- Hackensack Meridian Health (Hackensack, NJ)
- …and projects as assigned, including but not limited to work on Commercial and Medicare quality contracts, Roster Management , Health and wellness campaigns. ... as a leader of positive change. Practice facilitation, also referred to as quality improvement peer coach, is an approach to supporting improvement in primary care… more
- CommuniCare Health Services Corporate (Indianapolis, IN)
- Medicare Biller The CommuniCare Family of Companies currently owns/manages over 130 World-Class Nursing and Rehabilitation Centers, Specialty Care Centers, and ... and Maryland. Since 1984, CommuniCare Health Services has provided superior, comprehensive management services for the development and management of adult living… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- … management , discharge planning, care coordination, clinical outcomes, and quality of service. + Evaluate members' clinical status, benefits, and appropriateness ... use of the member's benefit to provide the best quality care. This role is eligible for our eWorker,...(Inpatient, outpatient, or differing levels of care). + Utilization Management experience, preferred + Experience with Medicare … more
- AmeriHealth Caritas (Detroit, MI)
- …proficiency in working within Electronic Health Records + Strong knowledge of Medicare /MMP/DSNP Integrated Care Management programs + Ability to communicate with ... it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other… more
- BrightSpring Health Services (St. Clairsville, OH)
- …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 ... services/training programs on a routine basis in cooperation with Operations management ; monitoring both skilled and non-skilled healthcare services + Directly… more
- Sutter Health (Auburn, CA)
- …**Job Description** : **EDUCATION:** + Graduate of an accredited school of nursing . **CERTIFICATION & LICENSURE:** + RN-Registered Nurse of California + ... SAFH-Sutter Auburn Faith Hospital **Position Overview:** Supervises and oversees all nursing activities of patient care in an inpatient setting, ensuring consistent… more
- Northwell Health (New York, NY)
- **Req Number** 137365 Coordinates and implements the Quality Management /Performance Improvement Program at the facility. + Conducts education on quality ... management and performance improvement theoretical frameworks to promote high quality patient care. + Assists in developing appropriate measurements to assess… more
- Medical Mutual of Ohio (OH)
- …pre-employment substance abuse and nicotine testing._ **Title:** _Medical Drug Management Nurse Reviewer_ **Location:** _Ohio_ **Requisition ID:** _2500036_ ... Nursing Board. . 3 years as a Registered Nurse with a combination of clinical and utilization/case ...Nurse with a combination of clinical and utilization/case management experience in medical specialty drugs (ie, intravenous, or… more
- CVS Health (Phoenix, AZ)
- …care more personal, convenient and affordable. **Position Summary** This is a fulltime Quality Management Nurse Consultant opportunity within Arizona. The ... 60 miles) about 25-50% of the time. The QM Nurse Consultant is a work at home role. Experienced...limited to member services, provider relations and integrated care management ) to achieve the common goal of improving member… more
- HCA Healthcare (Asheville, NC)
- …Hospital we support our colleagues in their positions. Join our Team as a(an) Case Management Registered Nurse and access programs to assist with every stage of ... certifications and job skills. Apply today for our Case Management Registered Nurse opening and continue to...and leadership. + Preferred Experience: Previous 5 years in nursing practice and 3 years care management .… more
- UCLA Health (Los Angeles, CA)
- Description As the Utilization Management & Quality Review Nurse , you will be responsible for: + Ensuring appropriate, cost-effective, and high- quality ... California RN license, required * Two or more years of experience in utilization management , preferably in Medicare Advantage or managed care * Knowledge of … more
- Texas Health Resources (Arlington, TX)
- **RN/Registered Nurse -Utilization Management , Clinical Reviews** **Work location:** 100% remote but must live in Texas, preferably in the Dallas-Fort Worth ... of medical necessity criteria preferred **Licenses and Certifications** + RN - Registered Nurse Current license to practice professional nursing in the state… more
- Cleveland Clinic (Cleveland, OH)
- Assistant Nurse Manager - Care Management Join Cleveland Clinic Fairview Hospital and experience world-class healthcare at its best. Fairview Hospital provides ... the highest honor an organization can receive for professional nursing practice. The Assistant Nurse Manager utilizes... Manager utilizes clinical expertise and understanding of care management , Medicare regulations, and contributes to the… more
- HCA Healthcare (Asheville, NC)
- …**Are you passionate about delivering patient-centered care?** Submit your application for Case Management Registered Nurse position and spend more time at the ... and leadership. + **Preferred Experience:** Previous 5 years in nursing practice and 3 years care management ....RN, must have and maintain current licensure as registered nurse with the North Carolina Board of Nursing… more
- Lancaster General Health (Lancaster, PA)
- …responsibility and accountability as defined by the American Nurses Association standards of nursing practice. The Clinical Nurse 1 New to Practice/Apprentice is ... concepts, knowledge, skills and attitudes to meet standards for competent professional nursing practice. The Clinical Nurse 1 New to Practice/Apprentice exhibits… more
- Penn Medicine (Lancaster, PA)
- …responsibility and accountability as defined by the American Nurses Association standards of nursing practice. The Clinical Nurse 2 Colleague is an RN that ... skills and the attitude to effectively meet standards for competent professional nursing practice. The Clinical Nurse 2 Colleague exhibits Penn Medicine's… more
- Penn Medicine (Lancaster, PA)
- …responsibility and accountability as defined by the American Nurses Association standards of nursing practice. The Clinical Nurse 1 New to Practice/Apprentice is ... concepts, knowledge, skills and attitudes to meet standards for competent professional nursing practice. The Clinical Nurse 1 New to Practice/Apprentice exhibits… more
- Lancaster General Health (Lancaster, PA)
- …responsibility and accountability as defined by the American Nurses Association standards of nursing practice. The Clinical Nurse 2 Colleague is an RN that ... skills and the attitude to effectively meet standards for competent professional nursing practice. The Clinical Nurse 2 Colleague exhibits Penn Medicine's… more
- Lancaster General Health (Lancaster, PA)
- …responsibility and accountability as defined by the American Nurses Association standards of nursing practice. The Clinical Nurse 2 Colleague is an RN that ... skills and the attitude to effectively meet standards for competent professional nursing practice. The Clinical Nurse 2 Colleague exhibits Penn Medicine's… more
- Gentiva (Clinton Township, MI)
- …give people the care they need with dignity, grace, and love. The ** Nurse Practitioner Advanced Illness Management (AIM)** facilitates advanced illness ... Quality Measures collection, documentation and reporting. **About You** ** Nurse Practitioner Requirements:** **Specialized Knowledge/Skills:** + Excellent leadership, interpersonal,… more
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