- Mount Sinai Medical Center (Hialeah, FL)
- Care Management Nurse (Population Health) As Mount Sinai grows, so does our legacy in high-quality health care. Since 1949, Mount Sinai Medical Center has remained ... of all recommended preventive care services *Medication reconciliation with review of adherence and potential interactions *Oversight of patient self-management… more
- UnitedHealth Group (Long Island City, 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- Defense Health Agency (Fort Irwin, CA)
- …( HEDIS ) metrics, procedure preparation, wellness screening paperwork, etc. Review patient appointments, 24-78 hours prior to scheduled appointment and identifies ... **Overview** **Practical Nurse - FT Irwin,CA** **About the Position: This...assigned rooms for clinic schedule. Attends clinic huddle to review scheduled patients with Primary Care Manager to coordinate… more
- CareFirst (Baltimore, MD)
- …required in addition to the required work experience. **Licenses/Certifications Upon Hire Required:** RN - Registered Nurse Active State Licensure and/or ... as a resource for the nurses to conduct concurrent review for medical necessity and appropriate level of care...health care costs. **We are looking for an experienced Registered Nurse and people leader with UM/CM… more
- Humana (Madison, WI)
- …confidentiality. **Use your skills to make an impact** **Required Qualifications** + Registered Nurse ( RN ), physician or physician's assistant licensed ... raise the bar for excellence. Key responsibilities include: + Oversees HEDIS , CAHPS, Star ratings, and other State-required measure reporting and evaluation.… more
- University of Miami (Miami, FL)
- …Providers supervises advance d practice providers (APPs) ( ie, Advanced Registered Nurse Practitioners, Physician Assistants etc.). Key responsibilities of ... Medicare annual wellness exam documentation preferred + Knowledge of HEDIS Quality Care Gaps - review and...Knowledge of HEDIS Quality Care Gaps - review and closure preferred + Knowledge of Hierarchical Condition… more
- CenterWell (Savannah, GA)
- …to the strategic intent Overseeing other clinicians which includes Physicians, Advanced Registered Nurse Practitioners (ARNP), and Physicians Assistants (PA) in: ... inquiries, requests, and complaints from patients + Ongoing chart review / audit of clinical staff to ensure quality...Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice… more
- Praxis Health (Portland, OR)
- …+ Coordinate with centralized PXH/Regence teams to drive performance in: + HEDIS metric tracking + Transitional Care Management (TCM) + Annual Wellness Visit ... are included in the Interdisciplinary Team (IDT) agenda for review 3. High Emergency Room Utilization Oversight + Monitor...Required Education + High school diploma + Licensed Practical Nurse (LPN) or Highly Skilled MA + Basic Healthcare… more
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