- WesleyLife (Des Moines, IA)
- …communities (eg, mock surveys) within our health centers and assisted living services to review clinical standards of practice as well as compliance with State ... to improve performance. + Facilitate the development and implementation of clinical systems and services related to Quality Assurance Performance Improvement (QAPI),… more
- WesleyLife (Johnston, IA)
- …on **joy** in your day-to-day work life, consider one of our roles. From clinical positions to hospitality roles to administrative positions, we offer all our team ... as the people whose lives they touch. **A Typical Day for a RN, Clinical Quality Specialist:** + You will serve the organization in a provisional status, providing… more
- WesleyLife (Urbandale, IA)
- …growth and purpose. Come be a part of the revolution! ? **About the Role: Registered Nurse Case Manager** As a Registered Nurse Case Manager, you'll play a key ... happiness, and daily experience of the residents at Wesley at Home. **As a Registered Nurse Case Manager, you will:** + You will have the opportunity to directly and… more
- WesleyLife (Johnston, IA)
- …ICD-10 coding. + Set and complete accurate MDS ARDs. + Collaborate with all clinical teams to ensure care plans are accurate and thorough. + Follow corporate ... routinely update for resolved or new diagnoses. + Participate in oversight, review , and improvement plans related to Quality Measures. **Qualifications:** + Must… more
- WesleyLife (West Des Moines, IA)
- …and purpose. Come be a part of the revolution! ? **About the Role: Registered Nurse ** As an RN, you'll play a key role in supporting the health, happiness, and ... care plans in collaboration with the interdisciplinary team. + Monitor clinical outcomes and assist in implementing quality improvement initiatives to improve… more
- Actalent (West Des Moines, IA)
- …duties as assigned, complying with all policies and standards. Essential Skills + Clinical review experience. + Case management expertise. + Health informatics ... Prior Authorization Nurse Job Description This...of medical care. Responsibilities + Perform medical necessity and clinical reviews of authorization requests to determine the appropriateness… more
- Actalent (West Des Moines, IA)
- Description + Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national ... quality and cost effectiveness of medical care.\\Performs medical necessity and clinical reviews of authorization requests to determine medical appropriateness of… more
- Elevance Health (West Des Moines, IA)
- ** Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 ... to recover, eliminate and prevent unnecessary medical-expense spending. The ** Clinical Fraud Investigator II** is responsible for identifying issues and/or… more
- Sharecare (Des Moines, IA)
- … helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their ... more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and...and to take the pre and post tests to review competency during orientation. Yearly competency tests are required… more
- WesleyLife (Johnston, IA)
- …growth and purpose. Come be a part of the revolution! **About the Role: Registered Nurse Supervisor** As a Registered Nurse Supervisor, you'll play a key role in ... the residents at Brio in Johnston. **As a Registered Nurse Supervisor, you will:** + Oversee Staff and Patient...training and mentorship to nursing staff, helping them develop clinical skills, stay current on best practices, and maintain… more
- Elevance Health (West Des Moines, IA)
- **Telephonic Nurse Case Manager II** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person training ... different states; therefore Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for performing care management within… more
- Fresenius Medical Center (Des Moines, IA)
- …regulations at: https://content.intranet.fmcna.com/regulatory-affairs/wp-content/uploads/sites/46/2019/05/Pre-Licensed- Nurse -50-State- Review ... of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a...for other staff members. + Routinely meets with the Clinical Manager to discuss personnel and patient care status,… more
- CenterWell (Des Moines, IA)
- …with the ability to obtain Compact Nursing License + A minimum of three years clinical RN experience; + Prior clinical experience, managed care experience, ... actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that… more
- Select Medical (Des Moines, IA)
- …highly effective level of care. **Qualifications** **What we're looking for in a Clinical Liaison** **Required Skills:** + Registered Nurse (RN) or Respiratory ... + Will consider other designations like LPN, PT, OT, etc., upon further review . + Ability to complete clinical assessments of medically complex patients.… more
- Molina Healthcare (Des Moines, IA)
- …of high speed required. JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that ... For this position we are seeking a (RN) Registered Nurse who must be licensed for the state they...years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent… more
- Molina Healthcare (Des Moines, IA)
- …review , and medical coding. JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying ... For this position we are seeking a (RN) Registered Nurse who must hold a compact license. This is...years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent… more
- Molina Healthcare (Des Moines, IA)
- JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... least 2 years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent combination of relevant… more
- Molina Healthcare (Des Moines, IA)
- JOB DESCRIPTION **Job Summary** The Care Review Clinician (RN) provides support for clinical member services review assessment processes. Responsible for ... least 2 years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent combination of relevant… more
- Molina Healthcare (Des Moines, IA)
- JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for ... least 2 years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent combination of relevant… more
- Molina Healthcare (Des Moines, IA)
- JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... least 2 years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent combination of relevant… more
