- OhioHealth (Columbus, OH)
- …/or to provide shadowing experiences for students. **Minimum Qualifications:** Bachelor's Degree: Nursing (Required) RN - Registered Nurse - Ohio Board of ... **Job Description Summary:** Given that the organization self-insures for professional liability claims , it is essential that the Sr Consultant Risk Management… more
- MetLife (Oriskany, NY)
- …Required: . Bachelors in Nursing . 4+ years clinical experience. . Current RN licensure. Preferred: . 7+ years Disability claims and/or clinical ... professional medical, technical, consulting advice, and recommendations in support of claims evaluation, investigation and assessment for various claims -related… more
- Sedgwick (Juneau, AK)
- …Bachelor's degree from an accredited college or university preferred. Current valid RN license required. Legal Nurse Consultant (LNC) Certification ... Work(R) Fortune Best Workplaces in Financial Services & Insurance RN Consultant Team Lead **PRIMARY PURPOSE** **:**...clinical nursing experience to include two (2) years nurse consultant experience or equivalent combination of… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …and administrative staff at all levels of the organization. Education and Experience: + Registered nurse with BSN and 3-5 years in a managed care health ... healthcare? Bring your true colors to blue. The RoleThe Clinical Business Consultant for Cost and Trend...a wide variety of stake holders to analyze high-cost claims and members, evaluate clinical trends, and… more
- The County of Los Angeles (Los Angeles, CA)
- …Requirements SELECTION REQUIREMENTS: Option I: Five (5) years of experience as a Registered Nurse including two (2) years of experience in an administrative*, ... HEALTH FACILITIES CONSULTANT , NURSING Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2307969) Apply HEALTH FACILITIES...university AND four (4) years of experience as a Registered Nurse including two (2) years of… more
- CVS Health (Phoenix, AZ)
- …difference in the lives of patients? Join Mercy Care as a Utilization Management Clinical Consultant and become part of a mission-driven team that's transforming ... AZT (No weekends or holidays) Location: 100% Remote (Must have Arizona RN license or compact license that includes Arizona.) Candidate may have opportunities… more
- HCA Healthcare (Nashville, TN)
- …and experience in multiple markets/divisions is a plus + Legal Nurse Consultant Certified (LNCC) preferred + Registered Nurse - Currently licensed ... in the pursuit of payment on unpaid and underpaid claims . Additionally, the Nurse Subject Matter Advisor...of similar claim issues. Major Responsibilities: + Conducts comprehensive clinical record reviews and detailed claims analyses.… more
- Unum Group (Chattanooga, TN)
- …Help us help others, and join Team Unum today! **General Summary:** The clinical consultant is responsible for reviewing, analyzing and interpreting medical ... information. Works collaboratively with claims professionals, on-site physicians and other resources in multiple...**Job Specifications** + Associate Degree in Nursing and active RN License is required but BS degree strongly preferred… more
- NHS Management, LLC (Fayetteville, AR)
- …the successes they experience along the way. We are in search of a qualified Regional Nurse Consultant : The Regional Nurse Consultant will be responsible ... policies and established customer service program. 4. Monitor corporate clinical benchmarks, QI's, QM's and other available consultant...Holidays and Paid Vacation Requirements + Must be a Registered Nurse in good standing + Previous… more
- Capgemini (Chicago, IL)
- …solution recommendation. + Mastery of Microsoft Office (Excel, PowerPoint, Word). Preferred: + Clinical background (MD, PharmD, RN , PA). + PV certification (DSS, ... identify new revenue sources. **YOUR ROLE** **Scope & Responsibilities** As a Senior Consultant , you will act as a **pharmacovigilance and drug safety expert** for… more
- US Tech Solutions (Chesapeake, VA)
- …healthcare costs and improve healthcare program/operational efficiency involving clinical issues Determines medical necessity/ appropriateness Facilitates optimal ... enable decision making at most appropriate level **Duties:** + Nurse Case Manager is responsible for face to face...policies and programs are comprised of network management and clinical coverage policies. + Through the use of … more
- Corewell Health (Grand Rapids, MI)
- …Required + 3 years of relevant experience Leading others (supervisory role) Required + LIC- Registered Nurse ( RN ) - STATE_MI State of Michigan required for ... and safety of patient care, loss control, management of claims , monitoring of risk trends, implementation of strategies to...records for area of responsibility. + Serves as a consultant to the organization regarding clinical risk… more
- Tufts Medicine (Boston, MA)
- …**Minimum Qualifications** **:** 1. Bachelor's degree in Pharmacy or Nursing. 2. Licensed Pharmacist, Registered Nurse ( RN ), or Licensed Practical Nurse ... The Clinical Liaison serves as an expert clinical consultant to hospital staff and ...information needed for effective back-office administration (eg, authorization processes, claims accuracy) related to new patient on-boarding and the… more
- Baylor Scott & White Health (College Station, TX)
- … experience. Or, an Associate's Degree in a healthcare field and six years of clinical experience. Or, an RN with less than a Bachelor's Degree and six ... patient harm. If organizational risk is found, the Corporate claims manager will review the event further. The CRM...years of clinical experience. + TX RN license if… more
- Carle Health (Champaign, IL)
- …the Clinical Denial Management team, the Utilization management team and the Clinical Denial Management team in defending payor claims denials for medical ... Health Physician Advisor can, at times, serve as a consultant and as a resource for attending physicians in...Chief Medical Officer and works with our Utilization Management RN team, Clinical Denials Management team and… more
- Baystate Health (Springfield, MA)
- …standards from TJC, CMS, and other relevant agencies. **Preferred Qualifications:** + Clinical licensure (eg, RN , MD, DO) highly preferred. + Certified ... expert knowledge in federal, state and TJC standards and clinical and operational expertise to achieve and maintain a...not limited to, functioning as an expert resource and consultant to the organization, as a liaison between the… more
Related Job Searches:
Claims,
Claims Consultant,
Clinical,
Clinical Consultant,
Consultant,
RN,
RN Clinical,
RN Clinical Consultant