• California Practice Staff (Modesto, CA)
    …and staffing Assists the physician as follows, but not limited to Utilization Review , Quality Assurance , Program Evaluation, Infection Control, Safety ... of nursing: Master's degree in nursing; completion of a state acceptable Nurse Practitioner's program Certification: Advanced Nurse Practitioner license to… more
    job goal (12/24/25)
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  • University Health (Hondo, TX)
    …full time hospital experience preferred. Work experience in case management, utilization review , or hospital quality assurance experience is preferred. ... setting by gathering information, coordinating utilization efforts, and reviewing HCC quality indicators, and RAF scores to eligible Medicare Advantage beneficiary.… more
    job goal (12/24/25)
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  • University of New Mexico - Hospitals (Albuquerque, NM)
    …short-term and long-term patient responses to interventions in collaboration with quality assurance and utilization review , maintaining interdependent ... Management - UHFTE: 1.00Full TimeShift: DaysPosition Summary:Responsible for the initial review , triage and assignment of patients to case managers and for… more
    job goal (12/23/25)
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  • VitalCore Health Strategies (Munising, MI)
    …Life Support (BLS) Certification. Must have knowledge of managed healthcare systems, medical quality assurance , quality improvement and risk management is ... retaining and acquiring hardworking ethical individuals who are committed to providing quality services. Join our team and experience first-hand how VitalCore Health… more
    job goal (12/23/25)
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  • University Health (San Antonio, TX)
    …recent, full-time hospital experience preferred. Work experience in case management, utilization review or hospital quality assurance experience is ... hire date. LICENSURE/CERTIFICATION Current license from the Board of Nurse Examiners of the State of Texas to practice...the State of Texas to practice as a registered nurse is required. National certification in related field is… more
    job goal (12/24/25)
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  • VitalCore Health Strategies (Georgetown, DE)
    …Director is responsible for providing clinical leadership, medical oversight, and quality assurance for healthcare services delivered within the correctional ... retaining and acquiring hardworking ethical individuals who are committed to providing quality services. Join our team and experience first-hand how VitalCore Health… more
    job goal (12/21/25)
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  • Quality Assurance Coordinator - RN

    Prime Healthcare (Weslaco, TX)
    …referred to as a Performance Improvement Nurse Coordinator or Stroke Program Nurse Coordinator . Quality Assurance RN Coordinator for our Performance ... Overview QUALITY ASSURANCE RN COORDINATOR We are...Activities include but are not limited to integrity reliability review , medical chart reviews, data abstraction for CMS Core… more
    Prime Healthcare (12/02/25)
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  • Nurse Manager 1 (1st shift) - South…

    Commonwealth of Pennsylvania (PA)
    …Work Behavior as a charge nurse , head nurse , utilization review nurse , quality assurance nurse , or an industrial, employee or public health ... Behavior as a charge nurse , head nurse , utilization review nurse , quality assurance nurse , or an industrial, employee or public health … more
    Commonwealth of Pennsylvania (12/22/25)
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  • Practical Nurse /Vocational Nurse

    Defense Health Agency (Colorado Springs, CO)
    …Room, Surgery, Lead Practical Nurse , Orthopedic/Podiatry, Supervisory Practical Nurse , Dermatology, Quality Assurance Evaluation, Gastroenterology, ... **Overview** Practical Nurse , Fort Carson, CO Fort Carson, CO: Located...and emotional needs of the patient. + Screen and review immunization records to select required immunizations, correct dosages,… more
    Defense Health Agency (12/23/25)
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  • Registered Nurse PT

    Koniag Government Services (Dock Junction, GA)
    …levels to the Clinic Nurse Manager + Participate in Quality Assurance activities, data analysis and review to make improvements within clinic operations. ... Koniag Government Services company **,** is seeking a Registered Nurse - Part- Time to support **KOS** and our government...+ Report site-specific problems to the Clinic Nurse Manager (eg, staffing difficulties, supply issues, environment of… more
    Koniag Government Services (10/20/25)
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  • Nursing Supervisor (Adult Hospitals: University…

    University of Michigan (Ann Arbor, MI)
    …+ Board all add-on/trauma/urgent cases + Coordinate communication hand-off to Midnight Charge Nurse Quality Assurance and Research + Assists in the ... collaboration, and peer review are exercised + Plan, coordinate and evaluate quality assurance activities + Participate in the development of patient care… more
    University of Michigan (12/03/25)
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  • DRG Clinical Dispute Reviewer

    Zelis (St. Petersburg, FL)
    …and Operations teams regarding important issues and trends. + Ensure adherence to quality assurance guidelines. + Monitor, research, and summarize trends, coding ... and support ad hoc projects, including time-sensitive requests. + Ensure adherence to quality assurance guidelines. + Maintain awareness of and ensure adherence… more
    Zelis (12/17/25)
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  • Inpatient DRG Sr. Reviewer

    Zelis (NJ)
    …is responsible for conducting post-service, pre-payment and post pay comprehensive inpatient DRG Quality Assurance reviews in an effort to increase the savings ... specific coverage policies. What you'll do: + Perform comprehensive inpatient DRG validation Quality Assurance reviews to determine accuracy of the DRG billed,… more
    Zelis (10/03/25)
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  • Senior Nurse Consultant

    PruittHealth (Columbia, SC)
    …**JOB PURPOSE:** Senior Nurse Consultant assumes responsibility for conducting quality assurance reviews in the assigned facilities. Senior Nurse ... of resident and facility information. 8. Able to assist in coordination of Quality Assessments and Assurance activities with Nursing Home Administrator and DON… more
    PruittHealth (11/30/25)
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  • RN - Quality Assurance /Utilization…

    Emanate Health (Covina, CA)
    …and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity by ... using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete medical necessity and… more
    Emanate Health (12/06/25)
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  • Quality Assurance Coordinator-…

    Bozeman Health (Bozeman, MT)
    The Interfacility Transport Team (IFT) Quality Assurance Coordinator is responsible for overseeing and managing the quality assurance processes within ... ensure the highest transport standards are met. The IFT Quality Assurance Coordinator will work alongside Bozeman...in Nursing (BSN). + Current State of Montana Registered Nurse (RN) license. + Current Basic Life Support (BLS),… more
    Bozeman Health (12/04/25)
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  • Quality /Utilization Review

    George C. Grape Community Hospital (Hamburg, IA)
    Quality /Utilization Review Nurse Position Summary: The Quality /Utilization Review Nurse is responsible for evaluating the medical necessity, ... with insurance providers for pre-certifications, continued stay reviews, and authorizations. * Quality Assurance : o Monitor compliance with hospital quality more
    George C. Grape Community Hospital (11/25/25)
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  • Call Center Quality Assurance

    AssistRx (Orlando, FL)
    …well as system data entry quality . Within this role, the Quality Assurance Specialist serves customers by identifying, analyzing, and developing improvements ... productivity, quality , internal team relationships, and customer service. The Quality Assurance Specialist regularly provides support to the department… more
    AssistRx (11/11/25)
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  • Quality Assurance Coordinator

    Hackensack Meridian Health (Edison, NJ)
    …mission to transform healthcare and serve as a leader of positive change. The ** Quality Assurance Coordinator** evaluates patient care quality by using ... also supports the medical staff quality program and medical staff quality review committees and requires effective communication and collaboration with… more
    Hackensack Meridian Health (11/20/25)
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  • RN, Quality Assurance

    University of Rochester (Rochester, NY)
    …preferred - Clinical chart review and abstraction experience preferred - Quality Assurance and Process Improvement (QA/PI) experience preferred LICENSES AND ... of strict inclusion/exclusion criteria and protocols. Performs meticulous chart review and enters clinical data into the quality...CERTIFICATIONS - RN - Registered Nurse - State Licensure and/or Compact State Licensure Current… more
    University of Rochester (11/06/25)
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