- Kaiser Permanente (Hyattsville, MD)
- …Planning -Design Diligence; Member Service; Patient Safety; Health Care Quality Standards; Organizational Culture Preferred Qualifications: Clinical Nurse ... us at the heart of health care. Pediatric Clinical Nurse Specialist II, Acute Care Services - Advanced Urgent...culture of consistency and continuity of care, and optimizing quality outcomes for patients. Analyzes patient needs to develop… more
- University of Iowa Health Care (Iowa City, IA)
- … external customers. Operations, Standards of Care, Regulatory Compliance, Quality and Patient Satisfaction: Provide leadership to establish and/or maintain ... Description: The University of Iowa Healthcare is seeking a Nurse Manager to perform specific tasks to assist members...employees, students, and volunteers work together to provide safe, quality health care and excellent service for our patients.… more
- Fresenius Medical Care (Olmito, TX)
- …ensure that medical practices and procedures meets applicable standards. Ensures provision of quality patient care and the role is responsible to the ASC Governing ... operational oversight. PRINCIPAL DUTIES AND RESPONSIBILITIES: Environment of Care & Quality . Manage site employees, environment, clinical processes and procedures,… more
- UNIVERSITY HEALTH (San Antonio, TX)
- …for Medicare and Medicaid Services (CMS), Agency for Healthcare Research and Quality (AHRQ), National Committee for Quality Assurance (NCQA) that promotes ... Healthcare Effectiveness Data and Information Set (HEDIS) metrics, Utilization Review Accreditation Commission (URAC), and the Joint Commission (TJC). EDUCATION AND… more
- STG International (Rockville, MD)
- …communicate with fellow team members, internal, and external customers. Exam Processing Quality and Safety + Ensure case review processing timeframes and ... STGi is currently seeking a Registered Nurse -Case Review Specialist . The position...+ Suggest process improvements to PM to ensure that quality and efficiency goals for the case review… more
- Houston Methodist (Houston, TX)
- …for hospital services by communicating medical information required by all external review entities, managed care contracts, insurers, fiscal intermediaries, ... At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is...evidence-based criteria, initiates discussions with attending physicians, coordinates with external utilization review teams to facilitate efficient… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …may require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for evaluating the ... guidelines and evidence-based practice * Quality of Practice*: * Promotes quality through evidence-based utilization review processes and actively contributes… more
- CDPHP (Latham, NY)
- …these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review and documentation ... physician-founded, member-focused, and community-based not-for-profit health plan that offers high- quality affordable health insurance to members throughout New York.… more
- Beth Israel Lahey Health (Cambridge, MA)
- …and improve patient outcomes. The nurse works with clinical staff to review clinical charts, interpret data, and implement quality improvement initiatives to ... Director of Quality & Patient Safety, the Quality and Patient Safety nurse specialist plays...+ Reviews medical records to collect data for reporting quality measures, including both concurrent medical record review… more
- US Tech Solutions (Chicago, IL)
- …experience with Utilization Review ? + Do you have an Active Registered Nurse License? **About US Tech Solutions:** US Tech Solutions is a global staff ... development and ongoing implementation of QM Work Plan activities. + Improve quality products and services, by using measurement and analysis to process, evaluate… more
- Albany Medical Center (Albany, NY)
- …America) Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. * Completes ... Utilization Management and Quality Screening for assigned patients.* Applies MCG criteria to monitor appropriateness of admissions and continued stays, and documents… more
- US Tech Solutions (May, OK)
- …development and ongoing implementation of QM Work Plan activities. . Improve quality products and services, by using measurement and analysis to process, evaluate ... to meet QM objectives Responsibilities: . Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations.… more
- Huron Consulting Group (Chicago, IL)
- … Review Preparation: Assists in preparation for on-site reviews by outside review organizations and ensures readiness for external evaluations. + Standards of ... for planning, organizing, developing, and directing implementation of the Utilization Review Plan and the overall operation of the Utilization Management Department… more
- Beth Israel Lahey Health (Boston, MA)
- …the online Quality Improvement reporting system: Ensures timely and satisfactory review of cases, data trending, and coordinates root case analysis of all ... and Community. Ensures ongoing participation in and compliance with departmental quality initiatives, provides education for staff and collects and maintains data… more
- State of Colorado (Pueblo, CO)
- …formulation of quality improvement strategies. Managers and peers internal, and external to CMHHIP rely on this position when making decisions regarding course ... met. + Prepare accurate summaries and possibly presentation materials for leadership review , regulatory submissions, or quality committee discussions. + Monitor… more
- Bon Secours Mercy Health (Newport News, VA)
- …accreditation, and certification surveys in successful completion. + Prepares and submits quality reports as required by external agencies and payors.Facilitates ... improvement committees and projects as needed. + Supports Medical Staff Quality and Peer Review . + Promotes practices that detect, mitigate or prevent harm using… more
- State of Colorado (Golden, CO)
- …care delivery and/or programs, which include staffing patterns and assignments, training and quality assurance review in collaboration with the DYS Quality ... Medical Operations Coordinator ( Nurse V) - Lookout Mountain Youth Services Center...but not limited, to protocols, diagnostic equipment, medication formulary, quality assurance program, and hospitalization utilization review .… more
- Penn Medicine (Philadelphia, PA)
- …roles, accountabilities and performance measures to all staff. * Identify unit quality metrics, review and track regularly. * **Regulatory Compliance (In ... has a great career opportunity to be the next Nurse Manager of 5 Cathcart/5 Schiedt, our 62-bed Medical-Surgical...as our care delivery model to provide the highest quality of care. Our physicians, nurses, and patient care… more
- Beth Israel Lahey Health (Needham, MA)
- …Educator Team Nurse will perform all of the duties of a Team Nurse , including: a. Coordinate and facilitate quality clinical management of a broad based ... to be a leader in patient experience, provider and care team work life and quality of care both regionally and nationally. Additionally we are working to establish a… more
- Ventura County (Ventura, CA)
- …the Senior Medical Management Nurse is responsible for performing utilization review , case management, and quality improvement functions to ensure that ... two (2) years of full-time experience in Case Management, Disease Management, Quality Assurance, HEDIS and/or Utilization Review . NECESSARY SPECIAL REQUIREMENTS… more
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