- Parkview Health (Fort Wayne, IN)
- …Licensure/Certification: Valid Indiana Registered Nurse license required. Certification in Case Management highly desirable. Experience: Required at least ... 2 years of experience in acute care setting. Preferred experience in Case Management activities. Preferred experience or knowledge of InterQual criteria. Other… more
- Sedgwick (Atlanta, GA)
- …as a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Case Management Specialist This person must live in Ohio in order ... the injured worker, employer, and medical providers, create a case management strategy to facilitate medical recovery...of the United States required. Bachelor's degree in nursing ( BSN ) from accredited college or university or equivalent work… more
- Veterans Affairs, Veterans Health Administration (Bay Pines, FL)
- …substantial coordinated group of activities impacting patients and/or employees. The QS Specialist may be assigned responsibility in risk management , peer ... planning, designing, integrating, implementing, modifying, and administering, a comprehensive quality management program area. The QS Specialist participates in… more
- Veterans Affairs, Veterans Health Administration (MO)
- …actively pursuing licensure (may be extended up to two years on a case -by- case -basis.) NOTE: Grandfathering Provision - All persons currently employed in VHA ... to Nurse I, Level 1 ;OR a Bachelor of Science in Nursing ( BSN ) with no additional professional nursing experience required. Nurse I, Level III Demonstrates… more
- Billings Clinic (Billings, MT)
- …(https://billingsclinic.csod.com/ats/careersite/search.aspx?site=15&c=billingsclinic) to learn more! Patient Safety Specialist PATIENT SAFETY (Billings Clinic Main ... every two weeks (Exempt) Starting Wage DOE:$40.91 - $51.14 Patient Safety Specialist is a position within the Patient Safety Department and Transformation Division… more
- AdventHealth (Orlando, FL)
- …each position may vary based on geographical location. **Category:** Case Management **Organization:** AdventHealth Orlando **Schedule:** Full-time **Shift:** ... medical/surgical, Intensive Care, post-acute care unit, or Emergency Department experience. + BSN and 3 years of Clinical Documentation Specialist experience +… more
- Cedars-Sinai (Marina Del Rey, CA)
- …remote workdays per week** , depending on departmental needs. The **Patient Safety Specialist ** is a clinical expert entrusted with the oversight and strategic ... management of the organization's policies and procedures. The role...processes, to ensure sustained optimal performance. The Patient Safety Specialist is dedicated to advancing patient safety and ensuring… more
- AdventHealth (Minneola, FL)
- …health setting and critical care **LICENSURE, CERTIFICATION, OR REGISTRATION PREFERRED:** + Case Management certification Accredited Case Manager (ACM) + ... each position may vary based on geographical location. **Category:** Case Management **Organization:** AdventHealth Minneola **Schedule:** Full-time **Shift:**… more
- United Therapeutics (Concord, NH)
- …with respect to ISCR processing and reporting. The Lead Pharmacovigilance QC Specialist provides strategic oversight of end-to-end case safety quality, ensuring ... a SME on evaluating and ensuring appropriate quality standards and adherence to case processing procedures. You are passionate about PV and enjoy partnering with… more
- Cedars-Sinai (CA)
- …patient care we strive for. **About the Team** **:** The Patient Safety Specialist is a highly motivated, reliable, clinical expert on internal and external patient ... identify potential or actual risk of harm to patients. The Patient Safety Specialist identifies and addresses the need for system opportunities in clinical practice,… more
- McLaren Health Care (Flint, MI)
- …Two (2) years clinical nursing experience. + One (1) year previous case management or utilization review experience. **Preferred:** + BSN . + Two (2) years' ... overuse of services. Collaborates with Medical Director and senior management on complex cases and specialist projects....experience in Managed Care Utilization Management , Medical Management , Case Management . + Two… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …**Minimum Experience:** + 1 year of clinical and/or related experience required. Case Management , Utilization Review and/or Prior Authorization experience is ... Working in a fast-paced, high volume, dynamic environment, the Clinical Authorization Specialist will bring clinical expertise to the prior authorization and appeals… more
- Geisinger (Danville, PA)
- …driver for overall System Case Mix Index. Job Duties The RN CDI Specialist acts as a liaison between the clinical and coding functions. Provides education to the ... of care of the patient. The role of the Clinical Documentation Improvement Specialist (CDIS) is to assist the providers with accurately identifying and documenting… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …for self and others to include but not limited to CEO, DBD, CLs and Case Management team that may help grow relationships and impact results. Maintains ... 40 hours** Using discretion and independent judgment, the **Payor Relations Specialist ** (PRS), **Acute Rehab** manages the pre-certification and prior authorization… more
- UTMB Health (Galveston, TX)
- …positive and open communication with physicians, members of the patient care team, case management , and hospital coding staff. + Adhere to internal controls ... Clinical Documentation Specialist (Remote -Texas Resident) - Clinical Data **Galveston,...is highly desirable.** + Bachelor of Science in Nursing ( BSN ). + CCDS or CDIP Certification. **Job Summary:** **Scope:**… more
- AdventHealth (Maitland, FL)
- …in acute care hospital discharge planning + One year of Experience Nursing, Case Management , and/or Social work **EDUCATION AND EXPERIENCE PREFERRED:** + Master ... Cardiac Life Support) certification **LICENSURE, CERTIFICATION, OR REGISTRATION PREFERRED:** + Case Management certification Accredited Case Manager (ACM)… more
- AssistRx (Orlando, FL)
- …system data entry quality. Within this role, the Quality Assurance Specialist serves customers by identifying, analyzing, and developing improvements in ... quality, internal team relationships, and customer service. The Quality Assurance Specialist regularly provides support to the department managers and director to… more
- Parkview Health (Fort Wayne, IN)
- …scheduling, and ED software preferred. Experience in pre-certification, utilization, or case management desirable. Previous coding experience desirable. Other ... Summary: The Patient Placement Specialist will be responsible for daily patient flow,...initial clinical care. Works collaboratively with Point of Entry Case Manager to ensure all patients have verified admission… more
- CommonSpirit Health Mountain Region (Colorado Springs, CO)
- …regulatory requirements, including attending physicians, allied health practitioners, nursing, and case management . + Support timely, accurate, and complete ... lead the way. Overview: As a Clinical Documentation Integrity (CDI) Specialist , you will work under indirect supervision, facilitate and obtain appropriate… more
- Nuvance Health (Danbury, CT)
- …per diem and percentage of charge reimbursement payers. * If concurrent inpatient case does not meet medical necessity review criteria during the first level review, ... documentation to support inpatient level of care. If the case still does not meet, send to the Physician...and communicating on a daily/regular basis with the Denials Management team. * Assists with informing Managed Care contracting… more