- Evolent (Providence, RI)
- …scheduled. + Determines medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all review ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks… more
- Humana (Providence, RI)
- …Manager, Fraud and Waste Investigator: Nurse Audit/ Review performs clinical audit/validation processes to ensure that medical record documentation and ... approach, resources, schedules and goals. The Manager, Fraud and Waste Investigator: Nurse Audit/ Review validates and interprets medical documentation to… more
- Fresenius Medical Center (Warwick, RI)
- …regulations at: https://content.intranet.fmcna.com/regulatory-affairs/wp-content/uploads/sites/46/2019/05/Pre-Licensed- Nurse -50-State- Review ... of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a...transcribes, and enters physician lab orders accurately into the Medical Information System. + Ensures appropriate preparation of lab… more
- University Medicine (Providence, RI)
- SUMMARY: Reporting to the Manager of Case Management, the nurse case manager is responsible for providing comprehensive screenings, assessment, care coordination ... the intent of encouraging self-management for patients with chronic conditions. The Nurse Case manager is integrated in the office-based healthcare team and thereby… more
- Fallon Health (Foxborough, MA)
- …Information (CORI) results and reliable transportation **Experience:** * 1+ years of clinical experience as a Registered Nurse managing chronically ill members ... the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge,… more
- Brown University (Providence, RI)
- …and conduct support activities related to these duties. The Research NP will review medical histories with research participants, perform a physical examination ... Job Description: Position Purpose: The Research Nurse Practitioner (NP) will provide medical ...research participation, and administer questionnaires. The Research NP will review health updates and adverse event reports from study… more
- Humana (Providence, RI)
- …needs and by providing guidance along the healthcare continuum. You will perform clinical case review on members during an inpatient hospital admission. You ... us put health first** The NICU Care Manager, Telephonic Nurse 2, in a telephonic environment, assesses and evaluates...+ Bilingual is a plus - preferably Spanish + Clinical claim review experience **Additional Information** +… more
- CVS Health (Providence, RI)
- …benefit overall claim management. + Using a holistic approach, consults with clinical colleagues, supervisors, Medical Directors and/or other programs to ... in the US with virtual training.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993,… more
- BioLife Plasma Services (Attleboro, MA)
- …You will report to the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. BioLife ... of laboratory test results, and donor notification of unsuitable test results. The Medical Support Specialist (Plasma Center Nurse ) works under the guidance of… more
- Highmark Health (Providence, RI)
- …over a specified panel of members that range in health status/severity and clinical needs; and assesses health management needs of the assigned member panel and ... utilizing data/analytics in conjunction with professional clinical judgement to identify the right clinical intervention for each member. The incumbent conducts… more
- University Medicine (East Providence, RI)
- …and chief complaint. + Obtains lab specimens, gives injections, and performs routine medical tests. + Implements clinical and technical aspects of nursing care ... as they pertain to office nursing, which includes routine medical exams and/or procedures and tests in conjunction with...with prescribed policies, procedures, and techniques. + Assisting with review of test results under guidance of a physician… more
- Aveanna Healthcare (Fall River, MA)
- Clinical Supervisor - RN Hybrid ApplyRefer a FriendBack Job Details Requisition #: 208995 Location: Fall River, MA 02723 Category: Nursing Salary: $85,000.00 - ... per year Position Details Aveanna Healthcare is hiring a Nurse Supervisor in your area! Make a difference every...by being a part of the delivery of unmatched clinical care for Aveanna' s clients at home. Put… more
- Cardinal Health (Providence, RI)
- …to ensure a positive and satisfactory experience for all customers. The Supervisor, Clinical Operations monitors nurse to patient contact quality and provides ... manufacturers to rethink the reach and impact of their products. The Supervisor, Clinical Operations provides management and clinical oversight to a team of… more
- Fujifilm (Providence, RI)
- **Position Overview** The Clinical Consultant, MI - I shall be responsible for providing clinical consulting for the project, report configuration (CV), workflow ... go-live support to Synapse PACS/MI projects. In addition, provide clinical support for sales and company team members with...HCUS team to gain customer acceptance of the FUJIFILM Medical Systems solution. + Participates in teaching and training… more
- University Medicine (East Providence, RI)
- …Inc., a clinical , research and teaching affiliate of the Warren Alpert Medical School of Brown University. Clinical Psychologist + Seeking a psychologist to ... General Internal Medicine and Primary Care is seeking a Clinical Psychologist with an interest in Integrated Behavioral Health...based in Rhode Island. Brown Medicine is a nonprofit medical group with over 200 physicians and multiple patient… more
- Fresenius Medical Center (Attleboro, MA)
- …direct patient care staff on appropriate programs under the supervision of a nurse . + Provides developmental support to applicable clinical and facility staff. ... for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training...Related** + Participates in the recruitment process for new clinical staff + Assists with clinical orientation… more
- Zurich NA (Providence, RI)
- Sr Supplier Medical Process Specialist 128416 Zurich North America is seeking am experienced Sr. Supplier Medical Process Specialist to join our team in one of ... commitment to work/life balance, and outstanding culture. As a Sr. Supplier Medical Process Specialist, you will manage supplier performance and work product in… more
- Humana (Providence, RI)
- …our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... documentation and communication of medical services and/or benefit administration...of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge, communication skills,… more
- Charter Care Health Partners (North Providence, RI)
- …'s primary state of legal residency if that state is a member of the Nurse Licensure Compact. Five (5) years of clinical experience that includes recent ... or designee. Provides coordinated care support to Physician leadership and Clinical Manager(s) of respective services. Makes daily rounds and collaborates with… more
- CVS Health (Woonsocket, RI)
- …and is knowledgeable in clinically appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health and/or medical conditions ... it all with heart, each and every day. **Position Summary** Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit… more