- AlohaCare (Honolulu, HI)
- …analysis and interpretation skills with prior experience leading teams focusing on quality management , utilization management , discharge planning and/or home ... on Quality Improvement and HEDIS/STARS metrics initiatives. Oversees Utilization Management toward an effective concurrent review process and case management … more
- PruittHealth (Columbia, SC)
- **Description - External** **JOB PURPOSE:** Senior Nurse Consultant assumes responsibility for conducting quality assurance reviews in the assigned ... facilities. Senior Nurse Consultant recommends resources in an efficient and economical manner...* Desired Software: Matrix Care, Point Right, AHT, Abaqis ( Quality Management System), COMS * Expert level… more
- US Tech Solutions (RI)
- …support as required. **Responsibilities:** + Reviews documentation and evaluates potential quality of care issues based on clinical policies and benefit ... Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1 YEAR OF UTILIZATION... review. + MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. + MUST HAVE… more
- Community Wellness Partners (Oswego, NY)
- …22. Maintains open communication with Medical Staff, Administrator, DON, ADON and Pharmacy consultant 23. Attends Nurse Management meetings, Patient Care ... social services, therapy, and physician services to ensure appropriate quality of care and reimbursement. 5. MDS Nurse...QM and QRP manuals to ensure the highest quality of care is provided, documentation supports outcomes and… more
- CareFirst (Baltimore, MD)
- …and providers who appeal on behalf of members for Commercial lines of business. Ensures quality management of the clinical appeal process to reduce the risk of ... support NCQA accreditation and the Divisional Goals for Care Management . We are looking for an experienced clinical leader...Manager Upon Hire Preferred or + LNCC - Legal Nurse Consultant Certified Upon Hire Preferred **Experience:**… more
- Waystar (Atlanta, GA)
- …of experience in utilization management + Knowledge and understanding of Utilization Management , Quality Management , Care Management , and/or Chronic ... **ABOUT THIS POSITION** The Clinical Product Consultant for Utilization Management is a...workflows. We are specifically seeking an experienced Utilization Review Nurse who will serve as an integral contributor in… more
- University of Utah Health (Salt Lake City, UT)
- …Knowledge of the organization's Value Management System (ie internal ISO Quality Management System). + Excellent written and verbal communication skills and ... **Overview** Top candidates for this Quality position will have a clinical working background...position will have a clinical working background (ie Registered Nurse , Respiratory Therapist, etc ).** _As a patient-focused organization,… more
- Sutter Health (Emeryville, CA)
- …health care delivery and quality improvement is required, including clinical care management and/or quality management . + Knowledge of lean performance ... and facilitates the development, deployment and monitoring of clinical quality improvement projects, patient safety improvement initiatives, and organization… more
- Veterans Affairs, Veterans Health Administration (Palo Alto, CA)
- …and maintenance of reprocessing equipment, staff education program for RMDs, and quality management of SPS. Responsible for assessing, monitoring, developing, ... storage, biological monitoring, and high-level disinfection monitoring through an SPS Quality Management System. Assesses the environment, analyzes trends,… more
- Veterans Affairs, Veterans Health Administration (Fayetteville, AR)
- …professional nursing experience Knowledge of Performance Improvement tools and practices Quality Management experience preferred Vast knowledge of Accreditation ... position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex patient care. The Nurse III registered… more
- HCA Healthcare (Richmond, VA)
- …the program. + Along with other clinical disciplines-medical staff, clinical staff, quality management , infection prevention, and risk management - ... We are seeking a highly-skilled Patient Safety Coordinator Registered Nurse RN to join our quality team....patient safety activities and act as a resource, internal consultant , and educator for patient safety issues. + You… more
- ChenMed (Houston, TX)
- …directors to ensure compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as required ... for health: The PCP acts as a health coach, rather than just a consultant for sickness, by helping patients set short and long-term health goals, partners with… more
- University of Southern California (Los Angeles, CA)
- …The role integrates the functions of complex case management , utilization management , quality management , discharge planning assessment, and coordination ... meet an individual's health care needs to promote cost-effective, quality outcomes. Serves as a consultant to...status and processing of requests received from ambulatory care management nurse . 8. Assesses ongoing discharge planning… more
- Covenant Health Inc. (Lenoir City, TN)
- Overview Registered Nurse Care Manager, Quality Management PRN/OCC,Hours and Shifts Vary Fort Loudoun Medical Center Overview: Fort Loudoun Medical Center is ... and patients and serving as a clinical resource and consultant to the health care team. The RN Care...Job Title RN Care Mgr II ID 4349977 Facility Fort Loudon Medical Center Department Name QUALITY MANAGEMENT… more
- University of Southern California (Los Angeles, CA)
- …populations. The RN case manager role integrates the functions of utilization management , quality management , discharge planning assessment, and coordination ... meet an individual's health care needs to promote cost-effective, quality outcomes. Serves as a consultant to...staff. * Delegates and assists with supervision of Case Management Assistants. * Makes appropriate referrals to Physician Advisor,… more
- Commonwealth of Pennsylvania (PA)
- …strict regulatory standards. If you are looking to evolve your nursing career toward quality management and public service, we encourage you to apply today! ... Department of Human Services is seeking a clinically-seasoned and exceptionally organized registered nurse to join our incident management team. In this critical… more
- Albany Medical Center (Albany, NY)
- …The Nurse Manager utilizes the patient care framework that includes Total Quality Management , Shared Governance, and Primary nursing to assure patient care. ... Day (United States of America) Salary Range: $106,604.71 - $170,567.54 The Nurse Manager has 24-hour responsibility, accountability, and authority for the … more
- Elderwood (Burlington, VT)
- …staff, other service providers, and consultants + Participation and promotion of Quality Management activities and programs for ongoing improvement in nursing ... the health and well-being of our residents by being responsible for: + Overall nurse staffing, staff training and development, and management of personnel in the… more
- Elderwood (Hornell, NY)
- …facility staff, external providers, and consultants + Participate in and promote Quality Management initiatives to improve nursing services + Direct orientation ... weekends for eligible positions Responsibilities Responsibilities + Manage overall nurse staffing, training, and development within the Nursing Services Department… more
- ChenMed (Berwyn, IL)
- …directors to ensure compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as required ... for health: The PCP acts as a health coach, rather than just a consultant for sickness, by helping patients set short and long-term health goals, partners with… more
