• Suzanne Snell Human Resources and Recruiting Solutions (Newport Beach, CA)
    …job Registered Nurse (Bi-Lingual- Spanish) Seeking candidates for a HEDIS STARS Registered Nurse (Bi-Lingual- Spanish) position for our Healthcare ... includes fulfilling select CMS quality metrics that require documentation by a licensed registered nurse . Compensation & Benefits: Hourly rate of pay is $30-40… more
    Upward (07/25/25)
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  • UnitedHealth Group (Phoenix, AZ)
    …education can be substituted/is equivalent to one year of experience. Required Qualifications: Registered Nurse (within AZ and/or a compact state) 4+ years of ... us to start Caring. Connecting. Growing together. The Sr. Clinical Quality Consultant RN will drive consistency, efficient processes and share best practices, in a… more
    Upward (07/16/25)
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  • Fallon Health (Worcester, MA)
    …care related field preferred. License : Active, unrestricted license as a Registered Nurse in Massachusetts Certification : Certification in Case Management ... Fallon Health Pharmacist, referring members in need of medication review based upon Program process o Develops and fosters...transportation Experience: *1+ years of clinical experience as a Registered Nurse managing chronically ill members or… more
    Upward (07/19/25)
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  • UnitedHealth Group (Waterbury, 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
    Upward (07/07/25)
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  • UnitedHealth Group (Syracuse, NY)
    …of Nurse Practitioner or Physician Assistant accredited program Current state RN license if Nurse Practitioner Current NP or PA license Certification ... of the Optum family of businesses, is seeking a Nurse Practitioner or Physician Assistant to join our team...hospitalization. Meets with members and/or their legal representatives to review newly developed or modified care plans; involves the… more
    Upward (06/28/25)
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  • Community Health Centers of the Central Coast (Santa Maria, CA)
    …care plan. Coordinates with the Care Team (Primary Care Provider, Health Educator, Registered Dietitian, RN , Behavioral Health Provider, Director of Nursing, or ... to perform the essential functions. EDUCATION and/or EXPERIENCE Graduation from an accredited Registered Nursing program. Current RN license issued by the State… more
    Upward (07/14/25)
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  • HEDIS Overreader Registered

    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 (07/01/25)
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  • HEDIS Registered Nurse

    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
    Insight Global (07/01/25)
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  • Registered Nurse , RN

    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
    Hackensack Meridian Health (05/22/25)
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  • Utilization Review - Registered

    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
    Community Health Systems (07/12/25)
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  • Registered Nurse (Family/Internal…

    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
    Adelante (07/04/25)
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  • Advanced Practice Registered Nurse

    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
    MyFlorida (07/19/25)
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  • Registered Nurse - PACT Outpatient

    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
    Veterans Affairs, Veterans Health Administration (07/18/25)
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  • RN

    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
    Catholic Health Services (06/18/25)
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  • RN Care Coordinator II

    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
    Covenant Health Inc. (07/23/25)
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  • Quality Management Clinical Nurse

    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
    UCLA Health (07/14/25)
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  • Case Manager, RN

    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
    University of Miami (06/24/25)
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  • Case Manager, RN or Licensed Behavioral…

    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
    Excellus BlueCross BlueShield (06/27/25)
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  • Senior Care Options Nurse Case Manager…

    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
    Fallon Health (07/16/25)
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  • Nurse Practitioner - Occupational Health

    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
    ERP International (07/23/25)
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