- Monte Nido (West Linn, OR)
- …while providing the opportunity for people to realize their healthy selves. ** Nurse Manager** **Monte Nido Portland** **Located in** **_West Linn, Oregon_** **Monte ... necessary for their personal recovery. We are seeking a ** Nurse Manager** to lead the Nursing team. Monte Nido...client to include treatment plans and discharge summaries. 5. Review and document employee performance 90 days after hire,… more
- Actalent (Portland, OR)
- Job Title: Clinical Review Nurse - Prior Authorization Location: Remote (this position is looking for east coast nurses who would be willing to help out the ... 8:00 AM-5:00 PM PST (occasional weekend/holiday rotation) Position Summary The Clinical Review Nurse will conduct medical necessity reviews for prior… more
- Actalent (Portland, OR)
- …of Nursing or Bachelor's degree in Nursing. + 2-4 years of related experience in clinical review or prior authorization. + LPN - Licensed Practical Nurse ... Job Title: Medical Authorization Review Specialist Job Description We are seeking a...cost-effective medical care. Responsibilities + Perform medical necessity and clinical reviews of authorization requests to determine the medical… more
- Molina Healthcare (Vancouver, WA)
- JOB DESCRIPTION **Job Summary** The Medical Claim Review Nurse provides support for medical claim review activities. Responsible for ensuring timely claims ... coding experience including diagnosis. Candidates with knowledge of CPT/HCPCS codes, record review , chart audit, provider disputes, appeals, and 1500 & UB04 claim… more
- Molina Healthcare (Vancouver, WA)
- …identified by the Payment Integrity analytical team; requires decision making pertinent to clinical experience + Documents clinical review summaries, bill ... Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing clinical... review , and medical coding. **Job Summary** Utilizing clinical knowledge and experience, responsible for review … more
- The Cigna Group (Portland, OR)
- …retention, and network performance. **OVERVIEW:** + TheNurse ExecutiveSalesSpecialist, trusted Clinical Leader, Educator and Advocate, is closely aligned with ... trendsand maintains a working knowledge of Cigna business segment strategies, clinical programs, services and operational processes necessary to educate and provide… more
- Fresenius Medical Center (Portland, OR)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
- CVS Health (Portland, OR)
- …ability to drive long distances **Preferred Qualifications:** + Long term care clinical experience **Education:** + Licensed Practical Nurse or Licensed ... with heart, each and every day. **Job Purpose and Summary:** The Field Nurse LPN will conduct quality reviews and provide education specific to medication compliance… more
- Surgery Care Affiliates (Wilsonville, OR)
- …do it. Each decision we make is rooted in seven core values: + Clinical quality + Integrity + Service excellence + Teamwork + Accountability + Continuous improvement ... Audit reports; Monthly or quarterly data collection from ongoing systematic chart review to assess quality of documentation. + Infection Control reports + Hospital… more
- BioLife Plasma Services (Portland, OR)
- …Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. BioLife Plasma Services is a subsidiary of ... determine donor eligibility to donate plasma, management of donor adverse events, review of laboratory test results, and donor notification of unsuitable test… more
- BioLife Plasma Services (Vancouver, WA)
- …Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. BioLife Plasma Services is a subsidiary of ... determine donor eligibility to donate plasma, management of donor adverse events, review of laboratory test results, and donor notification of unsuitable test… more
- Fresenius Medical Center (Clackamas, OR)
- …dialysis treatments in the comfort of their home, often even as they sleep! Great clinical skills and a passion for patient education required, but we are able to ... our team members, we have built an atmosphere of clinical excellence and trust. Offering vast resources, we advance...the Home Dialysis Team as the Home Therapy Staff Nurse . Ensures provision of quality Home Dialysis Training and… more
- Surgery Care Affiliates (Portland, OR)
- …do it. Each decision we make is rooted in seven core values: + Clinical quality + Integrity + Service excellence + Teamwork + Accountability + Continuous improvement ... team today! We are actively hiring for an Registered Nurse (RN) PreOp PACU. + Promote the mission, vision,...with other disciplines as needed. + Participate in quality review and performance improvement projects. + Participate in the… more
- CenterWell (Lake Oswego, OR)
- …policies and standards. + Assesses staff education needs based on own the review of clinical documentation in addition to feedback and recommendations by ... caring community and help us put health first** The ** Clinical Manager** coordinates and oversees all direct care patient...Utilization Review staff. Upon completion of the assessment, creates and… more
- Providence (Beaverton, OR)
- …best people, we must empower them.** **Providence Health Plan is calling a Clinical Program Coordinator RN, Medicare / Medicaid who will:** + Provide care ... are terminal and nearing end of life + Care management services include: nurse education, care coordination and general assistance with managing day to day… more
- Molina Healthcare (Vancouver, WA)
- …and other data in support of annual HEDIS project management and ongoing review of medical records submitted by providers. + Implements Molina Healthcare goals ... completion of any of the following programs: + Registered Nurse (RN) or State Licensed Vocational Nurse ...collection and abstraction * 2+ years of medical record review experience **REQU** **I** **RED L** **I** **C** **E**… more
- Molina Healthcare (Vancouver, WA)
- JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery… more
- Molina Healthcare (Vancouver, WA)
- JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery… more
- Molina Healthcare (Vancouver, WA)
- JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery… more
- Molina Healthcare (Vancouver, WA)
- …compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical ... in consistent and efficient manner. + Makes appropriate referrals to other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care… more
