- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The role of the Quality Review Nurse (RN) is to evaluate clinical quality and procedures within the Clinical ... Management, Case Management, Claims, Quality Management and Compliance. The Nurse , Quality Review position develops procedures and reinforce quality … more
- Prime Therapeutics (Annapolis, MD)
- …This position has managerial and clinical oversight of the Clinical Pharmacist and Registered Nurse Review Team, playing a key role in medical and pharmacy ... our passion and drives every decision we make. **Job Posting Title** Supervisor Clinical Pharmacist Review - Remote in California **Job Description Summary**… more
- System One (Baltimore, MD)
- …participating in internal audits for Supplemental Data, and supporting other needs within the Quality Department. Pay: $37/HR 90% Remote May need to go onsite in ... if errors are found. Correct errors identified through over-read process, including a re- review of charts that may contain similar errors. + Identify and report… more
- WellSpan Health (York, PA)
- Licensed Practical Nurse - Tri Hill OB / GYN Location: WellSpan Medical Group, York, PA Schedule: Full Time Schedule Full Time: 4, 10 hour shifts, per week General ... a nursing resource for clinical staff. Position may be onsite, hybrid or remote . Duties and Responsibilities Remote Work Capable Essential Functions: + Obtains… more
- BrightSpring Health Services (Greenbelt, MD)
- …prevention. Provide case management. Core Requirements + Deliver quality results through operational excellence, meeting daily/weekly/monthly/quarterly and annual ... Drive and deliver profitable growth Essential Job Responsibilities + Review daily appointment needs: packets completed and available to...accredited school of nursing OR License as a Registered Nurse , current and in good standing + Valid driver's… more
- WellSpan Health (Gettysburg, PA)
- Licensed Practical Nurse (Outpatient) - Onsite Clinics Gettysburg Location: WellSpan Medical Group, Gettysburg, PA Schedule: Full Time Full-Time (80 Hours Biweekly) ... nursing resource for clinical staff. Position may be onsite, hybrid or remote . Duties and Responsibilities Essential Functions: + Obtains patient history and gathers… more
- Elevance Health (Hanover, MD)
- **Diagnosis Related Group Clinical Validation Auditor-** **Registered Nurse ** **Location:** This position will work a hybrid model ( remote and office). Ideal ... documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims. **How you will make… more
- WellSpan Health (York, PA)
- Medical Assistant or Licensed Practical Nurse -Outpatient - Stony Brook - Days Location: WellSpan Medical Group, York, PA Schedule: Full Time Schedule Full Time: Day ... a nursing resource for clinical staff. Position may be onsite, hybrid or remote . Duties and Responsibilities + Obtains patient history and gathers information. +… more
- Trinity Health (Silver Spring, MD)
- …pathway protocols, Home Program Instructions, phone visits etc.). + Participates in quality improvement processes including peer review as directed. **Minimum ... requested by the client/family, and in compliance with the state's Nurse Practice Act, any applicable licensure/certification requirements, and the organization's… more
- Gentiva (Windsor Mill, MD)
- …care for everyone, so we offer ongoing professional training, lower nurse -to-patient ratios, and comprehensive benefits for eligible employees. Here, you'll join ... for this opportunity.** Additionally, you must be a **Registered Nurse (RN)** and must have a minimum of **3...implementation and evaluation of operational policies and procedures, delivering quality patient care and family services programs in a… more
- Sanofi Group (Baltimore, MD)
- …**Reports To** : Division Director, Patient Education Liaison **Location** : Remote /Field **FLSA** : Exempt **Department:** Rare Disease PSS **Job Purpose** **:** ... with healthcare professionals, primarily the center coordinating genetic counselor, registered nurse , or other ancillary staff. The PEL works collaboratively in a… more
- Erickson Living (Silver Spring, MD)
- …practice; insurance benefit structures and related legal/medical issues; and utilization review and quality assurance procedures. Please note that specific ... Village by Erickson Senior Living **This is NOT a remote or hybrid opportunity ** Join our team as...per the team's "care plan". + Reassesses the effectiveness, quality of services, and treatments provided, per health plan… more
- Veterans Affairs, Veterans Health Administration (Baltimore, MD)
- …an MSA or an equivalent position in a non-VA hospital or clinic setting Quality of Experience. Qualifying experience must be at a level comparable to MSA experience ... coordinated care delivery model. Coordinates with the patient care team to review clinic appointment availability (utilization) to ensure that clinic schedules are… more