- Staffing Solutions Organization (Albany, NY)
- …workforce, which is a reflection of our clients and the people they serve. ** Medicaid Registered Nurse in Albany, NY** **Division of Program Development ... of services and programs for children provided under the Medicaid program including the Children's Health Home program, the...of OHIP. **Basic Qualifications:** + Current license as a registered professional nurse in New York State… more
- Seattle Children's (Seattle, WA)
- ** Registered Nurse - PICU (0.9FTE Day/Night...an integral member of the Health Care Team, the RN functions within the Scope of Practice as defined ... safe, family centered patient care. Using the Nursing Care Process, the RN is responsible for assessing, planning, implementing and evaluating patient care in… more
- Commonwealth Care Alliance (Boston, MA)
- …Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day timely ... clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA meets… more
- Seattle Children's (Seattle, WA)
- As an integral member of the Health Care Team, the RN functions within the Scope of Practice as defined by the State, the ANA Scope and Standards for Pediatric ... safe, family centered patient care. Using the Nursing Care Process, the RN is responsible for assessing, planning, implementing and evaluating patient care in… more
- Seattle Children's (Seattle, WA)
- ** Registered Nurse - CICU (0.9 FTE...pediatric patients and their families while leveraging the adult RN experience you already have. We will personalize an ... an integral member of the Health Care Team, the RN functions within the Scope of Practice as defined...required to provide supervision and delegation of tasks to Nurse Technicians, Licensed Practical Nurses, Certified Medical Assistants, Certified… more
- Seattle Children's (Seattle, WA)
- ** Registered Nurse - PICU (0.9FTE, Nights)** Up to $15,000 sign-on bonus and relocation assistance available for experienced pediatric ICU RNs that meet ... on working with pediatric patients and their families while leveraging the adult RN experience you already have. We will personalize an orientation just for you… more
- Seattle Children's (Everett, WA)
- ** Registered Nurse - Transport Team (Nights, North)** Shifts start at 5pm or 7pm (12 hours). As an integral member of the Transport Team, the Transport RN ... the ambulance or aircraft and during transit. The Transport Nurse must also be familiar with ambulance and aircraft...American Pathologists (CAP) and the Centers for Medicare and Medicaid Services (CMS), for RN 's performing moderately… more
- Stanford Health Care (Palo Alto, CA)
- …180 Days or + CCDS - Cert Clinical Document Spec required within 180 Days + RN - Registered Nurse - State Licensure And/Or Compact State Licensure preferred ... detailed review of medical records. Ensure compliance with Medicare, Medicaid , third-party guidelines, Local Coverage Determinations (LCD), National Coverage… more
- EGA Associates (Albany, NY)
- …Other Requirements: Qualifications: Bachelor's Degree and current NYS license as a registered professional nurse , 6 years of clinical healthcare experience ... **Job Type:** Local **Position Urgency** Normal **Offering** Nursing **Profession** RN **Specialty** Case Manager **Job ID** 17430566 **Shift Details** **Shifts… more
- BroadPath Healthcare Solutions (Tucson, AZ)
- **Overview** BroadPath is seeking a highly motivated and results-driven **UM RN Appeals Coordinator.** This role collaborates with clinical review staff, medical ... most appropriate course of action + Provides education to nurse and therapist reviewers regarding appeal updates and process...reviewers and clinical review staff on managed care and Medicaid policies and procedures D. Conducts staff and medical… more
- National Health Care Associates (Wethersfield, CT)
- …of our residents **-** **What You'll Bring:** **Qualifications of a MDS Coordinator / Nurse Assessment Coordinator include:** + Valid state RN nursing license + ... appreciated. We invite you to join our team! **-** ** RN - floater supporting MDS/NAC needs across CT facilities.** **Local...reimbursed.** **What You'll Do:** As an MDS Coordinator / Nurse Assessment Coordinator, you will complete and assure the… more
- National Health Care Associates (Stafford Springs, CT)
- …**What You'll Bring:** **Qualifications of the MDS Director include:** + Valid state RN license preferred + Advanced degree or certification preferred + Direct care ... + Knowledge and understanding of Electronic Medical Record (EMR), PDP, MDS 3.0, Medicaid and Medicare requirements + Interest in the nursing needs of the aged… more
- Alameda Health System (Alameda, CA)
- AHD Infection Preventionist - PB - (LVN or RN experience preferred) + Alameda, CA + Park Bridge + PB Hospital Administration + Services As Needed / Per Diem - Day + ... of The Joint Commission (TJC), Centers for Medicare and Medicaid Services (CMS) Center for Disease Control (CDC), Occupational...in bacteriology, microbiology, epidemiology, or related field; For LTC: RN or LVN with two years LTC experience and… more
- Alameda Health System (Oakland, CA)
- …using adult learning principles. Required Licenses/Certifications: Valid license to practice as a Registered Nurse in the State of California; & Basic Life ... + Participates in continuing education provider unit as a Nurse Planner; utilizes Board of Registered Nursing...The Joint Commission and CMS (Centers for Medicare and Medicaid Services) criteria to assess needs, plan, implement and… more
- Commonwealth Care Alliance (Boston, MA)
- …preferred. Required Experience (must have): - 5+ years - Experience with Medicaid and Medicare products and programs - Value-based program oversight and performance ... that CCA implements. - Working knowledge of Medicare and Medicaid (MassHealth) - Demonstrated skills in Excel and PowerPoint...applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance is an… more
- Commonwealth Care Alliance (Boston, MA)
- …degree in Business or Health related field preferred Required Licensing: - active RN license required Required Experience: - 7-10 years - 8-10 years of managed ... health care delivery Required Knowledge, Skills & Abilities: - Medicare and Medicaid managed care experience - Demonstrated knowledge of federal and state… more
- Commonwealth Care Alliance (Boston, MA)
- …on CCA's Population Health goals; including Medicare Star measures, Medicaid -Medicare Plan withhold measures, quality performance metrics incorporated into other ... value-based contract performance metrics + Experience with Medicare Advantage, Medicaid ; and dually eligible populations **Desired Experience** + Experience managing… more
- Seattle Children's (Seattle, WA)
- **Charge Nurse - CICU 0.75-0.9 FTE (Nights)** *Sign on bonus up to $15,000 + Relocation for qualified external, experienced Pediatric ICU nurses* Position can be ... integral member of the health care team, the Charge RN functions within the scope of practice as defined...American Pathologists (CAP) and the Centers for Medicare and Medicaid Services (CMS), for nurses performing moderately complex point… more
- Commonwealth Care Alliance (Boston, MA)
- …and regulatory benchmarks. - Ensure provider network compliance with CMS, state Medicaid agency, and NCQA standards. - Lead initiatives to streamline provider ... provider operations and satisfaction. - Strong understanding of Medicare and Medicaid health plan operations, including regulatory and compliance requirements. -… more
- Commonwealth Care Alliance (Boston, MA)
- …required. Required Experience (must have): - 5+ years - Experience with Medicaid and Medicare products and programs - Experience or knowledge of behavioral ... alignment with clinical licensure. - Strong understanding of Medicare, Medicaid (MassHealth), and dual-eligible program operations, including regulatory and… more
