- Luminis Health (Lanham, MD)
- Position Objective: To promote the delivery of high- quality , cost-effective health care through the provision of expert clinical education and professional ... to perform the essential functions Provides professional support to internal and external customers that meet the needs of their diverse age and cultural… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The role of the Nurse , Quality Review Utilization Management (UM) is to evaluate clinical quality and procedures ... Collaborates with utilization management to develop procedures and reinforce quality standards to support critical-thinking skills and provide and/or facilitate… more
- STG International (Rockville, MD)
- …communicate with fellow team members, internal, and external customers. Exam Processing Quality and Safety + Ensure case review processing timeframes and ... STGi is currently seeking a Registered Nurse -Case Review Specialist . The position...+ Suggest process improvements to PM to ensure that quality and efficiency goals for the case review… more
- Veterans Affairs, Veterans Health Administration (Bronx, NY)
- Summary The Bronx VA Medical Center is recruiting for (1) full-time Registered Nurse Risk Manager reporting to the Quality and Patient Safety service at the ... medical management of the patient, and assurance of compliance with internal and external regulatory requirements and standards. The Nurse Risk Manager is… more
- Minnesota Visiting Nurse Agency (Minneapolis, MN)
- …may require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for evaluating the ... guidelines and evidence-based practice * Quality of Practice*: * Promotes quality through evidence-based utilization review processes and actively contributes… more
- US Tech Solutions (Chicago, IL)
- …experience with Utilization Review ? + Do you have an Active Registered Nurse License? **About US Tech Solutions:** US Tech Solutions is a global staff ... development and ongoing implementation of QM Work Plan activities. + Improve quality products and services, by using measurement and analysis to process, evaluate… more
- Beth Israel Lahey Health (Boston, MA)
- …the online Quality Improvement reporting system: Ensures timely and satisfactory review of cases, data trending, and coordinates root case analysis of all ... and Community. Ensures ongoing participation in and compliance with departmental quality initiatives, provides education for staff and collects and maintains data… more
- Albany Medical Center (Albany, NY)
- …America) Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. * Completes ... Utilization Management and Quality Screening for assigned patients.* Applies MCG criteria to monitor appropriateness of admissions and continued stays, and documents… more
- US Tech Solutions (May, OK)
- …development and ongoing implementation of QM Work Plan activities. . Improve quality products and services, by using measurement and analysis to process, evaluate ... to meet QM objectives Responsibilities: . Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations.… more
- Bon Secours Mercy Health (Newport News, VA)
- …accreditation, and certification surveys in successful completion. + Prepares and submits quality reports as required by external agencies and payors.Facilitates ... improvement committees and projects as needed. + Supports Medical Staff Quality and Peer Review . + Promotes practices that detect, mitigate or prevent harm using… more
- Sanford Health (Rapid City, SD)
- …care planning, facilitation and coordination of discharge needs. Enhances the quality of clinical outcomes and patient satisfaction while managing the cost ... to inter-professional teams when necessary. Initiates links with post-acute external care resources. Anticipates and/or identifies patient educational needs,… more
- Huron Consulting Group (Chicago, IL)
- … Review Preparation: Assists in preparation for on-site reviews by outside review organizations and ensures readiness for external evaluations. + Standards of ... for planning, organizing, developing, and directing implementation of the Utilization Review Plan and the overall operation of the Utilization Management Department… more
- US Tech Solutions (RI)
- **Job Description:** + Responsible for the review and evaluation of clinical information and documentation. + Reviews documentation and interprets data obtained from ... provider issues. + Independently coordinates the clinical resolution with internal/ external clinician support as required. **Responsibilities:** + Reviews documentation… more
- Stanford Health Care (Palo Alto, CA)
- …vital role in the management of post-operative cardiac surgery patients, providing high- quality care in a fast-paced and critical environment. This position offers ... feedback, and educational opportunities. Supervise and support student learners ( nurse practitioner and physician assistant students) during clinical rotations. Work… more
- Beth Israel Lahey Health (Needham, MA)
- …Educator Team Nurse will perform all of the duties of a Team Nurse , including: a. Coordinate and facilitate quality clinical management of a broad based ... to be a leader in patient experience, provider and care team work life and quality of care both regionally and nationally. Additionally we are working to establish a… more
- Ventura County (Ventura, CA)
- …the Senior Medical Management Nurse is responsible for performing utilization review , case management, and quality improvement functions to ensure that ... two (2) years of full-time experience in Case Management, Disease Management, Quality Assurance, HEDIS and/or Utilization Review . NECESSARY SPECIAL REQUIREMENTS… more
- Penn Medicine (Philadelphia, PA)
- …roles, accountabilities and performance measures to all staff. * Identify unit quality metrics, review and track regularly. * **Regulatory Compliance (In ... has a great career opportunity to be the next Nurse Manager of 5 Cathcart/5 Schiedt, our 62-bed Medical-Surgical...as our care delivery model to provide the highest quality of care. Our physicians, nurses, and patient care… more
- University of Utah (Salt Lake City, UT)
- …as a change strategist, implementor and/or recipient by participating in continuous quality initiatives, internal and external committees designed to promote ... **Open Date** 01/07/2026 **Requisition Number** PRN43960B **Job Title** PS Clinical Nurse Specialist **Working Title** Clinical Research Nurse **Career… more
- Veterans Affairs, Veterans Health Administration (Fayetteville, AR)
- …and rules and procedures in addition to maintaining a working knowledge of other external review procedures are needed to (1) assists with accurate submission of ... Summary The Accreditation Coordinator, Registered Nurse (RN), is responsible for utilizing the nursing...and practice principles to ensure the delivery of safe high- quality , patient-centered care at Veterans Health Care System of… more
- State of Colorado (Denver, CO)
- Registered Nurse , Health Compliance Inspector Home Care - FAA00601 (HP III RN) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5183355) Apply ... Registered Nurse , Health Compliance Inspector Home Care - FAA00601 (HP..., you will use your clinical expertise to ensure quality of care, protect patient rights, and promote excellence… more
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