• Clinical Compliance

    Highmark Health (Augusta, ME)
    …Description :** **JOB SUMMARY** This job is responsible for working with HHO clinical departments in the areas of compliance and process improvement. Serves ... as a corporate resource regarding accreditation standards, clinical performance and continuous improvement...maintenance of Care Management policies and procedures to ensure accreditation and compliance with NCQA and DMMA… more
    Highmark Health (06/28/25)
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  • Quality & Compliance Nurse…

    Woodlands Senior Living LLC (Augusta, ME)
    …and inclusive work environment. What you will do as a Quality & Compliance Coordinator : + Collaborates with multidisciplinary teams to conduct regular visits ... Quality & Compliance Nurse Coordinator Augusta, ME (http://maps.google.com/maps?q=108+Anthony+Ave+Augusta+ME+USA+04330-8089) * Admin Job Type Full-time… more
    Woodlands Senior Living LLC (04/23/25)
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  • Advanced Practice Nurse - (Certified Nurse…

    Veterans Affairs, Veterans Health Administration (Togus, ME)
    …satisfaction among patients and staff, as well as meet and exceed compliance standards. Provides anesthetic services within five general categories to include: ... induction, maintenance, and emergence; post anesthesia care; peri-anesthetic and clinical support functions; and emergency response techniques. Develops and… more
    Veterans Affairs, Veterans Health Administration (06/15/25)
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  • Senior Social Worker - Residential Rehabilitation…

    Veterans Affairs, Veterans Health Administration (Togus, ME)
    …with VISN for referrals to RRTP Programs in VISN 1.Position will oversee clinical case management in Domiciliary to ensure compliance and clinical ... Act as a consultant to other team/staff members and take a lead clinical role in case consultation. Fulfill ethical responsibilities to Veterans, colleagues and VA… more
    Veterans Affairs, Veterans Health Administration (06/20/25)
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  • Case Manager, Registered Nurse - Oncology,…

    CVS Health (Augusta, ME)
    …clients. + Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory ... and/or member's needs to ensure appropriate administration of benefits. + Applies clinical judgment to the incorporation of strategies designed to reduce risk… more
    CVS Health (06/28/25)
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  • Registered Nurse, Case Manager - Oncology…

    CVS Health (Augusta, ME)
    …clients. - Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory ... and/or member's needs to ensure appropriate administration of benefits. - Applies clinical judgment to the incorporation of strategies designed to reduce risk… more
    CVS Health (06/25/25)
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  • Telephonic Nurse Case Manager

    Humana (Augusta, ME)
    …to maximize each beneficiary's capacity for self-care, to cost-effectively achieve desired clinical outcomes and to enhance quality of medical care. The case manager ... of case management involvement. The case manager will serve as the primary coordinator and point of contact for the beneficiary for all activities within the… more
    Humana (07/01/25)
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