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Online Application form
First Name
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Last Name
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City
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State
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
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Phone Number
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Email Address
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Desired Position
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Catastrophic Case Manager
Manager of Case Management
Complex Care Manager
Administrative Assistant
Do you have experience as an Administrative Assistant?
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Yes
No
Please tell us what kind of duties you performed as an Administrative Assistant?
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What past experience do you have that makes you suited to work as an Administrative Assistant?
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How many years of nurse case management experience do you have?
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Do you have Management experience?
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Yes
No
How many years of Management experience do you have?
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Do you have a BSN degree?
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Yes
No
Do you have an RN?
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Yes
No
In which State(s)?
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🛈
+
-
Do you have an RN in the state of California?
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Yes
No
How many years of critical care nursing (e.g., neuro, ICU, ER) experience do you have?
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How many years of **field** case management experience do you have?
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Do you have catastrophic case management experience?
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Yes
No
Tell us about you catastrophic case management experience.
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Tell us about your Management experience. (example; duties, team size, etc.)
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Resume
*