- State of Maine, Bureau of Human Resources (Augusta, ME)
- MaineCare Quality Review Nurse Augusta , Maine , United States | Nursing | Full-time Apply by: Jan. 22, 2025 Apply with Linkedin Apply Department of Health ... work hours? If you answered yes and you are licensed as a Registered Professional Nurse in the State of Maine, as issued by the State board of Nursing, and… more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- …+ Conducts various types of case reviews for quality and appropriate medical management, cost containment, peer review and rehabilitation; + Summarizes and ... Utilization Review Nurse (40 Hour) Office/On-site Recruitment...party administrator files to oversee contractor handling; + May review medical records of various health care… 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
- Martin's Point Health Care (Portland, ME)
- …has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of a team responsible for ensuring the ... receipt of high quality , cost efficient medical outcomes for those...authorization requests as well as claims disputes. The Utilization Review Nurse will use appropriate governmental policies… more
- HCA Healthcare (Webster, TX)
- …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision...Qualifications** We are seeking a RN Clinical Reviewer in Quality Management for our facility to ensure that we… 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
- Glens Falls Hospital (Glens Falls, NY)
- …can be foundhere. **Job:** **Nursing - Case Management* **Title:** *RN - Utilization Review Nurse * **Location:** *NY-Glens Falls* **Requisition ID:** *2410V* ... Will Fulfill Your Potential* *Responsibilities* * Conducts concurrent and retrospective review (s) utilizing InterQual (IQ) medical necessity criteria to monitor… 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
- Catholic Health Initiatives (Little Rock, AR)
- **Overview** As a Utilization Review nurse with CHI St Vincent Little Rock, you'll work with physicians, other registered nurses, specialized departments, and ... a 600 bed faith-based, non-profit, acute care 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
- 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 (Tampa, FL)
- …James A Haley Veterans Hospital and Clinics has a Registered Nurse Quality Management consultant for the External Peer Review Program (EPRP). Quality ... patients and/or employees. The QM Consultant is assigned responsibility for their assigned quality management program area activities for the Medical Center and… more
- Molina Healthcare (AZ)
- … review of potential quality of care and critical incident cases; review of medical record documentation for credentialing and model of care oversight; ... quality of care events, member service concerns, and mortalities. * Performs quality monitoring activities, including audits of medical record quality ,… more
- Veterans Affairs, Veterans Health Administration (Wilmington, NC)
- Summary The Quality Nurse is accountable to the Assistant Chief, Quality & Safety. The Quality Nurse is a registered professional nurse , ... regulatory activities.- Healthcare Effectiveness Data and Information Set (HEDIS) Measures The Quality Nurse is also responsible and accountable for performing… more
- HCA Healthcare (Derry, NH)
- …set us apart from any other healthcare provider. We are seeking a(an) Registered Nurse RN Clinical Quality Lead to join our healthcare family. **Benefits** ... Parkland Medical Center, offers a total rewards package that supports...passion for patient care. Apply today for our Registered Nurse RN Clinical Quality Lead opportunity. **Job… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Staff Nurse - Medical Surgical Float Pool- MSH- Full Time Nights** Strength Through Diversity Ground breaking science. Advancing medicine. ... Mount Sinai nursing float pool is a Registered Professional Nurse who provides safe, competent quality care...Care, 5 Minute Sit Down, Purposeful Hourly Rounding, Medication Review , Discharge Wrap Up, and MD/RN Unit Collaboration. 2.… more
- Trinity Health (Mason City, IA)
- …**Position Purpose:** Clinic Nurse is a professional nursing position that provides quality patient care and is a patient advocate. **What you will do:** + ... written test preparation handout with patient and documents in medical record. Refers patient to provider/ nurse if...in the medical field by performing various medical and clerical activities to assure quality … more
- Mount Sinai Health System (New York, NY)
- …**_Roles & Responsibilities:_** The Clinical Nurse is a Registered Professional Nurse who provides safe, competent quality care based on nursing theory ... of Care), AM/PM Care, 5 Minute Sit Down, Purposeful Hourly Rounding, Medication Review , Discharge Wrap Up, and MD/RN Unit Collaboration. + Considers the patient's… more
- Penn Medicine (Philadelphia, PA)
- …our future each day. Are you living your life's work? We are looking for an Assistant Nurse Manager to join the Medical Unit at the Hospital of the University of ... for Improvement. Communicates roles, accountabilities and performance measures to all staff. Review unit dashboard with Nurse Manager monthly and communicate to… more
- Intermountain Health (Las Vegas, NV)
- **Job Description:** The LPN, under the direction of a registered nurse , licensed physician, or other specified health care professional, participates in patient ... after initial training period.** + Additional Shift Details: **Reviews requests for medical treatments, services, or procedures to determine whether they qualify for… more
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