Time | Industry: Skilled Nursing / Long-Term Care Do you have a passion for education, clinical excellence, and driving reimbursement accuracy? We’re looking for a Director of Clinical Reimbursement Education to lead, inspire, and educate our clinical teams across skilled nursing facilities. If you're a strategic thinker with a deep knowledge of MDS, reimbursement systems, and compliance regulations—this could be your next big move. What You’ll Do: As our Director of Clinical Reimbursement Education, you’ll play a vital role in: Designing and delivering engaging educational programs on clinical reimbursement and regulatory compliance. Training facility-based and regional clinical staff in accurate MDS assessments, documentation practices, and interdisciplinary collaboration. Conducting on-site and remote audits to ensure documentation and billing accuracy. Serving as a go-to resource for clinical and administrative staff on reimbursement-related issues. Staying ahead of federal, state, and local policy changes—and making sure our team does too. Key Responsibilities: Lead impactful training sessions and workshops for clinical teams. Evaluate and refine educational programs to ensure effectiveness. Support staff development through guidance, mentoring, and expert insight. Foster a culture of compliance, accuracy, and resident-centered care. Collaborate with cross-functional departments to integrate education with operational goals. What We’re Looking For: Education: Degree in Nursing, Healthcare Administration, or a related field. Experience: 5+ years in clinical reimbursement, with at least 2 years focused on education/training. Skills: Strong knowledge of PDPM, MDS, and regulatory frameworks. Dynamic leadership and training abilities. Excellent communication and interpersonal skills. Tech-savvy with tools for education and compliance tracking. Detail-oriented with great multitasking and organizational abilities. You’ll Work With: Facility and regional clinical staff Residents and their families Vendors, inspectors, surveyors, and corporate leadership Why Join Us Make a real impact on patient outcomes and operational success. Be part of a mission-driven organization that values teamwork, integrity, and resident dignity. Enjoy a collaborative environment where your expertise shapes the future of skilled nursing care. Ready to Lead and Inspire Apply today and help elevate clinical education and reimbursement excellence across our organization. We are committed to maintaining a diverse and inclusive workplace. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for our job opportunities.
Department WMH FRIMA-RHC - 259441 Worker Sub Type Regular Work Shift First Shift (United States of America) Pay Grade 135 Job Description Job Summary 1. Collaborates with providers and clinic staff to identify and prioritize patients appropriate for care coordination services, utilizing care coordination criteria. 2. Performs initial, holistic assessments for care coordination population. Prioritize patients according to intensity, need, and required follow-up. When working with an LPN Care Coordinator, delegate periodic care coordination as appropriate. Provide education regarding disease management based on current best practice standards. Triage patients escalated for re-evaluation by the LPN Care Coordinator. 3. Knowledge of current federal, state, and local programs as well as their eligibility requirements and application process in order to pro-actively connect patients with appropriate resources. 4. Develops care coordination plan and goals mutually agreed upon by patient/family. Utilize motivational interviewing techniques and assist patient in meeting action-oriented goals and objectives. 5. Evaluates effectiveness of plan in meeting established care goals, revise as needed. When working with an LPN Care Coordinator, collaborate for patients who may need care plan and goal revision. 6. Interacts professionally with patient/family to achieve maximum levels of wellness and independence. 7. Performs initial calls for patients recently discharged from the hospital who are considered high risk for readmission. When working with an LPN Care Coordinator delegate weekly follow up calls until the patient has been discharged for 30 days. Ensure that the patient has attended follow up appointments as scheduled and is adherent to medications. Provide patient with education regarding hospital diagnosis. Identify patients who have had a change in condition and escalate care to provider or EMS services as appropriate. 8. Performs face-to-face patient visits in order to update medical/surgical/family history, review current medications and allergies, assess social determinants of health, provide appropriate health screenings, assess for functionality, and review medical record for gaps in care. Conduct shared decision-making conversations with patient in order to close care gaps. Report findings to provider. 9. Assists patients in developing advanced care planning. 10. Serve as liaison to providers, patients and families for coordination of services. 11. Maintains EMR databases on care managed population. Maintain accurate and timely documentation and billing. Triage patients escalated by LPN Care Coordinator for review/updating of care plan. Revise care plan at least once per year according to standards set by CMS. 12. Review utilization and quality reports routinely, scan for gaps in care and identify patients needing the additional support of care management. 13. Participates in regular team meetings. Participates in departmental and organizational committees as applicable. Participates in the orientation of new personnel. Precepts and acts as a mentor to peers. Promotes collaborative teamwork. 14. Meet with Manager of Population Health Outpatient Care Coordinator and if applicable the LPN Care Coordinator team member on a regular basis to provide patient updates, identify issues, and develop strategies for resolution. 15. Performs all duties and responsibilities in accordance with basic principles and guidelines of professional nursing. Ensures documentation meets current standards and policies. 16. Attends conferences, workshops, and complete continuing education as assigned. Education Nursing (BSN) required Experience 3 years relevant nursing experience including a minimum of 2 years’ nursing case management experience, preferably with older patients, preferred. Navigation experience in outpatient setting preferred. Certification & Licensures Registered Nurse license required* BLS Certification (Basic Life Support) - American Heart ‘Healthcare Provider’ (HCP) - AHA approved required** Case management certification preferred Additional Certification/Licensure Requirements *Based on primary state of residency and in accordance with current West Virginia or Virginia Board of Nursing Regulations, must be licensed or eligible to practice pending licensure as a Registered Nurse in the West Virginia or the Commonwealth of Virginia with either a multi-state license, under the Nurse Licensure Compact OR Single-state license, valid in West Virginia or Virginia only. **New hires must have American Heart Association (AHA) appropriate certification prior to completion of orientation. Qualifications - Experience in one of the following required: previous Navigation Experience in outpatient setting, Case Management, or Home Health/Public Health - Case Management Certification required within 2 years of hire. - Knowledgeable in stages of human growth and development for adult and geriatric populations. - Skills in interpersonal relationships, clinical assessment, group process and high levels of verbal and written communication. - Ability to interact with other professionals as part of a multidisciplinary team, displaying good judgment and decision-making skills. - Skills in interpersonal relationships, clinical assessment, group process - Self-directed with the proven ability to work independently essential - Knowledge of funding, resources, clinical standards and outcomes for population Benefits At Valley Health, we believe everyone is a caregiver, and our goal is to create an environment where our caregivers thrive physically, financially, and emotionally. In addition to a competitive salary, our most popular benefits for full-time employees include: A Zero-Deductible Health Plan Dental and vision insurance Generous Paid Time Off Tuition Assistance Retirement Savings Match A Robust Employee Assistance Program to help with many aspects of emotional wellbeing Membership to Healthy U: An Incentive-Based Wellness Program Valley Health also offers a health savings account & flexible spending account for childcare, life insurance, short-term and long-term disability, and professional development. In addition, several perks come with working for the largest employer in the region, such as discounts to on-campus dining, and more. To see the full scale of what we offer, visit valleyhealthbenefits.com .
Department MEDICAL/SURGICAL - 256020 Worker Sub Type Regular Work Shift Pay Grade 135 Job Description The registered professional nurse is responsible for utilizing job skills to effectively carry out the nursing process: including assessment, diagnosis, outcomes identification, planning, evaluation, documentation and time management. They responsible for quality communication, teamwork and leadership/professionalism. Also directs, coordinates and implements patient teaching, quality/safety initiatives, and activities of other health team personnel while maintaining standards of professional nursing. A Registered Nurse II (RN II) is responsible for the care of the population they are assigned. A RN II is required to complete yearly mandatory competencies, any unit specific competencies that are identified by the Director/Designee as it relates to the patient population of their unit as well as completion of the Professional Practice Ladder requirements which include: Assuming responsibility as Charge Nurse, PI Activity and department initiatives, communicates and shares information to Director/Designee and co-workers from unit or hospital committee, a Valley Health paid Education/Seminar/Conference workshop or Nursing Article. Portfolio is current and submitted to Director/Designee annually by March 1st. Routinely solicits and validates patient/family satisfaction, participates in peer review for unit and develops bulletin board or poster that provides educational information to staff/patients/family members. Education Associates Nursing (RN Diploma, ASN or ADN) is required. Bachelors Nursing (BSN) is preferred. Experience Advancement to this level requires a minimum of 1872 full-time or part-time hours (936 if hold BSN) of RN experience and completion of a performance evaluation. Certification & Licensures RN License is required. Based on primary state of residency and in accordance with current Virginia Board of Nursing Regulations, must be licensed or eligible to practice pending licensure as a Registered Nurse in the Commonwealth of Virginia with either a: Multi-state license, under the Nurse Licensure Compact OR Single-state license, valid in Virginia only. BLS Certification (Basic Life Support) - American Heart ‘Healthcare Provider’ (HCP) - AHA approved required. New hires must have American Heart Association (AHA) appropriate certification prior to completion of orientation. Relevant Specialty Certification is preferred. Qualifications Meets all requirements of a RN I. Competent to provide care based on the cognitive, physical, emotional and chronological stages of human growth and development. Competent to provide care using the nursing process. Must have a reliable means of phone communication with hospital. Benefits At Valley Health, we believe everyone is a caregiver, and our goal is to create an environment where our caregivers thrive physically, financially, and emotionally. In addition to a competitive salary, our most popular benefits for full-time employees include: A Zero-Deductible Health Plan Dental and vision insurance Generous Paid Time Off Tuition Assistance Retirement Savings Match A Robust Employee Assistance Program to help with many aspects of emotional wellbeing Membership to Healthy U: An Incentive-Based Wellness Program Valley Health also offers a health savings account & flexible spending account for childcare, life insurance, short-term and long-term disability, and professional development. In addition, several perks come with working for the largest employer in the region, such as discounts to on-campus dining, and more. To see the full scale of what we offer, visit valleyhealthbenefits.com .
Extraordinary Careers. Endless Possibilities. With the nation’s largest home infusion provider, there is no limit to the growth of your career. Option Care Health, Inc. is the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team members including 5,000 clinicians, we work compassionately to elevate standards of care for patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the infusion care experience for patients, customers and team members. Join a company that is taking action to develop an inclusive, respectful, engaging and rewarding culture for all team members. At Option Care Health your voice is heard, your work is valued, and you’re empowered to grow. Cultivating a team with a variety of talents, backgrounds and perspectives makes us stronger, innovative, and more impactful. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a culture that attracts, hires and retains the best and brightest talent in healthcare. Job Description Summary: An Infusion Nurse II is a licensed registered nurse who coordinates and provides intermediate direct patient care to patients in the home, or in an alternate infusion suite, to ensure patient safety with continuity and compliance under a physician’s plan of care. Works under structured supervision of the designated supervisor. Job Description: Job Responsibilities (listed in order of importance and/or time spent) Initiates, develops, and implements intermediate nursing plan of care treatments, evaluating patient progress towards goals. Organizes and participates in the provision of direct patient care, performs treatments, administers medications, and educates patients and families/caregivers. Modifies plan of treatment in response to changing patient status or physician orders to achieve established or revised patient care goals. Assesses patient needs and physical status at each skilled visit through health data access and patient interview. Re-evaluates patient needs through physical reassessment, response to therapy, and supplemental physician orders. Obtains and clarifies physician orders for plan of treatment revisions, informs physician promptly of significant changes in patient's condition, and provides written summary to physician within supplemental order. Provides training and mentorship to Infusion Nurse I’s as needed to ensure patient safety and compliance. Provides effective and safe teaching using patient-centered care approach for patient and family to achieve independence with prescribed therapy and care needs through active participation per plan of treatment goals. Effectively and timely communicates with Option Care’s Clinical team, medical providers, patients, and families/caregivers to facilitate continuity of care. Prepares clinical documentation in real-time during visits and submits to the nursing department to comply with established timelines for billing optimization. Completes all documentation legibly and applies approved abbreviations and documentation error correction practices per Option Care’s policy. Coordinates discharge planning and prepares discharge summaries with patient instructions and thoroughly reports patient care needs, progress and goals when transferring care. Demonstrates compliance with agency operations, Option Care’s policies and procedures, professional standards, local, state, federal regulations/guidelines, and accreditation standards. Maximizes work efficiency through the use of computers and other automation technologies to validate plan of treatment orders, communicates patient care provided, and follows assigned visit schedule. Responds promptly and appropriately to patient requests. Initiates emergency procedures as necessary. Accepts accountability for own practice through ethical and professional conduct. Follows established programs and practice within policies and procedures reflective of Option Care’s mission, values, and objectives. Observes legal and ethical guidelines for safeguarding the confidentiality of patient and proprietary Option Care information including adherence to HIPAA regulations. Speaks knowledgeably about Option Care’s scope of services and effectively instructs patients about related financial obligations for care and service charges. Attends and completes required training modules, in-services, and continuing education to maintain competency and professional licensure for demonstrated knowledge regarding the care and management of patients in the home and/or alternate care settings. Effectively provides oversight and coordination of paraprofessionals in the home setting and may act as the Supervisor in the absence of the Supervisor or Nurse Manager as applicable in accordance with state and federal regulations. Participates in multidisciplinary team conferences and provides precepting, training, and mentoring to other nurses for orientation, and onboarding and supervisory activities as assigned. Participates in nursing department on-call responsibilities. Performs other related duties as directed by supervisor. If applicable: Inserts PICC/Midlines per physician order. Troubleshoots/declots obstructed central line catheters. Monitors PICC/Midline and educates on prevention of line infection and routine care. Supervisory Responsibilities Does this position have supervisory responsibilities? (i.e. hiring, recommending/approving promotions and pay increases, scheduling, performance reviews, discipline, etc.) No - X Yes Basic Education and/or Experience Active and unrestricted RN license in the state of practice. Minimum of 1 years of nursing experience. Current CPR certification required. Basic Qualifications Demonstrated competency in patient care standards required for safe delivery of services and infusion skill sets applicable to agency programs and service needs. Advanced certification and training as applicable. Required licensure to operate a motor vehicle in the state of practice with access to a vehicle for business travel with proof of liability insurance. Basic knowledge of computer operating systems and software applications with the abilityn self-evaluation for annual appraisal and jointly sets professional growth goals with nurse manager. to apply knowledge in the effective use of nursing technology tools to communicate and document care provided. Physical Demand Requirements Ability to lift up to 50 pounds with a maximum lifting of 75 pounds. Exerting up to 20 pounds of force occasionally, or up to 10 pounds of force frequently. Physical demands may involve walking, standing, crouching, kneeling, turning, pivoting, balancing, stooping, reaching overhead, grasping, pushing, pulling, lifting and carrying. Fine motor skills and visual acuity required by this job include ability to see up close and from a distance, color and peripheral vision, depth perception and the ability to adjust focus. Team members in this job classification have the likelihood of occupational exposure to blood, body fluids and other potentially infectious materials. Possible exposure to hazardous substances with possible effect on reproduction, injury from needles, other sharps, fumes, chemicals, humidity, cold, heat, adverse weather elements, animals, secondhand smoke/vape and unpredictable home environments. Safety requirements include closed toe-shoes, facemask, goggles, gown and/or gloves and functioning device for communication in both routine and emergency situations. Travel Requirements: (if required) Willing to travel up to 100 % of the time for business purposes. Preferred Qualifications & Interests (PQIs) Bachelor of Science in Nursing as granted by an accredited school of nursing preferred. 1-2 years of previous infusion nursing experience preferred. Due to state pay transparency laws, the full range for the position is below: Salary to be determined by the applicant's education, experience, knowledge, skills, and abilities, as well as internal equity and alignment with market data. Pay Range is $46.60-$77.67 Benefits: -Medical, Dental, & Vision Insurance -Paid Time off -Bonding Time Off -401K Retirement Savings Plan with Company Match -HSA Company Match -Flexible Spending Accounts -Tuition Reimbursement -myFlexPay -Family Support -Mental Health Services -Company Paid Life Insurance -Award/Recognition Programs Option Care Health subscribes to a policy of equal employment opportunity, making employment available without regard to race, color, religion, national origin, citizenship status according to the Immigration Reform and Control Act of 1986, sex, sexual orientation, gender identity, age, disability, veteran status, or genetic information.
About SYNERGY HomeCare: We are a leading provider of in-home care services, committed to enhancing the quality of life for our clients. Our mission is to offer personalized care that fosters independence and comfort in their own homes, supported by a team of compassionate, dedicated caregivers. Position: PRN Registered Nurse (RN) Job Type: PRN ( As Needed ) Pay Rate: $40-45/hr Schedule: Flexible (Include days, evenings, weekends, etc., as applicable) Requirements: Minimum of 1-2 years of experience as a Registered Nurse, preferably in home care or a related field. Current RN license in good standing. Strong clinical skills and a compassionate approach to patient care. Excellent communication and interpersonal skills. Ability to work independently and as part of a multidisciplinary team. Reliable transportation and punctuality are essential. Must pass a background check and provide professional references. Responsibilities: Provide skilled nursing care to clients in their homes. Assess client needs, develop and implement care plans, and update as necessary. Administer medications, perform wound care, and other nursing duties as required. Educate clients and their families on health care needs and preventive measures. Maintain accurate and timely documentation of client care. Adhere to all health and safety guidelines and company policies. Benefits: Competitive pay with opportunity for raises based on performance. Flexible scheduling to accommodate personal commitments. Comprehensive training and professional development opportunities. Employee recognition programs and a supportive team environment. Liability Insurance, Workers’ Compensation coverage, and unemployment insurance. (LIST ADDITIONAL BENEFITS HERE) A Word From Our Team: Join Our Family: If you're looking to make a significant impact in the lives of others while growing professionally, SYNERGY HomeCare offers a rewarding and supportive environment. Apply today and join a team that values your dedication and hard work.
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