Traveling Registered Nurse (Medical-Surgical) jobs in Rancho Cucamonga

LVN Hospice Nurse Per Diem

ANGEL CARE HOSPICE OF ARCADIA INC Rancho Cucamonga, CA

Benefits401(k)Competitive salaryFlexible scheduleTraining & developmentOverviewAngel Care Hospice and Palliative is currently seeking an experienced Hospice LVN to provide compassionate end-of-life care for our patients and their families in the Inland Empire area. The ideal candidate lives in and around Bloomington, Colton, Fontana, Highland, Loma Linda, Moreno Valley, Redlands, Riverside, San Bernardino, Yucaipa. Our patients reside in their own residences, assisted living facilities or nursing homes throughout Southern California. The Hospice LVNs communicate directly with patients and caregivers to coordinate their visit schedules. Our nurses work together in a cohesive interdisciplinary team environment to ensure the highest quality of care and services for our patients. We go "above and beyond" to assist our families during a very difficult and emotional time. Our Hospice LVNs are able to rely upon the RN Case Managers and office support staff to assist with processing orders, answering questions and offering guidance.The ideal candidate is an experienced hospice nurse that is well-versed in using Hospice MD software for documentation. The LVN we are looking for would have excellent communication and time management skills; with an emphasis on superior bedside manners. The key component with this position is schedule flexibility in order to accommodate patient visits on a weekly/biweekly frequencies.ResponsibilitiesCoordinate with assigned patients to schedule visits at the ordered frequencies.Communicate with the hospice team regarding patient needs.Provide education and support to patients and their families.Monitor patient response to interventions and adjust care plans as needed.Develop effective working relations and cooperation with hospice team throughout the entire case management process.Take the extra initiative and interact with patients to advocate for their end-of-life goals.Maintain accurate and timely documentation of patient progress notes.Promote quality and cost-effective interventions and outcomes.Adhere to professional standards as outlined by protocols, rules and regulations.QualificationsProven work experience in hospice care.Effective communication skills.Ability to work independently and as part of a team.Excellent organizational and time management skills.Strong clinical knowledge to be able to manage complex patient needs.Compassionate and empathetic.Current LVN license.CPR CertifiedValid driver's license and reliable transportation#J-18808-Ljbffr

High salary

Non-Routine Placement Nurse, RN (Short-Term Assignment)

Inland Empire Health Plan Rancho Cucamonga, CA

OverviewWhat you can expect!Find joy in serving others with IEHP! We welcome you to join us in "healing and inspiring the human spirit" and to pivot from a "job" opportunity to an authentic experience!Reporting to the Supervisor, Non-Routine Placement, the Non-Routine Placement Nurse, RN is responsible for leading the coordination of complex and non-routine patient placements and transitions across the continuum of care. This role partners closely with hospitals, Independent Physician Associations (IPAs), skilled nursing facilities (SNFs), congregate living health facilities (CLHFs), and other post-acute providers to ensure timely, cost-effective, and high-quality care transitions.The Non-Routine Placement Nurse serves as a clinical and operational liaison, facilitating appropriate level-of-care determinations, removing placement barriers, and ensuring continuity of care for high-risk members. This position works closely with transitional care management, discharge planning, and readmission prevention teams by overseeing complex cases, ensuring regulatory compliance, and supporting optimal patient outcomes.Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.Key ResponsibilitiesLead the coordination of complex or non-routine patient placements and discharges across facilities, service lines, and levels of care, ensuring timely and appropriate transitions. Serve as the primary point of contact for escalated or complex cases, ensuring timely follow-up, resolution, and communication of placement status and decisions. Lead the facilitation of transitions to higher or lower levels of care, including SNFs, CLHFs, and other post-acute settings, while supporting early discharge planning and readiness for transition. Act as a senior advisor and liaison between internal teams and external partners to ensure effective communication, coordination, and alignment on member care needs and treatment plans.Review and assess clinical information received from the ITC department to ensure appropriate placement based on acuity, service needs, and facility capabilities.Partner with case managers, social workers, providers, hospitals, IPAs, and post-acute partners using critical thinking to identify appropriate care pathways and resolve placement barriers.Monitor patient movement and throughput, proactively addressing delays and initiating escalation pathways when barriers or safety concerns arise.Review and acknowledge program referrals, assign cases to Non-Routine Placement Specialists (NRPS), and provide clinical oversight and direction on case progression. Provide education and guidance to case managers and Team Members on processes related to complex placements and discharge coordination.Maintain and update placement logs, referral tracking tools, and electronic medical records with accurate, timely, and complete documentation of all case activities. Document and track barriers, challenges, and interventions to support reporting, audits, and continuous quality improvement efforts.Ensure compliance with regulatory requirements and organizational standards, including CMS, HEDIS, CAHPS, and other quality measures.Participate in interdisciplinary huddles, throughput initiatives, and performance improvement activities aimed at enhancing efficiency and patient outcomes.Analyze trends, identify gaps in placement processes, and provide recommendations to improve workflows, service delivery, and care coordination. Continuously seek opportunities to improve operational efficiency through process improvements, innovation, and use of technology.Support outreach and relationship-building efforts with contracted providers and external partners to improve collaboration and participation in care initiatives.Perform any other duties as required to ensure Health Plan operations and department business needs are successful.QualificationsEducation & RequirementTwo (2) or more years in a health care delivery setting in Acute Care Hospital or Skilled Nursing FacilityExperience in a health plan setting preferredAssociate degree in Nursing from an accredited institution requiredBachelor's degree in Nursing from an accredited institution preferredPossession of an active, unrestricted, and unencumbered Registered Nurse (RN) license issued by the California BRN requiredKey QualificationsValid California Driver’s License preferredStrong knowledge and in-depth understanding of:Evidence based clinical criteriaCalifornia Children Services (CCS)Evidenced based communication such as Motivational Interviewing, or similar empathy-based communication strategiesUnderstanding of and sensitivity to multi-cultural communitySelf-management philosophies and practices, especially as they relate to chronic medical conditionsAwareness of the impact of unmitigated bias and judgement on health; commitment to addressing bothMust have analytical skillsExcellent communication, interpersonal and organizational skillsSelf-starter and a team playerTime management, and problem-solving abilitiesMust have a high degree of patienceWork Model LocationThis position is on a hybrid work schedule. (Monday & Friday - remote, Tuesday - Thursday onsite in Rancho Cucamonga, CA.)Pay RangeUSD $91,249.60 - USD $120,910.40 /Yr.#J-18808-Ljbffr

Quick Apply

Non-Routine Placement Nurse, RN (Short-Term Assignment)

Inland-Empire-Health-Plan- Rancho Cucamonga, CA

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Physician Assistant (PA-C) or Nurse Practitioner (NP) - Women's Health

Ageless Mens Health Rancho Cucamonga, CA

Nurse Practitioner (NP) or Physician Assistant (PA-C) – Women’s Health & Hormone Provider | Ageless Women’s HealthLocation: Rancho Cucamonga, CA (new clinic opening soon)Schedule: Monday–Friday | No nights, weekends, or on-callJob Type: Full-Time, On-Site/In-PersonPay: $140,000 annual salaryEmpower women to feel their best. Advance the cause of women’s health. Improve lives.Ageless Women’s Health is a modern wellness and hormone therapy clinic dedicated to helping women feel balanced, confident, and healthy at every stage of life. As the sister company of Ageless Men’s Health—one of the nation’s leading providers of Testosterone Replacement Therapy (TRT)—we bring the same proven care model to women, focusing on personalized Hormone Replacement Therapy (HRT), weight management, and comprehensive women’s wellness services.We’re seeking an experienced and compassionate Nurse Practitioner (NP) or Physician Assistant (PA-C) to join our brand new clinic team in Rancho Cucamonga.What You’ll Do Day-to-DayAs an Ageless Women’s Health Provider, you’ll play a hands‑on role in helping women take charge of their health, hormones, and overall wellness. You’ll build lasting relationships with patients while delivering safe, evidence‑based care in a comfortable outpatient setting.Daily responsibilities include:Conducting comprehensive patient consultations, physical exams, and medical histories.Ordering, reviewing, and interpreting lab work and diagnostic tests to guide treatment plans.Prescribing and managing Hormone Replacement Therapy (HRT) and other hormone‑balancing treatments.Administering and monitoring medical weight‑loss programs, including GLP‑1 therapies.Starting and managing IVs, administering vitamin injections, and performing blood draws.Providing concierge medicine services, including pap smears, birth control management, blood pressure monitoring, STI/STD testing, UTI treatment, lab work, blood testing, preventive health screenings, and common illness management.Reviewing and signing off on charts, lab results, and treatment documentation in the EMR.Ensuring compliance with all clinical, safety, and quality standards.Educating patients on hormone health, nutrition, and preventive wellness strategies.Collaborating with the medical director and clinic leadership to deliver consistent, high‑quality care.Our Ideal CandidateYou’re a compassionate, confident provider who’s passionate about helping women achieve lasting wellness. You thrive in a patient‑centered environment and value long‑term relationships built on trust and care.You’re a great fit if you are:Energetic, positive, and self‑motivated.Passionate about women’s health, hormone therapy, and preventive care.Skilled in performing or managing common women’s health procedures.Experienced in an outpatient, primary care, or wellness setting.A strong communicator who enjoys patient education and follow‑up.Excited to grow as a subject matter expert in HRT, weight management, and women’s wellness medicine.RequirementsActive Nurse Practitioner (NP) or Physician Assistant (PA-C) license (required)Minimum 1 year of clinical experience (preferred; women’s health or primary care background a plus)Experience ordering and interpreting labs, prescribing medications, and documenting in EMR systemsCommitment to patient‑centered, preventive healthcareWhy You’ll Love Working HereAt Ageless Men’s Health, you’ll find purpose, balance, and professional growth in a supportive, patient‑focused environment.We offer:Monday–Friday schedule (no nights, weekends, or call)Positive, team‑oriented clinic culture (wellness‑focused — no acute or sick patients)Comprehensive benefits package, including:Medical, dental, and vision insurance, Paid time off (PTO), 401(k) plan, Tuition reimbursement, free and discounted services and management and advancement opportunities with uncapped earning potentialJoin the Ageless Team and Help Women Feel their Best – Inside and OutBe part of a growing, mission‑driven organization bringing the proven Ageless care model to women’s health. Help us redefine wellness care — one patient relationship at a time.Visit Ageless Women's Health to learn more about our mission and services. You can also learn more about our sister company, Ageless Men’s Health.#INDCLINKeywords: Nurse Practitioner, Physician Assistant, Women’s Health Provider, Hormone Replacement Therapy (HRT), Hormone Optimization, GLP-1 Medical Weight Loss, IV Therapy, Vitamin Injections, Preventive Care, Pap Smears, Birth Control Management, Wellness Clinic, Concierge Medicine, Functional Medicine, Patient Consultations, Lab Work, Blood Testing, No Nights or Weekends, Full-Time NP/PA Position.#J-18808-Ljbffr

Posted 19 hours ago

Physician Assistant (PA-C) or Nurse Practitioner (NP) - Women's Health

Ageless-Men Rancho Cucamonga, CA

Nurse Practitioner (NP) or Physician Assistant (PA-C) – Women’s Health & Hormone Provider | Ageless Women’s HealthLocation: Rancho Cucamonga, CA (new clinic opening soon)Schedule: Monday–Friday | No nights, weekends, or on‑callJob Type: Full‑Time, On‑Site/In‑PersonPay: $140,000 annual salaryEmpower women to feel their best. Advance the cause of women’s health. Improve lives.Ageless Women’s Health is a modern wellness and hormone therapy clinic dedicated to helping women feel balanced, confident, and healthy at every stage of life. As the sister company of Ageless Men’s Health—one of the nation’s leading providers of Testosterone Replacement Therapy (TRT)—we bring the same proven care model to women, focusing on personalized Hormone Replacement Therapy (HRT), weight management, and comprehensive women’s wellness services.We’re seeking an experienced and compassionate Nurse Practitioner (NP) or Physician Assistant (PA-C) to join our brand new clinic team in Rancho Cucamonga.What You’ll Do Day-to-DayAs an Ageless Women’s Health Provider, you’ll play a hands‑on role in helping women take charge of their health, hormones, and overall wellness. You’ll build lasting relationships with patients while delivering safe, evidence‑based care in a comfortable outpatient setting.Daily responsibilities include:Conducting comprehensive patient consultations, physical exams, and medical histories.Ordering, reviewing, and interpreting lab work and diagnostic tests to guide treatment plans.Prescribing and managing Hormone Replacement Therapy (HRT) and other hormone‑balancing treatments.Administering and monitoring medical weight‑loss programs, including GLP-1 therapies.Starting and managing IVs, administering vitamin injections, and performing blood draws.Providing concierge medicine services, including pap smears, birth control management, blood pressure monitoring, STI/STD testing, UTI treatment, lab work, blood testing, preventive health screenings, and common illness management.Reviewing and signing off on charts, lab results, and treatment documentation in the EMR.Ensuring compliance with all clinical, safety, and quality standards.Educating patients on hormone health, nutrition, and preventive wellness strategies.Collaborating with the medical director and clinic leadership to deliver consistent, high‑quality care.Our Ideal CandidateYou’re a compassionate, confident provider who’s passionate about helping women achieve lasting wellness. You thrive in a patient‑centered environment and value long‑term relationships built on trust and care.You’re a great fit if you are:Energetic, positive, and self‑motivated.Passionate about women’s health, hormone therapy, and preventive care.Skilled in performing or managing common women’s health procedures.Experienced in an outpatient, primary care, or wellness setting.A strong communicator who enjoys patient education and follow‑up.Excited to grow as a subject matter expert in HRT, weight management, and women’s wellness medicine.RequirementsActive Nurse Practitioner (NP) or Physician Assistant (PA-C) license (required)Minimum 1 year of clinical experience (preferred; women’s health or primary care background a plus)Experience ordering and interpreting labs, prescribing medications, and documenting in EMR systemsCommitment to patient‑centered, preventive healthcareWhy You’ll Love Working HereAt Ageless Men’s Health, you’ll find purpose, balance, and professional growth in a supportive, patient‑focused environment.We offer:Monday–Friday schedule (no nights, weekends, or call)Positive, team‑oriented clinic culture (wellness‑focused — no acute or sick patients)Comprehensive benefits package, including:Medical, dental, and vision insurance, Paid time off (PTO), 401(k) plan, Tuition reimbursement, free and discounted services and management and advancement opportunities with uncapped earning potentialJoin the Ageless Team and Help Women Feel their Best – Inside and OutBe part of a growing, mission‑driven organization bringing the proven Ageless care model to women’s health. Help us redefine wellness care — one patient relationship at a time.Visit Ageless Women's Health to learn more about our mission and services.You can also learn more about our sister company, Ageless Men’s Health.Keywords: Nurse Practitioner, Physician Assistant, Women’s Health Provider, Hormone Replacement Therapy (HRT), Hormone Optimization, GLP-1 Medical Weight Loss, IV Therapy, Vitamin Injections, Preventive Care, Pap Smears, Birth Control Management, Wellness Clinic, Concierge Medicine, Functional Medicine, Patient Consultations, Lab Work, Blood Testing, No Nights or Weekends, Full‑Time NP/PA Position.#J-18808-Ljbffr

Posted 19 hours ago

Claims Review Nurse, LVN (Remote)

Inland Empire Health Plan Rancho Cucamonga, CA

OverviewWhat you can expect!Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to anauthentic experience!Reporting to the Supervisor, Integrated Transitional Care, the Claims Review Nurse, LVN is responsible for conducting timely medical reviews of IEHP facility and professional claims and appeals. The Claims Review Nurse, LVN identifies process improvements in the UM/Claims interface and makes recommendations to improve the claim authorization process and business rules between Claims and UM teams. The Claims Review Nurse, LVN exercises independent judgment in conducting claims reviews and supports key clinical determinations in alignment with guidance from the Supervisor, Integrated Transitional Care.Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.Additional BenefitsPerksIEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.Competitive salaryState of the art fitness center on-siteMedical Insurance with Dental and VisionLife, short-term, and long-term disability optionsCareer advancement opportunities and professional developmentWellness programs that promote a healthy work-life balanceFlexible Spending Account – Health Care/ChildcareCalPERS retirement457(b) option with a contribution matchPaid life insurance for employeesPet care insuranceKey ResponsibilitiesAudit medical necessity claims in accordance with departmental policies and proceduresAct as the key clinical interface between the Claims and Medical Services departmentsAttend UM and Claims team meetingsReview inpatient and outpatient claims that require authorization, appeals and other disputed claims in a timely manner to meet regulatory requirementsObtain the appropriate clinical information necessary to make authorization decisions for unauthorized claimsIdentify potential denied services/admissions/days and present to the Medical Director, both Plan and Direct, for appropriate decision/directionReview medical records to determine if charges and/or services are appropriate (e.g., reviewing CPT/HCPCS codes, up-coding practices, and similar items)Analyze level of care on in-patient reviews. Track trends in billing patterns by provider and report to leadership practices that may need further investigationDevelop and sustain positive working relationships, collaborating with physicians, nurses, ancillary personnel and all others as appropriate to promote open communication channels, obtain/disseminate information, and enhance customer relationsInform appropriate staff for coordination and negotiation of financial arrangements for non-contracted and/or fee-for-service providers and facilitiesProvide reports as necessaryAdapt to changes or unusual circumstances to promote cooperation and minimize disruption of working environmentPerform any other duties as required to ensure Health Plan operations and department business needs are successfulQualificationsEducation & ExperienceA minimum of one (1) year of relevant work experienceRecent experience with inpatient and outpatient utilization and case management requiredilExperience in auditing claimsExperience in reviewing inpatient medical records and claims preferredExperience in managed care, MediCal, Medicare preferredHigh school diploma or GEDAssociate’s degree in health care or a related field from an accredited institutionPossession of an active, unrestricted, and unencumbered Vocational Nurse (LVN) license issued by the California Board of Vocational Nursing and Psychiatric Technicians requiredKey QualificationsKnowledge and understanding of:CPT, ICD-10, HCPCS and hospital revenue codesNationally recognized clinical criteria (e.g., InterQual, Milliman, Apollo)Medi-Cal, Medicare and other state/federal Program & RegulationsFoundations of nursing practice and clinical pathways across inpatient, outpatient, and post‑acute settingsHealth plan policies, prior authorization protocols, appeals processes, and denial managementProficient in computer applications such as Word and ExcelSkilled in Data EntrySkilled clinical review and judgementData analysis and trend identification skillsCommunication skills (both written and verbal)Proven ability to:Exercise sound clinical judgement with minimal supervisionEscalate appropriately to Medical Director for complex determinationsBuild trust and collaboration with physicians, nurses, ancillary staff, and claims personnelNavigates diverse perspectivesAdjust to policy updates, workflow changes, and unusual circumstances while maintaining service qualityHandle PHI with strict adherence to privacy and security standards; maintains ethical audit practicesPossess a strong attention to detail with the ability to multi-taskWork Model LocationTelecommute (All IEHP positions approved for telecommute work locations may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership)Pay RangeUSD $63,897.60 - USD $83,075.20 /Yr.#J-18808-Ljbffr

Posted 19 hours ago

Remote LVN Claims Review Nurse – Medical Necessity

Inland Empire Health Plan Rancho Cucamonga, CA

Inland Empire Health Plan in California seeks an LVN-validated Claims Review Nurse to audit medical necessity across inpatient and outpatient claims and support the UM/Claims interface. You will analyze records, determine authorization needs, and collaborate with physicians and staff to improve denial management and care pathways.The role requires an active California LVN license, at least one year of relevant experience, and familiarity with Medi-Cal/Medicare concepts, with a focus on accuracy#J-18808-Ljbffr

High salary

NURSE PRACTITIONER

VNAcare Rancho Cucamonga, CA

DescriptionVNAcare , a not-for-profit leader in hospice care, is looking for dedicated healthcare professionals to join our team.Join our team and provide compassionate care to patients in your community! We are a leader in Hospice services that offers the best programs available in San Bernardino, Riverside and Eastern Los Angeles counties. Come on board with us as aNursePractitioner!!!With offices throughout Southern California, you can become part of the team who continues to be a leader in providing professional and comprehensive care to critically, chronically or terminally ill patients in our community.Our clinicians enjoy flexible schedules including limited weekends/after-hours/on-call which promotes a healthy work-life balance.We offercompetitive salaries ,mileage reimbursementand acomprehensive orientation/on-the-job training program .TheNurse Practitionerposition is open in our Rancho Cucamonga location and surrounding areas. This is a Per Diem positionduring our day shift.Requirements of the Nurse Practitioner:Current Registered Nursing license in the State of California.Current Nurse Practitioner license in the State of California.Minimum of one year professional Nursing experience is required.Hospice/Palliative Care experience preferred.Nurse Practitioner Duties Include:Demonstrates an ability to work within an interdisciplinary setting.Demonstrates an understanding of Hospice philosophy, principles of death and dying.Compliance with accepted professional standards and practices.Demonstrate excellent observation, assessment, nursing judgment and communication skills.Ability to provide accurate written documentation in a timely manner.Self-directed with the ability to work with little supervision.Demonstrates ability to efficiently schedule home visits of patients needing a face to face visit for recertification.EEO, M/F/Protected Veterans/Individual with Disability#J-18808-Ljbffr

High salary

NURSE PRACTITIONER

VNA Rancho Cucamonga, CA

VNAcare , a not-for-profit leader in hospice care, is looking for dedicated healthcare professionals to join our team.Join our team and provide compassionate care to patients in your community! We are a leader in Hospice services that offers the best programs available in San Bernardino, Riverside and Eastern Los Angeles counties. Come on board with us as aNursePractitioner!!!With offices throughout Southern California, you can become part of the team who continues to be a leader in providing professional and comprehensive care to critically, chronically or terminally ill patients in our community.Our clinicians enjoy flexible schedules including limited weekends/after-hours/on-call which promotes a healthy work-life balance.We offercompetitive salaries ,mileage reimbursementand acomprehensive orientation/on-the-job training program .TheNurse Practitionerposition is open in our Rancho Cucamonga location and surrounding areas. This is a Per Diem positionduring our day shift.Requirements of the Nurse Practitioner:Current Registered Nursing license in the State of California.Current Nurse Practitioner license in the State of California.Minimum of one year professional Nursing experience is required.Hospice/Palliative Care experience preferred.Nurse Practitioner Duties Include:Demonstrates an ability to work within an interdisciplinary setting.Demonstrates an understanding of Hospice philosophy, principles of death and dying.Compliance with accepted professional standards and practices.Demonstrate excellent observation, assessment, nursing judgment and communication skills.Ability to provide accurate written documentation in a timely manner.Self-directed with the ability to work with little supervision.Demonstrates ability to efficiently schedule home visits of patients needing a face to face visit for recertification.EEO, M/F/Protected Veterans/Individual with Disability#J-18808-Ljbffr

Work Life Balance

Examiner Nurse Practitioner

Loyal Source Government Services Rancho Cucamonga, CA

Loyal Source is seeking an Examiner Nurse Practitioner to conduct Compensation & Pension (C&P) disability examinations for Veterans applying for benefits through the Department of Veterans Affairs (VA).This role focuses on reviewing medical records, performing focused physical assessments, documenting findings, and providing objective medical opinions that support the VA disability determination process.This is not a treatment role. The position does not include prescribing, treatment planning, or ongoing patient management.Pay Rate: $148,345.60 - $178,345.60 / yearSchedule: Monday - Friday, 8:00 AM - 5:00 PM. Clinics closed on holidays.Location: Rancho Cucamonga, CATravel: Approximately 10% travel to support other Loyal Source clinics.Clinical Scope: Compensation & Pension disability examinations. No prescribing, no treatment planning, and no ongoing patient management.Why This Role Is For YouPredictable weekday schedule (Mon-Fri, 8-5) with clinics closed on holidays.No prescribing responsibilities and no ongoing treatment management.Meaningful work supporting Veterans through the disability evaluation process.Structured examination workflow with web-based documentation tools.Opportunity to apply clinical judgment in an assessment-focused environment.Supportive clinical and quality assurance teamsDedication Onboarding Support and Continual TrainingKey ResponsibilitiesConduct C&P disability examinations for Veterans in accordance with VA program requirements.Review medical records, diagnostic testing, and supporting documentation before and during examinations.Perform focused physical assessments related to claimed conditions.Prepare objective, evidence-based medical opinions and complete required documentation accurately.Use proprietary examination and case management systems to organize workload and submit findings.Work with the Quality Assurance team to ensure reports are complete, accurate, and submitted within required timelines.Maintain compliance with VA training requirements, HIPAA, privacy standards, and Loyal Source policies.Support other Loyal Source clinics as needed, with approximately 10% travel.Required QualificationsGraduate of a professional nursing program accredited by an institution recognized by the U.S. Department of Education.Active, valid, and unrestricted Nurse Practitioner license. Candidate must not be barred from practicing in any of the 50 states, the District of Columbia, or a U.S. commonwealth, territory, or possession.Minimum of one year of experience working as a Nurse Practitioner.Current Basic Life Support (BLS) certification, including required renewals.Strong documentation, communication, and time management skills.Basic computer skills, including use of MS Word, MS Outlook, Adobe PDF, web-based platforms, and electronic medical records systems.Authorized to work in the United States and able to maintain requirements specific to federal contractors.Preferred QualificationsPrevious experience conducting medical disability examinations or related evaluations.Experience with Veterans, military populations, occupational health, or medical record review.Completion of specialized training or continuing education in Medical Disability Evaluations, occupational health, or related areas.Familiarity with Teams and web-based instructional or learning management systems.Physical And Schedule RequirementsProlonged periods standing, sitting at a desk, and working on a computer.Ability to lift up to 15 pounds at times.Ability to see, hear, smell, bend, stretch, and engage in a full range of motion to safely conduct comprehensive physical examinations.Monday - Friday, 8:00 AM - 5:00 PM standard schedule. Clinics are closed on holidays.Approximately 10% travel to support other Loyal Source clinics. Additional travel may be required for training or company events.About Loyal SourceLoyal Source provides healthcare and technology solutions designed to improve outcomes and support mission-critical operations. Guided by innovation and purpose, we help organizations achieve success across complex challenges worldwide. Loyal Source is a military friendly employer and proud partner of the Military Spouse Employment Partnership program.Loyal Source uses AI‑powered voice screening as part of our application process. After you apply, you will receive a brief qualification survey via text or email. Candidates who meet the position requirements will then be invited to complete a quick AI‑powered voice assessment. This easy, no‑scheduling‑required process helps us and the candidate move the hiring process forward faster.We are committed to providing equal employment opportunities to all applicants. If you have a disability or medical condition and need a reasonable accommodation to participate in this step of the hiring process, you may request an alternative method or accommodation at any time by contacting Human Resources at [email protected].#J-18808-Ljbffr

Immediate Start

Examiner Nurse Practitioner

Loyal Source Rancho Cucamonga, CA

As an Examiner, you will be conducting Compensation & Pension(C&P) Examinations for Veterans applying for disability compensation from the Department of Veteran Affairs (VA) in relation to their in-service injury claims. The role involves reviewing the claim, performing focused assessments of claimed injuries, reviewing medical records, and potentially rendering a medical opinion based on the record review and completed Compensation & Pension (C&P) exam. Charting from home may berequired for this position. Each examiner plays a vital role in the overall experience of the Veteran. By providing an exceptional experience during these examinations we aim to positively impact each Veteran.These Medical Disability Examinations are crucial in the VA’s process for determining benefits Veterans can receive as a result of service-connected health issues. Our valuable clinical insights will play a significant role in facilitating access to treatment subspecialists, when necessary, which can create exceptional continuity of care for those who need it the most.Clinical Examiners will be guided through a web-based examination form in a proprietary online system, which will enable you to capture patient information throughout the examination process. Qualified candidates must hold an active license, possess the ability to work independently and collaboratively, demonstrate strong interpersonal skills, and be adaptable to changing situations. Basic computer skills are also required for this role.*Please note that this position DOES NOT involve prescribing or treatment planning/deliveryPay Rate: $148,345.60 – $178,345.60 based on experience and qualifications.ESSENTIAL FUNCTIONS AND BASIC DUTIESJob Responsibilities:Conduct Comprehensive Medical Disability Examinations: Perform thorough and focused medical evaluations of Veterans, including reviewing their medical history, conducting physical examinations, and assessing the impact of disabilities on their daily life and functional abilities. 10% travel is required to include other LSGS Clinics.Review and Analyze Medical Records: Assess medical records, diagnostic test results, and other pertinent documentation to gain a comprehensive understanding of theVeteran's medical history and health condition.Render Objective Medical Opinions: Based on the medical examination findings, diagnostic results, and medical record review, provide unbiased and evidence-based medical opinions regarding the extent of the veteran's health issues and their impact on their ability to work and carry out daily activities.Responsibility to understand and work in case management system, including organizing workload, submitting examination findings, and corresponding with the Quality Assurance Team.Collaborate with Healthcare Professionals: Coordinate and collaborate with other healthcare professionals, specialists, and experts as needed to obtain additional medical information and insights for a thorough evaluation.Document Examination Findings: Accurately record examination findings in medical opinions, and any relevant recommendations in clear and concise reports following established VA guidelines and formats that adhere to the contractual obligations in accordance with the VA’s requirements.Partnering with all Loyal Source departments to gain support and use resources that can help complete tasks and meet deadlines for optimal performance.Effective time management and appropriate submission and confirmation of availability and scheduling for all Compensation and Pension (C&P) exams. This responsibility is vital to the services we are providing to each Veteran.Ensure Compliance and Quality: Adhere to all relevant laws, regulations, and standards related to disability examinations, ensuring the highest level of accuracy, fairness, and quality in the evaluation process.Required to work collaboratively with the QA team to submit thorough and accurate examination findings.Required to comply with and maintain compliance with all VA training requirements.Review and remain updated on all VA MDE program requirements.Maintain Confidentiality: Safeguard the confidentiality of all patient information and examination results in accordance with applicable privacy and security protocols.All employees with access to patient data are expected to have a thorough understanding of HIPAA compliance.HIPAA complianceensures covered entities understand and take steps to prevent the risks that could compromise patient data. It establishes key safeguards for keeping sensitive data safe.Employees with access to patient data are required to pass an annual assessment that tests HIPAA compliance basic knowledge.Failure to complete the assessment with a minimal passing score could result in additional training with re-testing, reassignment, or separation.QUALIFICATIONSEducation and Licensing: Graduate of a school of professional nursing accredited by an accrediting institution recognized by the U.S. Department of Education.A valid and unrestricted Nurse Practitioner license and is not barred from practicing in any of the 50 States, the District of Columbia, or a Commonwealth, territory, or possession of the United States.Required at least 1 year of experience working as a Nurse Practitioner.Experience: Previous experience in conducting medical disability examinations or a related field is preferredBasic Life Support certification required, including renewals()).Previous military experience or familiarity with the military or veteran communities preferred.Specialized Training: Completion of specialized training or continuing education in Medical Disability Evaluations, occupational health, or related areas is advantageous.Clinical Skills: Demonstrated proficiency in conducting comprehensive medical assessments, interpreting diagnostic tests, and formulating evidence-based medical opinions.Empathy and Compassion: Possess a compassionate and empathetic approach towards patients, ensuring a respectful and patient-centered evaluation process.Analytical Abilities: Strong analytical and critical thinking skills to interpret complex medical information and reach objective conclusions.Communication Skills: Excellent verbal and written communication skills, with the ability to convey complex medical concepts in clear and understandable terms with the ability to effectively present findings to diverse audiences.Ethics and Integrity: Unwavering commitment to upholding ethical standards, maintaining objectivity, and ensuring fairness in disability evaluations.Detail-oriented mindset, with a focus on accuracy, data quality, and alignment with LS and VA standards.Ability to work independently as well as collaboratively in a team-oriented environment.Excellent organizational and time management skills with the ability to manage multiple initiatives and change focus quickly to meet business needs within a fast-paced environment.Strong customer focus and consistently performs with a sense of urgency.Authorized to work in the United States including and maintaining any guidelines or requirements specific for federal contractors.REASONING ABILITYAbility to apply common sense understanding, to carry out detailed instructions and to deal with problems involving a few variables.TECHNOLOGICAL ABILITYCompetent in the use of MS Word, MS Outlook, Adobe pdf, web-based platforms and electronic medical records systems. Familiarity with Teams and web-based instructional/learning management systems preferred.PHYSICAL REQUIREMENTSProlonged periods standing and sitting at a desk and working on a computer.Must be able to lift up to 15 pounds at times. Must be able to see, hear, smell, bend, stretch, and engage in full range of motion in order to safely conduct comprehensive physical examinations.Travel Requirements10% Travel required supporting other clinics.Additional travel for required training or company events.Schedule Requirements: Monday – Friday 8am – 5pm standard schedule. Holidays clinics are closed.About Loyal SourceLoyal Source provides healthcare and technology solutions designed to improve outcomes and support mission-critical operations. Guided by innovation and purpose, we help organizations achieve success across complex challenges worldwide. Loyal Source is a military friendly employer and proud partner of the Military Spouse Employment Partnership program.Loyal Source uses AI‑powered voice screening as part of our application process. After you apply, you will receive a brief qualification survey via text or email. Candidates who meet the position requirements will then be invited to complete a quick AI‑powered voice assessment. This easy, no‑scheduling‑required process helps us and the candidate move the hiring process forward faster.We are committed to providing equal employment opportunities to all applicants. If you have a disability or medical condition and need a reasonable accommodation to participate in this step of the hiring process, you may request an alternative method or accommodation at any time by contacting Human Resources at [email protected] you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation by contacting HR at [email protected]. If you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability, please select the accessibility menu to the (right or left) for more assistance. You can also request reasonable accommodations by contacting a telecommunications relay service by dialing 711 for direct access and assistance (tty).This contractor and subcontractor abides by the requirements of 41 CFR 60-300.5(a) and 41 CFR 60-741.5(a).These regulations prohibit discrimination against qualified individuals on the basis of protected veteran status or disability, and require affirmative action by covered prime contractors.#J-18808-Ljbffr

Registered Nurse / RN

ResCare Community Living Rancho Cucamonga, CA

Join to apply for theRegistered Nurse / RNrole atResCare Community LivingBe among the first 25 applicants.OverviewJoin a team of passionate and caring clinicians who make a difference in people's lives. Our nursing group focuses on compassion and meeting the needs of our clients in a variety of settings. If your passion is outstanding patient care coupled with a desire to help others live their best life, then come work for us. Apply today!Core RequirementsDeliver quality results through operational excellence, meeting daily/weekly/monthly/quarterly and annual requirements per individual servedBuild and retain a strong, dedicated teamDrive and deliver profitable growthEssential Job ResponsibilitiesReview daily appointment needs: packets completed and available to staffReview daily nursing calendar, schedule, attend if possible. Ensure coverageMonitor staff, as needed (i.e., medication administration, meals {modified texture, therapeutic}, ADLs, implementation of plan(s) and interactions between staff and clientsReview incident reports – provide assessment and follow upReview findings and recommendations from appointments. Implement changes of orders. Complete notes of services provided. Review LPN notesApprove orders for prescribed medications/treatments (QuickMar)Monitor health status/vitals/seizure disordersAddress acute/on-going health issues including "Change of Condition" documentationAttend IPP’s as scheduledReview MAR’s for completeness and accuracyProvide on-call service. Manage resourcesPerform PRN Assessments: falls risk, skin integrity, chokingReview IPP schedule, submit assessments 2 weeks prior to IPPReview follow-up appointments on calendarFile health care documentsReview medication storage- cleanliness, organization, no out-of-date drugsReview narcotics count sheetsOrder medications that only have 7 days remainingBi-weekly orientation training as scheduledComplete Monthly nursing summary. Do Monthly reconciliationReview Med exchange at assigned locationsDevelop a Medication Support plan. Update as neededQualificationsDegree from an accredited school of nursing OR License as a Registered Nurse, current and in good standingValid driver’s license from state of residenceMust be at least 18 years of age and have one year of nursing experience, Supervisory experience preferredMinimal travel may be required to assigned operations/locationsAbout Our Line Of BusinessResCare Community Living, an affiliate of BrightSpring Health Services, has five decades of experience in the disability services field, providing support to individuals who need assistance with daily living due to an intellectual, developmental, or cognitive disability. We provide a comprehensive range of high-quality services, including: community living, adult host homes for adults regardless of disability, behavioral/mental health support, in-home pharmacy solutions, telecare and remote support, supported employment and training programs, and day programs. For more information, please visit www.rescarecommunityliving.com.Salary RangeUSD $97,760.00 / YearSeniority levelEntry levelEmployment typeFull-timeJob functionHealth Care Provider#J-18808-Ljbffr

Registered Nurse FT Days

ScionHealth Rancho Cucamonga, CA

DescriptionKindred Hospital Ranchois a 55-bed long-term acute care hospital offering the same in-depth care you would receive in a traditional hospital, but for an extended recovery period. We partner with your physician and offer 24-hour clinical care seven days a week so you can start your journey to wellness. For those who need special care, we offer an eight-bed ICU and three negative pressure rooms. We are located near downtown Rancho Cucamonga just off of Foothill Boulevard with close proximity to many shops and restaurants.Job SummaryProvides planning and delivery of direct and indirect patient care through the nursing process of Assessment, Planning, Intervention, and Evaluation. Develops nursing care plans in coordination with patient, family and interdisciplinary staff as necessary. Communicates changes in patient’s clinical condition with Physicians, Nursing Supervisor/Manager, and co-workers as appropriate. Participates in discharge planning process.Essential FunctionsMaintains the standard of nursing care and implements policies and procedures of the hospital and nursing department.Directs, supervises, provides and evaluates nursing care provided to patients.Assigns or delegates tasks based on the needs and condition of the patient, potential for harm, complexity of the task, and within scope of practice of the staff to whom the task is delegated.Assigns nursing care team members in accordance with patient needs, team member’s capabilities and qualifications.Documents patient admission assessment and reassessments, patient care plans and other pertinent information, completely in the patient’s medical record according to nursing standards and policies.Performs assessment on all patients on admission and reassessments as per policy. Makes referrals to other disciplines based on assessment.Develops nursing care plan of assigned patient on admission, updates plan of care as needed and ensures plan of care is coordinated with patient, family, and other members of the team.Assesses and reassesses pain. Utilizes appropriate pain management techniques. Educates the patient and family regarding pain management.Revises the plan of care as indicated by the patient’s response to treatment and evaluates overall plan daily for effectiveness.Performs patient care responsibilities considering needs specific to the standard of care for patient’s age.Receives physician’s orders, ensures transcription is accurate and documents completion.Administers medication utilizing the five rights of medication administration reducing the potential for medication errors.Formulates a teaching plan based upon identified learning needs and evaluates effectiveness of learning; family is included in teaching as appropriate.Assists physicians with examinations, treatments and special procedures and performs services requiring technical and manual skills within scope of practice.Performs treatments and provides services to level of licensure.Treats patients and their families with respect and dignity. Identifies and addresses psychosocial, cultural, ethnic, and religious/spiritual needs of patients and their families. Functions as liaison between administration, patients, physicians, and other healthcare providers.Interacts professionally with patient/family and involves patient/family in the formation of the plan of care.Interprets data about the patient’s status to identify each patient’s age specific needs and provide care needed by the patient group.Performs all aspects of patient care in an environment that optimizes patient safety and reduces the likelihood of medical/health care errors.Initiates or assists with emergency measures for sudden adverse developments in patients’ condition.Answers telephone, paging system, patients’ call lights, anticipates patients’ needs, and makes rounds of assigned patients and responds as appropriate.Consults other departments as appropriate to provide for an interdisciplinary approach to the patient’s needs.Provides end of shift report to oncoming nurse, narcotics are counted, documentation is complete, and physician orders signed off.Communicates appropriately and clearly to management, co-workers, and physicians.Identifies and addresses psychosocial needs of patients and family; communicates with Social Service/Discharge Planner regarding both in hospital and post discharge needs.Participates in orientation, instruction/training of new personnel.Manages and operates equipment safely and correctly.Knowledge/Skills/Abilities/ExpectationsKnowledge of medications and their correct administration based on age of the patient and their clinical condition.Basic computer knowledge.Able to organize tasks, develop action plans, set priorities and function under stressful situations.Ability to maintain a good working relationship both within the department and with other departments.Approximate percent of time required to travel: 0%Must read, write and speak fluent English.Must have good and regular attendance.Performs other related duties as assigned.QualificationsEducationPostsecondary certificate, diploma, or program graduation from an accredited school of nursing. (Required)Associate’s Degree or Bachelor’s Degree in Nursing. (Preferred)Licenses/CertificationsRegistered Nurse (RN) – State Licensure and/or Compact State Licensure in the state of practice. (Required upon hire)Basic Life Support (BCLS). (Required upon hire)Advanced Cardiac Life Support (ACLS). (Preferred upon hire)ExperienceSix (6) months of Medical/Surgical nursing experience in an acute care setting. (Preferred)Experience demonstrating critical thinking, decision-making, and effective prioritization in a fast-paced clinical environment. (Preferred)Pay Range: $44.80 - $56.82/HrScionHealth has a comprehensive benefits package for benefit-eligible employees that includes Medical, Dental, Vision, 401(k), FSA/HSA, Life Insurance, Paid Time Off, and Wellness.#J-18808-Ljbffr

Registered Nurse Home Health

CARE FIRST HOME HEALTH CARE INC Rancho Cucamonga, CA

Benefits:401(k)Competitive salaryFlexible scheduleJob TitleRegistered Nurse- Home HealthPositionRegistered NurseJob Description SummaryGives Report To: Director of Patient Care Services/Director of Nursing/Nursing Supervisor The registered nurse plans, organizes, and directs home care services to improve quality life for the patient.Roles & ResponsibilitiesCompletes an initial, comprehensive assessment of patient to determine home care needsCreates a plan of care which establishes goals based on nursing diagnosis and incorporates therapeutic, preventative, and rehabilitative nursing actionsProvide ongoing reassessments to regularly revise patients plan of care as patient’s status and needs changeUse health assessment data to determine nursing diagnosisReports all changes in patient condition to clinical supervisorProvides comprehensive assessment and nursing care based on nursing processDetermines and documents nursing diagnosis and interventions to meet patient needsDevelops an individualized plan of care using measurable goals with time frames for completionAdministers medications and treatments as ordered by the patient's physician, following the plan of care.Supervises LVNs and CHHAs according to agency supervisory policies and proceduresProvides patient and family education regarding medication management, compliance and measures to prevent disease process exacerbationCoordinates care with all care providers and ordering physicianCompletes and submits clinical notes accurately and timelyReports to physician and nursing supervisor any changes in patient condition and updates the plan of care as necessaryEnsures the patient has all appropriate medications and DME required to provide safe and effective patient careParticipates in QAPI programs and initiativesParticipates in professional development and skills training as required or neededAttends monthly in-servicesFollows all agency policies and procedures, including in Infection Control, Emergency management, medication management, emergency management, pain management and overall patient care policies and proceduresComplies with all Health Insurance Portability and Accountability Act (HIPAA) requirements in accordance with federal, state and organizational policiesQualificationsLicensed Registered Nurse authorized to practice professional nursing in the stateHolds and maintains current CPR certificationMust have a valid and active driver’s licenseMust have car insuranceLiability insurance is optionalMust have an automobile in good working conditionMust have at least one year of experience as a professional nurse, preferably in home health care, hospice or public healthBachelor's degree in nursing is optionalMust have great interpersonal and communication skillsMust be proficient in the use of computers for computerized clinical documentationMust be capable of autonomous work with basic safety knowledgeGraduate of an accredited school of nursing#J-18808-Ljbffr

Licensed Vocational Nurse (LVN)

Prime Providers Rancho Cucamonga, CA

We are looking for dedicated LVNs who want to provide quality care to home-based patients. You will work one-on-one with the patient and truly impact their life as well as their family's. The job is consistent, long-term, and can work with a variety of different schedules.We pride ourselves on providing our team members with a friendly and inviting work environment. Our success is largely based upon hiring ambitious team members who provide top quality care.The LVN is responsible for providing direct patient care under the supervision of a registered nurse. Responsibilities include following the plan of care, providing treatments, and working collaboratively with the members of the team to help meet positive patient care outcomes.Job DescriptionPrime Home Health is a leading provider of skilled in-home nursing care for patients. We are currently looking for a passionate, empathetic, motivated, and COMMITTED individual to fill our Licensed Vocational Nurse (LVN) positionQualificationsLICENSED VOCATIONAL NURSE (LVN) QUALIFICATIONS:Current CA Vocational Nurse License.Current PPD or chest x-ray if applicableCurrent State license, CPR certification and valid driver's license (local travel required)LICENSED VOCATIONAL NURSE (LVN) RESPONSIBILITIES:Provides direct patient care as defined in State's Nurse Practice ActImplements plan of care initiated by the registered nurseProvides accurate and timely documentation consistent with the plan of careAssesses and provides patient and family/caregiver education and information pertinent to diagnosis and plan of carePrepares and coordinates clinical notes and progress notesAdditional InformationPRIME HOME HEALTH OFFERS:Competitive Hourly PayFlexible work schedules that empower our employees to work independentlyBenefits include: Medical and Dental insurance, Vacation/sick days, 401(k)Professional, fun, and positive work culture24 hour on-call supportEmployee appreciation event & employee recognitionElectronic chartingAll your information will be kept confidential according to EEO guidelines.We welcome you to submit your resume or if you would prefer, call us during office hours, Mon-Fri 8:30 am-5:00pm at (909)390-5772. We are excited to add more fantastic LVNs to our Prime Home Health Family.Prime Home Health is an equal opportunity and affirmative action employer and is committed to providing employment opportunities to minorities, females, veterans, and disabled individuals, as well as all other protected groups.COVID-19 CONSIDERATIONS:Prime Home Health is practicing extra safety measure to protect our employees. You will be also provided with gloves, masks and face shields if requested. If hired, you will NOT be working with COVID-19 positive patients. Additionally we work to minimize multiple interactions across different staff and patients which is possible since you will most likely be exclusively working with one patient.401(k)Health insuranceLife insurancePaid time offVision insurancePrime Providers is an amazing place to work!#J-18808-Ljbffr

Regulatory Grievance & Appeals Nurse - Hybrid

Alura Workforce Solutions Rancho Cucamonga, CA

A healthcare services provider is seeking a Grievance and Appeals Nurse-LVN in Rancho Cucamonga, CA. This role involves investigating and resolving regulatory cases, ensuring compliance, and coordinating member care. Candidates must possess strong communication skills, knowledge of health plan regulations, and critical thinking abilities. The position offers a hybrid work schedule and a competitive salary.#J-18808-Ljbffr

Psychiatric Mental Health Nurse Practitioner

Simple-Solutions-Psychotherapy Rancho Cucamonga, CA

Psychiatric Mental Health Nurse PractitionerWe are a company that focuses on treating the whole person. Our work is grounded in understanding the emotional, psychological, social, and practical factors that impact an individual’s well being. We believe effective care requires compassion, accountability, collaboration, and a commitment to meeting people where they are while supporting meaningful growth and long term stability. Our team works across departments to provide coordinated, ethical, and person centered services that prioritize dignity, respect, and quality care.At Simple Solutions Psychotherapy we believe "It's SIMPLE people just make it complicated."Position Overview:We are seeking a licensed Psychiatric Mental Health Nurse Practitioner (PMHNP) to join our team as an independent contractor. This role is responsible for conducting psychiatric evaluations, diagnosing mental health conditions, and prescribing and managing psychotropic medications. The PMHNP will also work collaboratively with therapists and other members of the care team to ensure coordinated, high-quality patient care.Key Responsibilities:Conduct comprehensive psychiatric evaluations and establish accurate diagnosesPrescribe and manage psychotropic medications, including monitoring effectiveness and side effectsDevelop and adjust individualized treatment plansCollaborate closely with therapists to support integrated care and improve patient outcomesParticipate in case consultations and care coordination with the clinical teamMaintain timely and accurate clinical documentation in accordance with regulatory standardsQualifications:Board certification as a Psychiatric Mental Health Nurse Practitioner (PMHNP)Furnishing number and DEA registration (if prescribing controlled substances)Ability to diagnose and prescribe independently within scope of practiceStrong collaboration and communication skills, particularly in a multidisciplinary team environmentExperience in outpatient mental health or telehealth settings preferredWork Arrangement:Flexible schedule (part-time or full-time options available)HybridCompensation:Competitive, based on experience and patient volumeAdditional Notes:Candidates must be able to work collaboratively with therapists and other providers to ensure a cohesive and effective treatment approach. Knowledge of California regulations regarding independent contractor status and nurse practitioner scope of practice is required.The pay range for this role is:70 - 90 USD per hour (8350 Archibald Avenue)#J-18808-Ljbffr

Quality Program Nurse, RN — Elevate Care & Compliance

IEHP Rancho Cucamonga, CA

IEHP is seeking a Quality Program Nurse (QPN) to implement Quality Management policies under the direction of the Manager, Quality Management Nurses. You will ensure DHCS regulatory requirements for Facility Site Review and Medical Record Review are met and support the Quality Program goals including HEDIS, CAHPS, and NCQA accreditation.The role requires nursing licensure in California, CSR certification or willingness to obtain within 6 months, and 3+ years in QA, Utilization Management, or#J-18808-Ljbffr

Grievance and Appeals Nurse-LVN25-00372

Alura Workforce Solutions Rancho Cucamonga, CA

Grievance and Appeals Nurse-LVN 25-00372Base pay range$30.72/hr - $30.72/hrPosition Type:Full timeSchedule:(Hybrid) M-F, 8:00 am - 5 pm; Mon./Fri. Work From Home, Tue./Wed. Thursday/OnsitePay:$34.41/hrDescriptionUnder the general direction of the Grievance & Appeals Regulatory Manager, the Grievance & Appeals Regulatory Nurse is responsible for working directly with providers, delegated entities, and internal departments in investigating and resolving cases, and responding to regulatory agencies to ensure compliance with internal Policy & Procedures and Department of Managed Health Care (DMHC)/ Department of Health Care Services (DHCS)/ Center for Medicare and Medicaid Services (CMS) regulations. This position coordinates member care in conjunction with the member’s Providers to provide continuous quality care and assist in the development of quality initiatives. The Grievance & Appeals Regulatory Nurse serves as a resource to health plan personnel and providers.Key ResponsibilitiesProcess all incoming DMHC, DHCS and CMS regulatory cases (Consumer Complaints, Independent Medical Reviews, statement of positions, CMS complaints, etc.) and monitoring timeliness of responses for all Plan lines of business.Act as a primary contact between health plan and regulatory agencies in resolving Member grievance and appeals by maintaining positive communication and working closely with Compliance and Legal Departments in resolving Members’ complaints, grievances, and appeals.File Plan Grievances and Appeals / Claim Dispute / request State Fair Hearing process; distinguishing between an inquiry, a Grievance, an Appeal, a Claim Dispute, and a quality-of-care issue and know how to triage, resolve, or refer incoming calls/correspondence to appropriate personnel.Work closely with the Grievance and Appeals Team, with Internal Departments, and DMHC/DHCS/CMS to ensure all Member appeals are investigated, and care is coordinated appropriately.Process Plan level appeal and grievance cases as a result of a filed regulatory complaint.Review Member appeals and/or complaints and make appropriate determination based on documentation presented by appealing agent with references to federal, state, and local regulations as well as policy and procedures based on line of business in a timely manner.Manage all incoming court documents related to State Fair Hearing (SFH) cases, including preparing for scheduled SFH cases, preparation of witness (e.g., Medical Director) and arranging for appearance / telephonic requests of witnesses as well as exhibit gathering.Docket hearing notices, contact State / Office of Administrative hearings, establish duties and time frames in connection with each hearing and disseminate information with follow-up as appropriate.Support legal department as requested, to include participating in Plan Civil matters.Provide testimony on behalf of and administrative hearing and represent at hearings (virtual or in-person) when necessary and appropriate.Ensure Member appeals are fully investigated, to ensure timely and accurate decisions to either uphold or overturn denial using appropriate criteria hierarchy and work closely with Medical Director for approval.Ensure that written correspondence to Providers, Members, and regulatory entities is generated accurately and timely.Provide support to Civil Rights Coordinator with affiliated investigations both at the Plan level and for the Office of Civil Rights.Responsible for identifying potential cases that are high risk and using critical thinking to escalate to Manager and make appropriate decisions.Participate in initiatives using A3 thinking and concepts.Perform any other duties as required to ensure Health Plan operations and department business needs are successful.REQUIREMENTSMust have a valid California Driver's LicenseKnowledge of outside agencies and resources such as: CCS, CMS, DMHC, and DHCSKnowledge of applicable laws, regulations, Welfare & Institution codes, assembly bills and All Plan Letters that are affiliated with the health plans managed care settingGenerate written correspondence using appropriate grammar and punctuationMicrocomputer applications: spreadsheet, database, and word processing requiredExcellent written and verbal communication skillsKnowledge of outside agencies and resources such as; CCS, CMS, DMHC, or DHCS.Ability to effectively escalate issues as identified, following established protocols.Proven ability to:Demonstrate critical thinking, good judgment, and strong problem-solving capabilityPrioritize work to ensure adherence to project deadlinesEffectively escalate issues as identified, following established protocolsDemonstrate a commitment to incorporate LEAN principles into daily workShow strong attention to detailPossess a positive attitude and ability to work in a team settingExhibit flexibility in job roles and responsibilitiesExpress a strong drive to “do the right thing” and adhere to Health Plan Mission, Vision and Values#J-18808-Ljbffr

HEDIS Improvement Nurse (RN) — Hybrid & Impact

Comunidade Metodista Rancho Cucamonga, CA

IEHP seeks a Temporary HEDIS Improvement Nurse, RN in Rancho Cucamonga, CA. This agency-facilitated assignment lasts up to six months and supports IEHP’s clinical quality improvement initiatives.Under supervision, the nurse interprets data for QI studies and maintains knowledge of MedHOK and related regulatory requirements from DHCS, DMHC, and CMS, contributing to IEHP’s quality goals.#J-18808-Ljbffr