- Hackensack Meridian Health (Eatontown, NJ)
- …mission to transform healthcare and serve as a leader of positive change. The Registered Nurse , RN Community Based Care Management provides direct support ... and cost of patient care. Facilitate ongoing patient communications, review gaps in care and relevant outcome measures. HOMECARE...regulations. Responsibilities A day in the life of a Registered Nurse , RN Community Based… more
- The Judge Group Inc. (Philadelphia, PA)
- Job Posting: Registered Nurse - Case Manager (Day Shift) Schedule Details Shift: Day, 5x8-hour (08:00-16:30) Block Scheduling: Not available Weekend Requirement: ... evaluation Discharge planning Use of InterQual and Milliman guidelines Utilization Review Admission criteria Appeals and denials Concurrent and continued stay… more
- The University of Miami (Miami, FL)
- …QUALIFICATIONS Education: Bachelor's Degree/ Bachelor's Degree in Nursing Certification and Licensing: Registered Nurse ( RN ) CCM a plus Experience: Minimum ... faculty or staff position using the Career worklet, please review this tip sheet. The UHealth System at the...Miami has an exciting opportunity for a Case Manager RN in the Population Health Department. SUMMARY The Case… more
- UnitedHealth Group (Meriden, CT)
- …Home Base Medical Care, part of the Optum family of businesses, is seeking a Nurse Practitioner or Physician Assistant to join our team in New Haven County, CT. ... or following hospitalization Meets with patients and/or their legal representatives to review newly developed or modified care plans; involves the PCP or supervising… more
- Insight Global (Philadelphia, PA)
- …patient's care needs. The HEDIS nurse focuses solely on using HEDIS measuring criteria to review health plans in accordance with healthcare facility ... Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ . Skills and Requirements Previous HEDIS review experience Active RN License… more
- Insight Global (Philadelphia, PA)
- …) Strong computer skills Ability to occasionally travel to local providers Previous HEDIS review experience or experience with Utilization Review , Quality, ... Description A client of Insight Globals is looking for HEDIS RNs or LPNs for a partially remote contract...of medical records assigned by a Clinical Quality Lead nurse . Miles will be reimbursed for any travel. Computer… more
- Hackensack Meridian Health (Tinton Falls, NJ)
- …mission to transform healthcare and serve as a leader of positive change. The ** Registered Nurse , RN Community Based Care Management** provides direct ... in Nursing. **Licenses and Certifications Required** : + NJ State Professional Registered Nurse License. **Licenses and Certifications Preferred** : +… more
- Community Health Systems (Naples, FL)
- …meet deadlines. + Effective written and verbal communication skills. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact ... **Job Summary** Under the direction of the UR Director/Manager the UR Nurse reviews all admissions for medical necessity, correct orders based on medical condition… more
- Adelante (Goodyear, AZ)
- …Goodyear, AZ Position Type Full Time Job Category Health Care Description POSITION SUMMARY The Registered Nurse ( RN ) will play a pivotal role in guiding ... Registered Nurse (Family/Internal Medicine) - Goodyear,...acting as an advocate for those they serve. The RN will be a vital member of the multidisciplinary… more
- MyFlorida (Gainesville, FL)
- ADVANCED PRACTICE REGISTERED NURSE OR PHYSICIAN ASSISTANT-CERTIFIED - 64067906 Date: Jul 19, 2025 The State Personnel System is an E-Verify employer. For more ... Requisition No: 854945 Agency: Department of Health Working Title: ADVANCED PRACTICE REGISTERED NURSE OR PHYSICIAN ASSISTANT-CERTIFIED - 64067906 Pay Plan:… more
- Veterans Affairs, Veterans Health Administration (Elizabeth City, NC)
- …but are not limited to: Patient Aligned Care Team (PACT) Outpatient Staff Registered Nurse ( RN ) is responsible for providing competent, evidence-based ... the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible...level degree in Nursing may have opportunity to become registered as a nurse with a state… more
- Catholic Health Services (Melville, NY)
- Overview Position Summary: The Registered Nurse provides safe, direct patient care utilizing the nursing process in the ambulatory setting. The RN provides ... clinical leadership and is a resource for staff. The Registered Nurse must show an uncompromising commitment...in staff meetings and huddles as appropriate. Participates in Hedis , GPRO, and other quality programs as needed Enters… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Registered Nurse Care Coordinator, Quality Management Full Time, 80 Hours Per Pay Period, Day Shift Occasional travel as needed About Us Covenant ... a proud member of Covenant Health! Position Summary: The RN Care Coordinator II is responsible for integrating evidenced...coordination services within the scope of practice as a registered nurse meeting all required standards both… more
- UCLA Health (Los Angeles, CA)
- Description The Quality Management Nurse is responsible for conducting comprehensive facility site reviews (FSRs) to ensure compliance with healthcare standards and ... facilitate appropriate Health Education opportunities. Additionally, you will performs HEDIS related activities, Pay for Performance activities, Provider Access and… more
- University of Miami (Medley, FL)
- …QUALIFICATIONS Education: Bachelor's Degree/ Bachelor's Degree in Nursing Certification and Licensing: Registered Nurse ( RN ) CCM a plus Experience: Minimum ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The UHealth System… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... All Levels + Associates degree required. Bachelor's degree preferred. + Active NYS RN or Registered Dietician or Physical Therapist licensure required; or LMSW;… more
- Fallon Health (Berkshire, MA)
- …care related field preferred. **License** : Active, unrestricted license as a Registered Nurse in Massachusetts **Certification** : Certification in Case ... Fallon Health Pharmacist, referring members in need of medication review based upon Program process o Develops and fosters...**Experience:** * 1+ years of clinical experience as a Registered Nurse managing chronically ill members or… more
- ERP International (Barksdale AFB, LA)
- …NP experience after graduation Licensure:** Current, full, active, and unrestricted Registered Nurse license Life Support Certification:** Possess current ARC ... **Overview** ERP International is seeking a ** Nurse Practitioner,** for a Full-Time position supporting **Occupational...deployment status in a private setting. + Conduct pre-deployment review of health record for any conditions that may… more
- Defense Health Agency (Fort Irwin, CA)
- …( HEDIS ) metrics, procedure preparation, wellness screening paperwork, etc. Review patient appointments, 24-78 hours prior to scheduled appointment and identifies ... **Overview** **Practical Nurse - FT Irwin,CA** **About the Position: This...assigned rooms for clinic schedule. Attends clinic huddle to review scheduled patients with Primary Care Manager to coordinate… more
- CareFirst (Baltimore, MD)
- …addition to the required work experience. **Licenses/Certifications Upon Hire Required:** Health Services\ RN - Registered Nurse Active State Licensure and/or ... as a resource for the nurses to conduct concurrent review for medical necessity and appropriate level of care...health care costs. **We are looking for an experienced Registered Nurse and people leader with UM/CM… more
