- State of Georgia (Thomas County, GA)
- Registered Nurse (Regional Quality Review (RQR)) - Region 4 Georgia - Thomas - Thomasville ... located in downtown Atlanta. Job Description Job Title: Registered Nurse ( Regional Quality Review ...observations, interviews and record reviews aimed at assessing the quality of the environment, health, medical supports… more
- Rising Medical Solutions (Chicago, IL)
- …too. In fact, that's how our business was born - and continues to thrive. Rising Medical Solutions is looking for a Nurse Auditor who wants to make their mark ... Join our team and maximize client savings by reviewing medical bills from a nurse perspective, including...in acute care, surgery and/or orthopedic + Workers' Compensation medical bill review experience a major plus… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- Utilization Review Nurse Coordinator (40 Hour) Office/On-site Recruitment # 241106-5613FP-001 Location East Hartford, CT Date Opened 11/7/2024 12:00:00 AM Salary ... - is accepting applications for a full-time Utilization Review Nurse Coordinator (https://www.jobapscloud.com/CT/specs/classspecdisplay.asp?ClassNumber=5613FP&R1=&R3=) position, located… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply UTILIZATION REVIEW NURSE ... technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical ...Determines need for and conducts in-service training to improve quality of admission and continued stay reviews, and to… more
- Hackensack Meridian Health (Little Falls, NJ)
- …and follow up. + Review all new admission charts to ensure all quality indicators are completed at the initial encounter with the patient or within the five ... The VHSNJ multidisciplinary clinical and support teams provide high quality care to patients where they most want to...Hospice, and other clinical assessment tools as needed. + Review every Medicare and Managed Medicare admission chart to… more
- Premier Health (Troy, OH)
- …the patient experience with daily nurse leader rounding and executing quality actions plans. The **Utilization Review RN** manages the nursing care ... Position: ASSOCIATE NURSE MGR/ UTILIZATION REVIEW RN Dept:...Shift: Full time 72 hours/pp: 7am-7:30pm Facility: Upper Valley Medical Center **_*NOTE: THIS IS A COMBINATION POSITION: 24… more
- Hackensack Meridian Health (Brick, NJ)
- …and follow up. + Review all new admission charts to ensure all quality indicators are completed at the initial encounter with the patient or within the five ... coding, OASIS and Hospice, and other clinical assessment tools as needed. + Review every Medicare and Managed Medicare admission chart to determine that the coding… more
- InnovaCare (San Juan, PR)
- …to the business. MMM Holdings, Inc.Job Description Inpatient Unit POSITION: Concurrent Review Nurse (CRN) POSITION DESCRIPTION Manages the inpatient utilization ... of stay and levels of care, utilizing nationally recognized Medical Care Guidelines approved by CMS, NCQA and MMM...daily regarding patient and physician related issues.8. Performs concurrent quality review and reports identified quality… more
- Trinity Health (Springfield, MA)
- …Part time **Shift:** Rotating Shift **Description:** Requires BSN At **Mercy Medical Center** the **Utilization Review /Appeals & Denials** **RN** performs ... determinations using screening criteria, and assists the physician, bedside Registered Nurse , ICC and Social Worker with utilization management and clinical… more
- CommonSpirit Health Mountain Region (Durango, CO)
- …and leaders who care about your success. Assist with training and coordinating clinical review and quality assurance. Lead and review the appropriateness of ... clinical care and documentation practices related to patients/residents. Review and evaluate quality data to determine...of the home health and/or hospice patient. + Registered Nurse + Valid CO Driver's License. + BLS Sedentary… more
- US Tech Solutions (Columbia, SC)
- …resources to promote quality , cost effective outcomes. Performs medical or behavioral review /authorization process. Ensures coverage for appropriate ... review determinations. Identifies and makes referrals to appropriate staff ( Medical Director, Case Manager, Preventive Services, Subrogation, Quality of care… more
- Veterans Affairs, Veterans Health Administration (Kings County, NY)
- …risk, and guides the organization through frequent interactions with other service chiefs. The Nurse IV Deputy Chief of Quality Management (QM) functions as an ... such as the Joint Patient Safety Reporting (JPSR), Tort Claims, and Peer Review . Responsible for completing clinical quality reviews, clinical data analysis, and… more
- Centene Corporation (Reno, NV)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... member's overall health, reviewing the type of care being delivered, evaluating medical necessity, and contributing to discharge planning according to care policies… more
- Veterans Affairs, Veterans Health Administration (Coatesville, PA)
- …(Performance Measurement/Improvement, External Reviews/Accreditation, Risk Management/Peer Review Coordination, Infection Prevention, Patient Safety, Controlled ... quality activities (Performance Measurement/Improvement, External Reviews/Accreditation, Risk Management/Peer Review Coordination, Infection Prevention, Patient Safety, Controlled Substance Program).… more
- Catholic Health Initiatives (Little Rock, AR)
- **Overview** As a Utilization Review nurse with CHI St Vincent Hot Springs, you'll work with physicians, other registered nurses, specialized departments, and ... a 280 bed faith-based, non-profit, Magnet Accredited facility providing quality health care to patients and communities from all...statistics. + Monitors and tracts Medicare denials, works with medical records to review third party payor… more
- State of Colorado (Denver, CO)
- Youth Corrections Medical Operations Coordinator ( Nurse V) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4573875) Apply Youth ... Corrections Medical Operations Coordinator ( Nurse V) Salary $108,540.00 - $151,968.00 Annually Location Denver Metro, CO Job Type Full Time Job Number IKA 02221… more
- Veterans Affairs, Veterans Health Administration (St. Cloud, MN)
- Summary The Office of Director Quality Coordinator Registered Nurse (RN) functions directly to support the activities of the St. Cloud VA Health Care System ... and evaluating the effectiveness of the Veteran's care. The Quality and Patient Safety (QPS) Department foundational elements will...Whole Health System of care in each of the Medical Centers. This is an approach to healthcare that… more
- Bassett Healthcare (Cooperstown, NY)
- …health and enjoy the best quality of life possible. About the department Bassett Medical Center's Medical Inpatient units are on the 2nd and 3rd floors and ... in our conversations. What you'll do The Registered Professional Nurse (RN), Acute Care in the Medical ...than 3-5 exceptions, as measured by random supervisory chart review and/or direct supervisory observation and co-worker feedback. Analyzes… more
- Veterans Affairs, Veterans Health Administration (Walla Walla, WA)
- …their assigned quality management program area activities for the VA Medical Center and all off-site locations. The QM/HRO Consultant collects data, monitors ... plan the Medical Center. Prepares and delivers written and verbal review of findings and recommendations to HCS, VISN, and VHACO leadership to determine… more
- Veterans Affairs, Veterans Health Administration (Tucson, AZ)
- …of staff while caring for all patients throughout the continuum of care for Quality and Patient Safety. Responsibilities The Registered Nurse (RN) Safety Manager ... Summary The Registered Nurse (RN) Safety Manager (PSM) ,Supervisor executes position...the provision of staff education, orientation, competencies, and providing quality improvement and outcomes utilization consultation related to the… more
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