- Immigration and Customs Enforcement (IN)
- …Deputy Assistant Director for Healthcare Compliance, Office of Health Plan Management. The Senior Utilization Review Consultant will report directly to the ... Responsibilities DUTIES AND RESPONSIBILITIES: Serves in the capacity of Senior Utilization Review Consultant and...preferred. Meet the minimum education requirements for either a nurse , nurse practitioner, or physician assistant … more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …we need: As an integral part of HMM Quality and Compliance team, the Senior Medicare Clinical Compliance Consultant works through the influence as an individual ... strategies. Your Day to Day: + With minimal oversight, leads CMS utilization management related compliance activities including: + Identify and implement new CMS… more
- State of Minnesota (St. Paul, MN)
- …Restricted Recipient Senior Investigator** **Job Class: Human Services Program Consultant ** **Agency: Human Services Dept** + **Job ID** : 76409 + **Location** ... Restricted Recipient Program (MRRP). Experience must demonstrate the following: _._ _Registered Nurse (RN) License._ _._ _Experience working with or for a Managed… more
- MyFlorida (Macclenny, FL)
- SENIOR REGISTERED NURSE SUPV - 60022045 Date: Apr 29, 2024 Location: MACCLENNY, FL, US, 32063 The State Personnel System is an E-Verify employer. For more ... Requisition No: 807710 Agency: Children and Families Working Title: SENIOR REGISTERED NURSE SUPV - 60022045 Position...supervised and maintain documentation in unit. Serve as a consultant to the Registered Nurse , Licensed Practical… more
- Highmark Health (Buffalo, NY)
- …+ Performs as the clinical subject matter expert for clinical, quality, care, utilization , high cost claim and population health management as the part of the ... client cultures and trends to better support behavior change by increasing senior level support, improving value proposition with a goal of focused interventions,… more
- Sharp HealthCare (La Mesa, CA)
- …within the Magnet Program requirements that functions in the following roles: leader, consultant , mentor, change agent. + California Registered Nurse (RN) - CA ... **Shift Start Time** **Shift End Time** Master's Degree in Nursing; California Registered Nurse (RN) - CA Board of Registered Nursing; Clinical Nurse Specialist… more
- The Arora Group (Bethesda, MD)
- Registered Nurse Case Manager Nurse Currently recruiting a Registered Nurse (RN) Case Manager to work the Directorate of Healthcare Operations (DHO) at ... provided one month in advance. DUTIES OF THE REGISTERED NURSE CASE MANAGER (RN): The contracted RN shall provide...needs, to identify potential barriers to optimal health, resource utilization , and methods for minimizing barriers. + Assist the… more
- Veterans Affairs, Veterans Health Administration (Spokane, WA)
- …a wide range of experience and leadership ability. Responsibilities The Associate Chief Nurse (ACN) provides senior leadership and oversight for daily clinical ... Summary The Registered Nurse - Associate Chief Nurse (ACN)...and oversight of program management to ensure proper resource utilization . Assisting with the creation of a diverse and… more
- MyFlorida (Haines City, FL)
- …and Obstetrics. + Plans workloads, workflows, deadlines, work objectives and time utilization with employees. Serves as consultant for coordination of clinical ... SENIOR COMMUNITY HEALTH NURSING SUPV - 64029392 1...TB programs). In addition, serves as charge and triage nurse as needed. Directly supervises employees working in the… more
- Cleveland Clinic (Akron, OH)
- …to serving the community and treating our patients as family. As a Senior Safety, Quality, and Patient Experience Specialist you will be directing safety, quality, ... compliance with all standards and favorable performance on safety, quality, utilization , and experience metrics. * Participating in engraining the safety, quality,… more
- HCA Healthcare (Miami, FL)
- …assistance (tuition, student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program (paid time off, ... care and clinical research. + Serve as a nursing consultant to other members of the multidisciplinary team. +...and optimal documentation, including but not limited to the utilization of risk assessment tools, proper time out … more
- CVS Health (Richmond, VA)
- …is a clinical leader in the Medicaid plan focusing on utilization management, integrating member care, clinical coordination, leading the development, implementation ... mental health services and addiction recovery and treatment services through the utilization management process + Drives collaboration on quality of care, … more
- CareFirst (Baltimore, MD)
- …Services Roles: + Clinical Navigator "Registered Nurse " + Care Manager "Registered Nurse " + Senior Business Consultant + Medical Policy Analyst ... "Registered Nurse " + Utilization Management Coordinator + Quality Manager + Senior Business Process Analyst _By applying, you are expressing interest in… more
- Sharp HealthCare (San Diego, CA)
- …Case Manager (ACM) - American Case Management Association (ACMA); California Registered Nurse (RN) - CA Board of Registered Nursing; Master's Degree; Certified ... to identify areas of risk and act as a consultant to the facility based ICM leaders to develop...at System and site level meetings. Represents the ICM Senior Leadership as needed. **Required Qualifications** + Bachelor's Degree… more
- Cleveland Clinic (Akron, OH)
- …compliance with all standards and favorable performance on safety, quality, utilization , and experience metrics. * Participating in engraining the safety, quality, ... data and participates in improvement strategy development. + Acts as a consultant in educating and evaluating clinical and support department staff regarding quality… more
- Health First (Melbourne, FL)
- …administration, physicians, departments, and staff to ensure cost-effective utilization of services and processes. * Disseminates best practice ... Care Services as a full member of the * Nurse Executive Team. * Participates in the strategic and...the beginning of the fiscal year. * Collaborates with Providers/ Senior Leadership/Directors/Managers to ensure personnel management in an efficient… more