All Star is looking for a CRNA in Pennsylvania. <ul><li> Starts ASAP for 3 months ongoing </li><li> 7- 5:30 PM, 4x10's per week </li><li> Inpatient and Outpatient </li><li> Supervised </li><li> Cases: MAC, General, GYN, Ortho, ENT, Urology, Podiatry, Endo, some TEEs, and OB </li><li> 90 day credential </li></ul> All Star Healthcare Solutions benefits <ul><li> Full-service agency </li><li> 24/7 professional and reliable service </li><li> Dedicated, specialty-specific consultants </li><li> Competitive pay </li><li> Malpractice coverage </li><li> Paid and coordinated travel services </li><li> Member of NALTO </li></ul><img src="https://www.jobg8.com/Tracking.aspx?IUgT%2bA7JPWHp1Ey3hzC7Mgb" width="0" height="0" />

**CRNA**

All Star is looking for a CRNA in Pennsylvania.

**Job Description**

- Starts ASAP for 3 months ongoing
- 7:00 AM - 5:30 PM, 4x10's per week
- Inpatient and outpatient
- Supervised
- Cases: MAC, General, GYN, Ortho, ENT, Urology, Podiatry, Endo, some TEEs, and OB
- 90-day credential

**Benefits**

- Full-service agency
- 24/7 professional and reliable service
- Dedicated, specialty-specific consultants
- Competitive pay
- Malpractice coverage
- Paid and coordinated travel services
- Member of NALTO

Certified Registered Nurse Anesthetist (CRNA)

PURPOSE AND SCOPE:The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP). This position is accountable and responsible for the provision and coordination of clinically competent care including assessment, planning, intervention and evaluation for an assigned group of patients. This may include delegation of appropriate tasks to direct patient care staff including but not limited to RNs, LVN/LPNs and Patient Care Technicians. As a member of the End Stage Kidney Disease (ESKD) health care team, this position participates in decision-making, teaching, leadership functions, and quality improvement activities that enhance patient care outcomes and facility operations.PRINCIPAL DUTIES AND RESPONSIBILITIES:All duties and responsibilities are expected to be performed in accordance with Fresenius Kidney Care policy, procedures, standards of nursing practice, state and federal regulations. Performs all essential functions under the direction of the Supervisor and with guidance from the Clinical Educator, Preceptor or in collaboration with other Registered Nurses. Performs ongoing, systematic collection and analysis of patient data pre - during - post hemodialysis treatment for assigned patients and documents in the patient medical record, makes adjustments or modifications to treatment plan as indicated and notifies Team Leader, Charge Nurse, Supervisor or Physician as needed. Assesses, collaborates, and documents patient/family's basic learning needs to provide initial and ongoing education to patients and family. Directs and provides, in collaboration with direct and ancillary patient care staff, all aspects of the daily provision of safe and effective delivery of hemodialysis therapy to assigned patients. Administers medications as prescribed or in accordance with approved algorithm(s), and documents appropriate medical justification and effectiveness. Initiates or assists with emergency response measures. Serves as a resource for health care team, participates in staff training and orientation of new staff as assigned. Ensures correct laboratory collection, processing and shipping procedures are performed and reschedules missed or insufficient laboratory collections. Identifies expected outcomes, documents and updates the nursing assessment and plan of care for assigned patients through collaboration with the Interdisciplinary Team. Ensures patient awareness related to transplant and treatment modality options. Required to complete CAP requirements to advance. Performs all other duties as assigned by Supervisor.PHYSICAL DEMANDS AND WORKING CONDITIONS:The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The position provides direct patient care that regularly involves heavy lifting, moving of patients and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. This position requires frequent, prolonged periods of standing and the employee must be able to bend over. The employee may occasionally be required to move, with assistance, machines and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. as high as 5 feet. The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. Day to day work includes desk work, computer work, interaction with patients, facility/hospital staff and physicians. The position may require travel to training sites or other facilities. May be asked to provide essential functions of this position in other locations with the same physical demands and working conditions as described above.SUPERVISION:Assigned oversight of Patient Care Technicians/LPNs/LVNs/RNs as a Team Leader or designated Nurse in Charge, after meeting all the following: Successful completion of all FKC education and training requirements for new employees. Must have a minimum of 9 months experience as a RN. Must have a minimum of 3 months experience in chronic/acute hemodialysis as a RN.EDUCATION and LICENSURE: Graduate of an accredited School of Nursing. Current appropriate state licensure. Current or successful completion of CPR BLS Certification. Must meet the practice requirements in the state in which he or she is employed.EXPERIENCE AND REQUIRED SKILLS: Entry level for RNs with less than 2 years of Nephrology Nursing experience as a Registered Nurse. Chronic/acute hemodialysis experience (preferred). Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws. EOE, disability/veterans<img src="https://www.jobg8.com/Tracking.aspx?cfPkGcxe4OTBRUiZBmikZAa" width="0" height="0" />

**Outpatient RN CAP 1**

The professional registered nurse Outpatient RN CAP 1 is an entry-level designation into the Clinical Advancement Program (CAP). This position is accountable and responsible for the provision and coordination of clinically competent care including assessment, planning, intervention, and evaluation for an assigned group of patients. This may include delegation of appropriate tasks to direct patient care staff including but not limited to RNs, LVN/LPNs, and Patient Care Technicians. As a member of the End Stage Kidney Disease (ESKD) health care team, this position participates in decision-making, teaching, leadership functions, and quality improvement activities that enhance patient care outcomes and facility operations.

**Job Description**

- Perform all essential functions under the direction of the Supervisor and with guidance from the Clinical Educator, Preceptor, or in collaboration with other Registered Nurses.
- Perform ongoing, systematic collection and analysis of patient data pre, during, and post hemodialysis treatment for assigned patients and document in the patient medical record, making adjustments or modifications to treatment plans as indicated and notifying Team Leader, Charge Nurse, Supervisor, or Physician as needed.
- Assess, collaborate, and document patient/family's basic learning needs to provide initial and ongoing education to patients and family.
- Direct and provide, in collaboration with direct and ancillary patient care staff, all aspects of the daily provision of safe and effective delivery of hemodialysis therapy to assigned patients.
- Administer medications as prescribed or in accordance with approved algorithm(s), and document appropriate medical justification and effectiveness.
- Initiate or assist with emergency response measures.
- Serve as a resource for the health care team, participating in staff training and orientation of new staff as assigned.
- Ensure correct laboratory collection, processing, and shipping procedures are performed and reschedule missed or insufficient laboratory collections.
- Identify expected outcomes, document, and update the nursing assessment and plan of care for assigned patients through collaboration with the Interdisciplinary Team.
- Ensure patient awareness related to transplant and treatment modality options.
- Complete CAP requirements to advance.
- Perform all other duties as assigned by Supervisor.

**Physical Demands and Working Conditions**

The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

- The position provides direct patient care that regularly involves heavy lifting, moving of patients, and assisting with ambulation. Equipment aids and/or coworkers may provide assistance.
- This position requires frequent, prolonged periods of standing, and the employee must be able to bend over.
- The employee may occasionally be required to move, with assistance, machines and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. as high as 5 feet.
- The work environment is characteristic of a health care facility with air temperature control and moderate noise levels.
- May be exposed to infectious and contagious diseases/materials.
- Day-to-day work includes desk work, computer work, interaction with patients, facility/hospital staff, and physicians.
- The position may require travel to training sites or other facilities.
- May be asked to provide essential functions of this position in other locations with the same physical demands and working conditions as described above.

**Supervision**

Assigned oversight of Patient Care Technicians/LPNs/LVNs/RNs as a Team Leader or designated Nurse in Charge after meeting all the following:

- Successful completion of all FKC education and training requirements for new employees.
- Must have a minimum of 9 months experience as a RN.
- Must have a minimum of 3 months experience in chronic/acute hemodialysis as a RN.

**Education and Licensure**

- Graduate of an accredited School of Nursing.
- Current appropriate state licensure.
- Current or successful completion of CPR BLS Certification.
- Must meet the practice requirements in the state in which he or she is employed.

**Experience and Required Skills**

- Entry level for RNs with less than 2 years of Nephrology Nursing experience as a Registered Nurse.
- Chronic/acute hemodialysis experience (preferred).

Outpatient Registered Nurse- RN

Recent acute dialysis experience required PURPOSE AND SCOPE:The Inpatient RN provides direct patient care in accordance to company policies and procedures which includes FMCNA compliance programs and contracted hospitals' policies and procedures. Areas of practice are diverse, including, but not limited to, hemodialysis, peritoneal dialysis, continuous renal replacement therapies, apheresis, and ultrafiltration. The Inpatient RN will partner with the hospital to provide quality care to the patient and deliver care that provides a positive patient experience. PRINCIPAL DUTIES AND RESPONSIBILITIES:<ul><li>Under limited supervision, applies considerable knowledge to perform a broad range of tasks which include but are not limited to direct patient care in multiple modalities not limited to hemodialysis, peritoneal dialysis, ultrafiltration, continuous renal replacement therapy, and Apheresis.</li><li>Provides supervision and direction of Patient Care Technicians and clerical staff; provides direction and education to ICU staff for CRRT.</li><li>Responsible for direct patient care of assigned patients in the Inpatient Renal Replacement and Apheresis Services setting and providing the appropriate treatment technique for assigned patients as prescribed in all modality procedures, as appropriately defined - hemodialysis, peritoneal, continuous renal replacement therapies, ultrafiltration, and Apheresis.</li><li>Assesses patients' responses to treatment therapy making appropriate adjustments and modifications to the treatment plan as indicated by the appropriately credentialed physician. Communicate problems or concerns to the Inpatient Program Manager, appropriately credentialed physician, patient hospital primary nurse and others as indicated. </li><li>Delivers safe, effective care in a timely an efficient manner.</li><li>Gives organized, concise shift reports for patients on assigned shifts. Apply high level thinking skills to shift patient schedules to meet needs of more critical patients due to labs, MD order, or patient assessment.</li><li>Responsible for the implementation, administration, monitoring, and documentation of patient's response to prescribed intradialytic transfusions, including appropriate notification of adverse reactions to physician and appropriate blood supplier. </li><li>Collaborates and communicates with physicians and other members of the healthcare team to interpret, adjust, and coordinate daily patient care plan to ensure continuity of care.</li><li>Initiates and communicates to FMS facility nursing staff and appropriate hospital personnel as needed.</li><li>Accurately documents all treatment information in the individual patient record (ACES) and the hospital record, as needed.</li><li>Cleans and disinfects dialysis machine surface, chair, equipment, and surrounding areas between treatments according to inpatient renal services policies and procedures.</li><li>Conducts all tasks necessary for preparation for dialysis treatment and documents where appropriate.</li><li>Performs all required pre-treatment dialysis machine alarm testing.</li><li>If applicable, initiates Solution Delivery System.</li><li>Operates all related equipment appropriately and safely and provides minor trouble shooting when necessary; efficiently utilizes supplies to prevent waste.</li><li>Understands, conducts, and documents appropriately Dialysis/Apheresis machine safety tests/alarm tests, equipment calibration, dialysate testing, machine safety tests, functional testing, and internal and external disinfection on all water & dialysis machines, and complies with the documentation/notification standards per FMS policies.</li><li>Completes and documents ongoing participation in QAI activities.</li><li>Participates in staff meetings as scheduled.</li><li>Participates in staff training and orientation as assigned.</li><li>Acts as a subject matter expert to hospital staff for dialysis related patient/equipment complications.</li><li>Responsible for reporting all new or unusual incidents, information, complaints, or problems to the inpatient manager and other parties per the Adverse Event Report requirements. May be assigned to in-center patient care on an as needed basis</li><li>Review and comply with the Code of Business Conduct and all applicable company policies and procedures, local, state and federal laws and regulations.</li><li>Assist with various projects as assigned by direct supervisor.</li><li>Other duties as assigned.</li></ul>PHYSICAL DEMANDS AND WORKING CONDITIONS:<ul><li>The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</li><li>Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that: Failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodations can be made.</li></ul><ul><li>Direct patient care, interaction with patients, outpatient clinicians, hospital staff, and physicians. The position requires travel between assigned hospitals and facilities; as well as travel to regional meetings/educational events.</li><li>Position requires on call rotation including night, day, weekend, and holidays.</li><li>There is potential for exposure to potentially infectious material and contagious diseases/material. </li><li>Position provides direct patient care which regularly involves heavy lifting, moving of patient and/or equipment > 200lbs (with assistance); and may lift chemical and water solutions of up to 30lbs up as high as 5 feet. </li></ul>SUPERVISION: <ul><li>Provides supervision and direction of Patient Care Technicians (Certified Clinical Hemodialysis Technicians (CCHT and clerical staff; provides direction and education to ICU staff for CRRT.</li></ul>EDUCATION:<ul><li>Current appropriate state licensure.</li><li>Maintains acquired knowledge and remains current in advancements in nephrology, in particular, relative to inpatient care (hospitalized patients requiring varied treatment modalities, not limited to Renal Replacement, Apheresis, and Ultrafiltration services).</li><li>Must meet the practice requirements in the state in which employed.</li><li>Certification in Nephrology Nursing, Apheresis Nursing, or both is highly encouraged.</li></ul>EXPERIENCE AND REQUIRED SKILLS: <ul><li>One year RN experience required and required nursing skills.</li><li>Minimum 6 months nephrology experience required before working independently with no other Dialysis RNs to provide dialysis and ultrafiltration services.</li><li>Minimum 6 months Nephrology experience required before working independently with no other Apheresis RNs to provide Apheresis services.</li><li>Demonstrated strong assessment skills related to the critically ill patient.</li><li>ICU experience preferred but not required.</li><li>Successful completion of training course in the theory and practice of care of the ESRD patient - Progressive Renal Education Preparation.</li><li>BLS CPR Recognition.</li><li>ACLS CPR Recognition preferred, but not required.</li><li>Demonstrates organizational and time management skills, and a competency toward completing continuing and ongoing Renal/Nephrology education.</li><li>Displays leadership skills and ability to direct and supervise others (such as PCTs, CCHTs, clerical staff).</li><li>Successful completion of Nurses Technical Training.</li></ul> Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws. EOE, disability/veterans<img src="https://www.jobg8.com/Tracking.aspx?j8oImo%2fjvS3ZQfcYkQGVAAu" width="0" height="0" />

**Inpatient RN**

Recent acute dialysis experience required.

**Job Description**

- The Inpatient RN provides direct patient care in accordance with company policies and procedures, including FMCNA compliance programs and contracted hospitals' policies and procedures. Areas of practice are diverse, including, but not limited to, hemodialysis, peritoneal dialysis, continuous renal replacement therapies, apheresis, and ultrafiltration. The Inpatient RN will partner with the hospital to provide quality care to the patient and deliver care that provides a positive patient experience.
- Under limited supervision, applies considerable knowledge to perform a broad range of tasks which include but are not limited to direct patient care in multiple modalities not limited to hemodialysis, peritoneal dialysis, ultrafiltration, continuous renal replacement therapy, and apheresis.
- Provides supervision and direction of Patient Care Technicians and clerical staff; provides direction and education to ICU staff for CRRT.
- Responsible for direct patient care of assigned patients in the Inpatient Renal Replacement and Apheresis Services setting and providing the appropriate treatment technique for assigned patients as prescribed in all modality procedures, as appropriately defined - hemodialysis, peritoneal, continuous renal replacement therapies, ultrafiltration, and apheresis.
- Assesses patients' responses to treatment therapy making appropriate adjustments and modifications to the treatment plan as indicated by the appropriately credentialed physician. Communicates problems or concerns to the Inpatient Program Manager, appropriately credentialed physician, patient hospital primary nurse, and others as indicated.
- Delivers safe, effective care in a timely and efficient manner.
- Gives organized, concise shift reports for patients on assigned shifts. Applies high-level thinking skills to shift patient schedules to meet needs of more critical patients due to labs, MD orders, or patient assessment.
- Responsible for the implementation, administration, monitoring, and documentation of patient's response to prescribed intradialytic transfusions, including appropriate notification of adverse reactions to physician and appropriate blood supplier.
- Collaborates and communicates with physicians and other members of the healthcare team to interpret, adjust, and coordinate daily patient care plans to ensure continuity of care.
- Initiates and communicates to FMS facility nursing staff and appropriate hospital personnel as needed.
- Accurately documents all treatment information in the individual patient record (ACES) and the hospital record, as needed.
- Cleans and disinfects dialysis machine surfaces, chairs, equipment, and surrounding areas between treatments according to inpatient renal services policies and procedures.
- Conducts all tasks necessary for preparation for dialysis treatment and documents where appropriate.
- Performs all required pre-treatment dialysis machine alarm testing.
- If applicable, initiates Solution Delivery System.
- Operates all related equipment appropriately and safely and provides minor troubleshooting when necessary; efficiently utilizes supplies to prevent waste.
- Understands, conducts, and documents appropriately dialysis/apheresis machine safety tests/alarm tests, equipment calibration, dialysate testing, machine safety tests, functional testing, and internal and external disinfection on all water & dialysis machines, complying with the documentation/notification standards per FMS policies.
- Completes and documents ongoing participation in QAI activities.
- Participates in staff meetings as scheduled.
- Participates in staff training and orientation as assigned.
- Acts as a subject matter expert to hospital staff for dialysis-related patient/equipment complications.
- Responsible for reporting all new or unusual incidents, information, complaints, or problems to the inpatient manager and other parties per the Adverse Event Report requirements. May be assigned to in-center patient care on an as-needed basis.
- Reviews and complies with the Code of Business Conduct and all applicable company policies and procedures, local, state, and federal laws and regulations.
- Assists with various projects as assigned by direct supervisor.
- Other duties as assigned.

**Physical Demands and Working Conditions**

- The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Employees are required to take the Ishihara's Color Blindness test as a condition of employment. Note that failing the Ishihara Test for Color Blindness does not preclude employment. The Company will consider whether reasonable accommodations can be made.
- Direct patient care involves interaction with patients, outpatient clinicians, hospital staff, and physicians. The position requires travel between assigned hospitals and facilities; as well as travel to regional meetings/educational events.
- Position requires on-call rotation including night, day, weekend, and holidays.
- There is potential for exposure to potentially infectious material and contagious diseases/material.
- Position provides direct patient care which regularly involves heavy lifting, moving of patients and/or equipment > 200 lbs (with assistance); may lift chemical and water solutions of up to 30 lbs up as high as 5 feet.

**Supervision**

- Provides supervision and direction of Patient Care Technicians (Certified Clinical Hemodialysis Technicians) and clerical staff; provides direction and education to ICU staff for CRRT.

**Education**

- Current appropriate state licensure.
- Maintains acquired knowledge and remains current in advancements in nephrology, particularly relative to inpatient care (hospitalized patients requiring varied treatment modalities not limited to Renal Replacement, Apheresis, and Ultrafiltration services).
- Must meet the practice requirements in the state in which employed.
- Certification in Nephrology Nursing, Apheresis Nursing, or both is highly encouraged.

**Experience and Required Skills**

- One year RN experience required along with required nursing skills.
- Minimum 6 months nephrology experience required before working independently with no other Dialysis RNs to provide dialysis and ultrafiltration services.
- Minimum 6 months nephrology experience required before working independently with no other Apheresis RNs to provide Apheresis services.
- Demonstrated strong assessment skills related to critically ill patients.
- ICU experience preferred but not required.
- Successful completion of training course in the theory and practice of care of the ESRD patient - Progressive Renal Education Preparation.
- BLS CPR Recognition.
- ACLS CPR Recognition preferred but not required.
- Demonstrates organizational and time management skills, along with a competency toward completing continuing and ongoing Renal/Nephrology education.
- Displays leadership skills and ability to direct and supervise others (such as PCTs, CCHTs, clerical staff).
- Successful completion of Nurses Technical Training.

Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.

EOE, disability/veterans

Acute Registered Nurse - RN Dialysis

Work Dates Needed: Ongoing Preferred Schedule: 7am-5:30pm, Hours: 8 or 10-hour shifts, 40 hours per week. Must Be Open to working Fridays Worksite Setting: Inpatient, Outpatient. Scope of Work: MAC, General Anesthesia. Licenses, Certifications, Requirements: Active PA License, NBCRNA certification. EMR: TBD<img src="https://www.jobg8.com/Tracking.aspx?F6TXGkiP99OvTZpoM2HnzAu" width="0" height="0" />

**Job Title**

Join our team for ongoing work opportunities. The preferred schedule is from 7 am to 5:30 pm, with options for 8 or 10-hour shifts, totaling 40 hours per week. Candidates must be open to working Fridays.

**Job Description**

- Work in both inpatient and outpatient settings.
- Scope of work includes MAC and general anesthesia.

**Requirements**

- Active PA license.
- NBCRNA certification.

**EMR**

- To be determined.

CRNA / Anesthesiology / Pennsylvania / Locum or Permanent / Certified Registered Nurse Anesthetist (CRNA) in Pennsylvania Job

Private duty nursing (PDN) allows medically fragile patients to receive quality, skilled nursing care in the comfort of their home: a setting preferred by most patients and their families. City State Zip Skills Available Days Shift Estimated Pay Range Fleetwood PA 19522 Med management, BiPAP/CPAP Every other Sat/Sun night 9p-5a $32-35 Additional Openings on request! Company Information EEOC: Maxim Healthcare Services is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law. BenefitsAt Maxim Healthcare Services, we firmly believe that our employees are the heartbeat of our organization and we are happy to offer the following benefits:Competitive pay & weekly paychecksHealth, dental, vision, and life insurance401(k) savings planAwards and recognition programs CO Specific Benefits: Medical/Prescription, Dental, Vision, Health Advocacy (company paid if enrolled Medical), Health Advocate Employee Assistance Program, Health Savings Account , 401(k), 401(k) Company Match, Profit Sharing, Short Term Disability, Long Term Disability, Primary Caregiver Leave, Parental Leave, Life and Basic Accidental Death & Dismemberment Insurance, Voluntary Life and Accidental Death & Dismemberment Insurance, Hospital Expense Protection Plan, Critical Illness Insurance, Accident Insurance, Dependent Care Flexible Spending Account, Home and Auto Insurance, Pet Insurance, Transportation Benefits, Common Bond, Educational Assistance Program, College Partnership Program, Paid Time Off/Company Holidays<img src="https://www.jobg8.com/Tracking.aspx?FlA2m7Fs1RcE7ZiWc%2fcvxQe" width="0" height="0" />

**Private Duty Nurse**

Private duty nursing (PDN) allows medically fragile patients to receive quality, skilled nursing care in the comfort of their home: a setting preferred by most patients and their families.

**Job Description**

- Med management, BiPAP/CPAP
- Available every other Saturday/Sunday night
- Shift from 9 PM to 5 AM
- Estimated pay range of $32-35 per hour

**Benefits**

- Competitive pay and weekly paychecks
- Health, dental, vision, and life insurance
- 401(k) savings plan
- Awards and recognition programs
- CO Specific Benefits: Medical/Prescription, Dental, Vision, Health Advocacy (company paid if enrolled in Medical), Health Advocate Employee Assistance Program, Health Savings Account, 401(k), 401(k) Company Match, Profit Sharing, Short Term Disability, Long Term Disability, Primary Caregiver Leave, Parental Leave, Life and Basic Accidental Death & Dismemberment Insurance, Voluntary Life and Accidental Death & Dismemberment Insurance, Hospital Expense Protection Plan, Critical Illness Insurance, Accident Insurance, Dependent Care Flexible Spending Account, Home and Auto Insurance, Pet Insurance, Transportation Benefits, Common Bond, Educational Assistance Program, College Partnership Program, Paid Time Off/Company Holidays

**Company Information**

Maxim Healthcare Services is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.

RN Private Duty Nurse - Fleetwood, PA

Private duty nursing (PDN) allows medically fragile patients to receive quality, skilled nursing care in the comfort of their home: a setting preferred by most patients and their families. City State Zip Skills Available Days Shift Estimated Pay Range Reading PA 19609 Feeding Tube Every other Saturday 8:15a-3:30p $30-$32 Reading PA 19606 Trach/Vent, G-tube/J-tube, med management Every other Sat/Sun 6a-2p $32-35 Reading PA 19604 Gtube, med managment Random nights open 10p-6a $30-35 Reading PA 19604 G-tube, Seizure and Med managment Saturday nights 10p-6a $30-35 Reading PA 19611 G-tube, Seizure and Med managment Every other Sat/Sun night. Sat/Sun days Nights- 10p-6a, Days- up to 10 hours 7a-5p $30-35 Reading PA 19601 G-tube, Seizure and Med managment 7 nights, every week open 10p-6a $32-35 Additional Openings on request! Company Information EEOC: Maxim Healthcare Services is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law. BenefitsAt Maxim Healthcare Services, we firmly believe that our employees are the heartbeat of our organization and we are happy to offer the following benefits:Competitive pay & weekly paychecksHealth, dental, vision, and life insurance401(k) savings planAwards and recognition programs CO Specific Benefits: Medical/Prescription, Dental, Vision, Health Advocacy (company paid if enrolled Medical), Health Advocate Employee Assistance Program, Health Savings Account , 401(k), 401(k) Company Match, Profit Sharing, Short Term Disability, Long Term Disability, Primary Caregiver Leave, Parental Leave, Life and Basic Accidental Death & Dismemberment Insurance, Voluntary Life and Accidental Death & Dismemberment Insurance, Hospital Expense Protection Plan, Critical Illness Insurance, Accident Insurance, Dependent Care Flexible Spending Account, Home and Auto Insurance, Pet Insurance, Transportation Benefits, Common Bond, Educational Assistance Program, College Partnership Program, Paid Time Off/Company Holidays<img src="https://www.jobg8.com/Tracking.aspx?HdE4rzf4ktS3sOM7guLfngo" width="0" height="0" />

**Private Duty Nursing (PDN)**

Private duty nursing allows medically fragile patients to receive quality, skilled nursing care in the comfort of their home: a setting preferred by most patients and their families.

**Job Description**

- Provide skilled nursing care to medically fragile patients in their homes.
- Manage various medical needs including feeding tubes, trach/vent, G-tube/J-tube, and medication management.

**Available Positions**

- Reading, PA 19609: Feeding Tube, Every other Saturday, 8:15 AM - 3:30 PM, $30 - $32
- Reading, PA 19606: Trach/Vent, G-tube/J-tube, med management, Every other Saturday/Sunday, 6 AM - 2 PM, $32 - $35
- Reading, PA 19604: G-tube, med management, Random nights open, 10 PM - 6 AM, $30 - $35
- Reading, PA 19604: G-tube, Seizure and med management, Saturday nights, 10 PM - 6 AM, $30 - $35
- Reading, PA 19611: G-tube, Seizure and med management, Every other Saturday/Sunday night. Saturday/Sunday days, Nights 10 PM - 6 AM, Days up to 10 hours 7 AM - 5 PM, $30 - $35
- Reading, PA 19601: G-tube, Seizure and med management, 7 nights every week open, 10 PM - 6 AM, $32 - $35

**Benefits**

- Competitive pay and weekly paychecks
- Health, dental, vision, and life insurance
- 401(k) savings plan
- Awards and recognition programs
- CO Specific Benefits: Medical/Prescription, Dental, Vision, Health Advocacy (company paid if enrolled in Medical), Health Advocate Employee Assistance Program, Health Savings Account, 401(k), 401(k) Company Match, Profit Sharing, Short Term Disability, Long Term Disability, Primary Caregiver Leave, Parental Leave, Life and Basic Accidental Death & Dismemberment Insurance, Voluntary Life and Accidental Death & Dismemberment Insurance, Hospital Expense Protection Plan, Critical Illness Insurance, Accident Insurance, Dependent Care Flexible Spending Account, Home and Auto Insurance, Pet Insurance, Transportation Benefits, Common Bond, Educational Assistance Program, College Partnership Program, Paid Time Off/Company Holidays

**Company Information**

Maxim Healthcare Services is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.

RN Private Duty Nurse - Greater Reading, PA

Private duty nursing (PDN) allows medically fragile patients to receive quality, skilled nursing care in the comfort of their home: a setting preferred by most patients and their families. City State Zip Skills Available Days Shift Estimated Pay Range Birdsboro PA 19508 Trach/Vent Fridays- School and home. Sat/Sun 7a-5p $30-35 Additional Openings on request! Company Information EEOC: Maxim Healthcare Services is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law. BenefitsAt Maxim Healthcare Services, we firmly believe that our employees are the heartbeat of our organization and we are happy to offer the following benefits:Competitive pay & weekly paychecksHealth, dental, vision, and life insurance401(k) savings planAwards and recognition programs CO Specific Benefits: Medical/Prescription, Dental, Vision, Health Advocacy (company paid if enrolled Medical), Health Advocate Employee Assistance Program, Health Savings Account , 401(k), 401(k) Company Match, Profit Sharing, Short Term Disability, Long Term Disability, Primary Caregiver Leave, Parental Leave, Life and Basic Accidental Death & Dismemberment Insurance, Voluntary Life and Accidental Death & Dismemberment Insurance, Hospital Expense Protection Plan, Critical Illness Insurance, Accident Insurance, Dependent Care Flexible Spending Account, Home and Auto Insurance, Pet Insurance, Transportation Benefits, Common Bond, Educational Assistance Program, College Partnership Program, Paid Time Off/Company Holidays<img src="https://www.jobg8.com/Tracking.aspx?uACDoyOpNYOh3G882cgh7gm" width="0" height="0" />

**Private Duty Nursing (PDN)**

Private duty nursing allows medically fragile patients to receive quality, skilled nursing care in the comfort of their home: a setting preferred by most patients and their families.

**Job Description**

- Trach/Vent care for patients
- Available days: Fridays for school and home, Saturday and Sunday from 7 AM to 5 PM
- Estimated pay range: $30-35 per hour

**Benefits**

- Competitive pay and weekly paychecks
- Health, dental, vision, and life insurance
- 401(k) savings plan
- Awards and recognition programs
- Additional benefits including medical/prescription, health advocacy, short-term and long-term disability, parental leave, and more

**Community Overview**

Birdsboro, PA is a welcoming community that values family and healthcare accessibility.

RN Private Duty Nurse - Birdsboro, PA

PURPOSE AND SCOPE:The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP). This position is accountable and responsible for the provision and coordination of clinically competent care including assessment, planning, intervention and evaluation for an assigned group of patients. This may include delegation of appropriate tasks to direct patient care staff including but not limited to RNs, LVN/LPNs and Patient Care Technicians. As a member of the End Stage Kidney Disease (ESKD) health care team, this position participates in decision-making, teaching, leadership functions, and quality improvement activities that enhance patient care outcomes and facility operations.PRINCIPAL DUTIES AND RESPONSIBILITIES:All duties and responsibilities are expected to be performed in accordance with Fresenius Kidney Care policy, procedures, standards of nursing practice, state and federal regulations. Performs all essential functions under the direction of the Supervisor and with guidance from the Clinical Educator, Preceptor or in collaboration with other Registered Nurses. Performs ongoing, systematic collection and analysis of patient data pre - during - post hemodialysis treatment for assigned patients and documents in the patient medical record, makes adjustments or modifications to treatment plan as indicated and notifies Team Leader, Charge Nurse, Supervisor or Physician as needed. Assesses, collaborates, and documents patient/family's basic learning needs to provide initial and ongoing education to patients and family. Directs and provides, in collaboration with direct and ancillary patient care staff, all aspects of the daily provision of safe and effective delivery of hemodialysis therapy to assigned patients. Administers medications as prescribed or in accordance with approved algorithm(s), and documents appropriate medical justification and effectiveness. Initiates or assists with emergency response measures. Serves as a resource for health care team, participates in staff training and orientation of new staff as assigned. Ensures correct laboratory collection, processing and shipping procedures are performed and reschedules missed or insufficient laboratory collections. Identifies expected outcomes, documents and updates the nursing assessment and plan of care for assigned patients through collaboration with the Interdisciplinary Team. Ensures patient awareness related to transplant and treatment modality options. Required to complete CAP requirements to advance. Performs all other duties as assigned by Supervisor.PHYSICAL DEMANDS AND WORKING CONDITIONS:The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The position provides direct patient care that regularly involves heavy lifting, moving of patients and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. This position requires frequent, prolonged periods of standing and the employee must be able to bend over. The employee may occasionally be required to move, with assistance, machines and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. as high as 5 feet. The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. Day to day work includes desk work, computer work, interaction with patients, facility/hospital staff and physicians. The position may require travel to training sites or other facilities. May be asked to provide essential functions of this position in other locations with the same physical demands and working conditions as described above.SUPERVISION:Assigned oversight of Patient Care Technicians/LPNs/LVNs/RNs as a Team Leader or designated Nurse in Charge, after meeting all the following: Successful completion of all FKC education and training requirements for new employees. Must have a minimum of 9 months experience as a RN. Must have a minimum of 3 months experience in chronic/acute hemodialysis as a RN.EDUCATION and LICENSURE: Graduate of an accredited School of Nursing. Current appropriate state licensure. Current or successful completion of CPR BLS Certification. Must meet the practice requirements in the state in which he or she is employed.EXPERIENCE AND REQUIRED SKILLS: Entry level for RNs with less than 2 years of Nephrology Nursing experience as a Registered Nurse. Chronic/acute hemodialysis experience (preferred). Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws. EOE, disability/veterans<img src="https://www.jobg8.com/Tracking.aspx?6UU%2fFb9QOBzPrHgLAotyagr" width="0" height="0" />

**Outpatient RN CAP 1**

The professional registered nurse Outpatient RN CAP 1 is an entry-level designation into the Clinical Advancement Program (CAP). This position is accountable and responsible for the provision and coordination of clinically competent care including assessment, planning, intervention, and evaluation for an assigned group of patients. This may include delegation of appropriate tasks to direct patient care staff including but not limited to RNs, LVN/LPNs, and Patient Care Technicians. As a member of the End Stage Kidney Disease (ESKD) health care team, this position participates in decision-making, teaching, leadership functions, and quality improvement activities that enhance patient care outcomes and facility operations.

**Job Description**

- Perform all essential functions under the direction of the Supervisor and with guidance from the Clinical Educator, Preceptor, or in collaboration with other Registered Nurses.
- Perform ongoing, systematic collection and analysis of patient data pre-during-post hemodialysis treatment for assigned patients and document in the patient medical record, making adjustments or modifications to treatment plan as indicated and notifying Team Leader, Charge Nurse, Supervisor, or Physician as needed.
- Assess, collaborate, and document patient/family's basic learning needs to provide initial and ongoing education to patients and family.
- Direct and provide, in collaboration with direct and ancillary patient care staff, all aspects of the daily provision of safe and effective delivery of hemodialysis therapy to assigned patients.
- Administer medications as prescribed or in accordance with approved algorithm(s), and document appropriate medical justification and effectiveness.
- Initiate or assist with emergency response measures.
- Serve as a resource for the health care team, participate in staff training and orientation of new staff as assigned.
- Ensure correct laboratory collection, processing, and shipping procedures are performed and reschedule missed or insufficient laboratory collections.
- Identify expected outcomes, document and update the nursing assessment and plan of care for assigned patients through collaboration with the Interdisciplinary Team.
- Ensure patient awareness related to transplant and treatment modality options.
- Complete CAP requirements to advance.
- Perform all other duties as assigned by Supervisor.

**Requirements**

- Graduate of an accredited School of Nursing.
- Current appropriate state licensure.
- Current or successful completion of CPR BLS Certification.
- Must meet the practice requirements in the state in which he or she is employed.
- Entry level for RNs with less than 2 years of Nephrology Nursing experience as a Registered Nurse.
- Chronic/acute hemodialysis experience (preferred).

**Physical Demands and Working Conditions**

The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

- The position provides direct patient care that regularly involves heavy lifting, moving of patients, and assisting with ambulation. Equipment aids and/or coworkers may provide assistance.
- This position requires frequent, prolonged periods of standing and the employee must be able to bend over.
- The employee may occasionally be required to move, with assistance, machines and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. as high as 5 feet.
- The work environment is characteristic of a health care facility with air temperature control and moderate noise levels.
- May be exposed to infectious and contagious diseases/materials.
- Day-to-day work includes desk work, computer work, interaction with patients, facility/hospital staff, and physicians.
- The position may require travel to training sites or other facilities.
- May be asked to provide essential functions of this position in other locations with the same physical demands and working conditions as described above.

**Supervision**

Assigned oversight of Patient Care Technicians/LPNs/LVNs/RNs as a Team Leader or designated Nurse in Charge after meeting all the following:

- Successful completion of all FKC education and training requirements for new employees.
- Must have a minimum of 9 months experience as a RN.
- Must have a minimum of 3 months experience in chronic/acute hemodialysis as a RN.

Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws. EOE, disability/veterans.

PURPOSE AND SCOPE:The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP). This position is accountable and responsible for the provision and coordination of clinically competent care including assessment, planning, intervention and evaluation for an assigned group of patients. This may include delegation of appropriate tasks to direct patient care staff including but not limited to RNs, LVN/LPNs and Patient Care Technicians. As a member of the End Stage Kidney Disease (ESKD) health care team, this position participates in decision-making, teaching, leadership functions, and quality improvement activities that enhance patient care outcomes and facility operations.PRINCIPAL DUTIES AND RESPONSIBILITIES:All duties and responsibilities are expected to be performed in accordance with Fresenius Kidney Care policy, procedures, standards of nursing practice, state and federal regulations. Performs all essential functions under the direction of the Supervisor and with guidance from the Clinical Educator, Preceptor or in collaboration with other Registered Nurses. Performs ongoing, systematic collection and analysis of patient data pre - during - post hemodialysis treatment for assigned patients and documents in the patient medical record, makes adjustments or modifications to treatment plan as indicated and notifies Team Leader, Charge Nurse, Supervisor or Physician as needed. Assesses, collaborates, and documents patient/family's basic learning needs to provide initial and ongoing education to patients and family. Directs and provides, in collaboration with direct and ancillary patient care staff, all aspects of the daily provision of safe and effective delivery of hemodialysis therapy to assigned patients. Administers medications as prescribed or in accordance with approved algorithm(s), and documents appropriate medical justification and effectiveness. Initiates or assists with emergency response measures. Serves as a resource for health care team, participates in staff training and orientation of new staff as assigned. Ensures correct laboratory collection, processing and shipping procedures are performed and reschedules missed or insufficient laboratory collections. Identifies expected outcomes, documents and updates the nursing assessment and plan of care for assigned patients through collaboration with the Interdisciplinary Team. Ensures patient awareness related to transplant and treatment modality options. Required to complete CAP requirements to advance. Performs all other duties as assigned by Supervisor.PHYSICAL DEMANDS AND WORKING CONDITIONS:The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The position provides direct patient care that regularly involves heavy lifting, moving of patients and assisting with ambulation. Equipment aids and/or coworkers may provide assistance. This position requires frequent, prolonged periods of standing and the employee must be able to bend over. The employee may occasionally be required to move, with assistance, machines and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. as high as 5 feet. The work environment is characteristic of a health care facility with air temperature control and moderate noise levels. May be exposed to infectious and contagious diseases/materials. Day to day work includes desk work, computer work, interaction with patients, facility/hospital staff and physicians. The position may require travel to training sites or other facilities. May be asked to provide essential functions of this position in other locations with the same physical demands and working conditions as described above.SUPERVISION:Assigned oversight of Patient Care Technicians/LPNs/LVNs/RNs as a Team Leader or designated Nurse in Charge, after meeting all the following: Successful completion of all FKC education and training requirements for new employees. Must have a minimum of 9 months experience as a RN. Must have a minimum of 3 months experience in chronic/acute hemodialysis as a RN.EDUCATION and LICENSURE: Graduate of an accredited School of Nursing. Current appropriate state licensure. Current or successful completion of CPR BLS Certification. Must meet the practice requirements in the state in which he or she is employed.EXPERIENCE AND REQUIRED SKILLS: Entry level for RNs with less than 2 years of Nephrology Nursing experience as a Registered Nurse. Chronic/acute hemodialysis experience (preferred). Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws. EOE, disability/veterans<img src="https://www.jobg8.com/Tracking.aspx?nyOUPDb5fxKdOkWte0TDNQq" width="0" height="0" />

**Outpatient RN CAP 1**

The professional registered nurse Outpatient RN CAP 1 is an entry-level designation into the Clinical Advancement Program (CAP). This position is accountable and responsible for the provision and coordination of clinically competent care including assessment, planning, intervention, and evaluation for an assigned group of patients. This may include delegation of appropriate tasks to direct patient care staff including but not limited to RNs, LVN/LPNs, and Patient Care Technicians. As a member of the End Stage Kidney Disease (ESKD) health care team, this position participates in decision-making, teaching, leadership functions, and quality improvement activities that enhance patient care outcomes and facility operations.

**Job Description**

- Perform all essential functions under the direction of the Supervisor and with guidance from the Clinical Educator, Preceptor, or in collaboration with other Registered Nurses.
- Perform ongoing, systematic collection and analysis of patient data pre-during-post hemodialysis treatment for assigned patients and document in the patient medical record, making adjustments or modifications to treatment plan as indicated and notifying Team Leader, Charge Nurse, Supervisor, or Physician as needed.
- Assess, collaborate, and document patient/family's basic learning needs to provide initial and ongoing education to patients and family.
- Direct and provide, in collaboration with direct and ancillary patient care staff, all aspects of the daily provision of safe and effective delivery of hemodialysis therapy to assigned patients.
- Administer medications as prescribed or in accordance with approved algorithm(s), and document appropriate medical justification and effectiveness.
- Initiate or assist with emergency response measures.
- Serve as a resource for the health care team, participate in staff training and orientation of new staff as assigned.
- Ensure correct laboratory collection, processing, and shipping procedures are performed and reschedule missed or insufficient laboratory collections.
- Identify expected outcomes, document and update the nursing assessment and plan of care for assigned patients through collaboration with the Interdisciplinary Team.
- Ensure patient awareness related to transplant and treatment modality options.
- Complete CAP requirements to advance.
- Perform all other duties as assigned by Supervisor.

**Physical Demands and Working Conditions**

The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

- The position provides direct patient care that regularly involves heavy lifting, moving of patients, and assisting with ambulation. Equipment aids and/or coworkers may provide assistance.
- This position requires frequent, prolonged periods of standing and the employee must be able to bend over.
- The employee may occasionally be required to move, with assistance, machines and equipment of up to 200 lbs., and may lift chemical and water solutions of up to 30 lbs. as high as 5 feet.
- The work environment is characteristic of a health care facility with air temperature control and moderate noise levels.
- May be exposed to infectious and contagious diseases/materials.
- Day-to-day work includes desk work, computer work, interaction with patients, facility/hospital staff, and physicians.
- The position may require travel to training sites or other facilities.
- May be asked to provide essential functions of this position in other locations with the same physical demands and working conditions as described above.

**Supervision**

Assigned oversight of Patient Care Technicians/LPNs/LVNs/RNs as a Team Leader or designated Nurse in Charge after meeting all the following:

- Successful completion of all FKC education and training requirements for new employees.
- Must have a minimum of 9 months experience as a RN.
- Must have a minimum of 3 months experience in chronic/acute hemodialysis as a RN.

**Education and Licensure**

- Graduate of an accredited School of Nursing.
- Current appropriate state licensure.
- Current or successful completion of CPR BLS Certification.
- Must meet the practice requirements in the state in which he or she is employed.

**Experience and Required Skills**

- Entry level for RNs with less than 2 years of Nephrology Nursing experience as a Registered Nurse.
- Chronic/acute hemodialysis experience (preferred).

We are seeking CRNAs to join our single specialty team at a leading Ambulatory Surgery Center. Specializing in diagnostic and therapeutic upper and lower endoscopic procedures, we offer facilities equipped with the latest gastroenterology technology. We offer flexible scheduling so that you can tailor your practice to fit your lifestyle. If you are passionate about this opportunity, we encourage you to apply! Independent position (no anesthesiologist is present), work in an ambulatory surgery center, not a hospital environment. Our CRNAs are offered the following benefits: <ul><li> Sign On Bonus </li><li> Competitive compensation, PTO package plus 8 holidays per year for full time </li><li> Retirement plan </li><li> Medical benefits for full time employees </li><li> CME stipend and CME time off </li><li> Paid Malpractice coverage </li><li> Pay increase for floating CRNA positions </li></ul> Location: <ul><li> Access to top-rated schools and educational opportunities </li><li> Living accommodations near great communities. </li><li> Affordable housing options and cost of living within a community-centric environment </li></ul> <img src="https://www.jobg8.com/Tracking.aspx?HdE4rzf4ktRjeS8JvYal9go" width="0" height="0" />

**CRNA**

We are seeking CRNAs to join our single specialty team at a leading Ambulatory Surgery Center. Specializing in diagnostic and therapeutic upper and lower endoscopic procedures, we offer facilities equipped with the latest gastroenterology technology. We offer flexible scheduling so that you can tailor your practice to fit your lifestyle. If you are passionate about this opportunity, we encourage you to apply! This is an independent position (no anesthesiologist is present), working in an ambulatory surgery center, not a hospital environment.

**Job Description**

- Join a single specialty team at a leading Ambulatory Surgery Center
- Specialize in diagnostic and therapeutic upper and lower endoscopic procedures
- Enjoy flexible scheduling to fit your lifestyle
- Work independently in an ambulatory surgery center

**Benefits**

- Sign-on bonus
- Competitive compensation, PTO package plus 8 holidays per year for full-time
- Retirement plan
- Medical benefits for full-time employees
- CME stipend and CME time off
- Paid malpractice coverage
- Pay increase for floating CRNA positions

**Location Overview**

- Access to top-rated schools and educational opportunities
- Living accommodations near great communities
- Affordable housing options and cost of living within a community-centric environment