- Humana (Augusta, ME)
- …Manager, Fraud and Waste Investigator: Nurse Audit/ Review performs clinical audit/validation processes to ensure that medical record documentation and ... approach, resources, schedules and goals. The Manager, Fraud and Waste Investigator: Nurse Audit/ Review validates and interprets medical documentation to… more
- Veterans Affairs, Veterans Health Administration (Togus, ME)
- …preceptor providing didactic and clinical instruction in anesthesia to student nurse anesthetists, medical and dental residents, and other health care ... determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.… more
- Humana (Augusta, ME)
- …in preparation of cases prior to review by the Humana G&A Medicare Medical Directors. The Nurse reviews the medical documentation, researching claims, ... and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to...Medical Directors on submitted G&A cases. The G&A Nurse will participate in initiatives which result in improved… more
- Northern Light Health (Pittsfield, ME)
- Northern Light Sebasticook Valley Hospital Department: Medical Surgical Unit Position is located: {Pittsfield} Work Type: Full Time Hours Per Week: 36 Hour/Week Work ... (minus tax) sign on bonus that is paid out incrementally. Summary: The Registered Nurse I is a Registered Nurse who is a beginning professional caregiver,… more
- Veterans Affairs, Veterans Health Administration (Togus, ME)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... Responsibilities This Registered Nurse - Outpatient Clinic Hospice and Palliative Care position...Provide education and collaborate with interdisciplinary teams throughout the Medical Center. Coordinate hospice and palliative care referrals for… more
- Humana (Augusta, ME)
- …and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis ... independent determination of the appropriate courses of action. The Nurse Auditor 2 validates and interprets medical ...coding experience to conduct a clinical validation review of the inpatient medical record to… more
- CVS Health (Augusta, ME)
- …benefit overall claim management. + Using a holistic approach, consults with clinical colleagues, supervisors, Medical Directors and/or other programs to ... in the US with virtual training.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993,… more
- Datavant (Augusta, ME)
- …years of CDI experience + 3+ years of clinical experience in an academic medical center + Registered Nurse license, Bachelor's degree in Nursing + CCDS or ... realize our bold vision for healthcare. **What We're Looking For:** As a Clinical Documentation Quality Improvement (CDQI) Specialist, you will play a pivotal role… more
- Highmark Health (Augusta, ME)
- …over a specified panel of members that range in health status/severity and clinical needs; and assesses health management needs of the assigned member panel and ... utilizing data/analytics in conjunction with professional clinical judgement to identify the right clinical intervention for each member. The incumbent conducts… more
- Cardinal Health (Augusta, ME)
- …to ensure a positive and satisfactory experience for all customers. The Supervisor, Clinical Operations monitors nurse to patient contact quality and provides ... manufacturers to rethink the reach and impact of their products. The Supervisor, Clinical Operations provides management and clinical oversight to a team of… more
- Fujifilm (Augusta, ME)
- **Position Overview** The Clinical Consultant, MI - I shall be responsible for providing clinical consulting for the project, report configuration (CV), workflow ... go-live support to Synapse PACS/MI projects. In addition, provide clinical support for sales and company team members with...HCUS team to gain customer acceptance of the FUJIFILM Medical Systems solution. + Participates in teaching and training… more
- Zurich NA (Augusta, ME)
- Sr Supplier Medical Process Specialist 128416 Zurich North America is seeking am experienced Sr. Supplier Medical Process Specialist to join our team in one of ... commitment to work/life balance, and outstanding culture. As a Sr. Supplier Medical Process Specialist, you will manage supplier performance and work product in… more
- Fresenius Medical Center (Gardiner, ME)
- …dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance ... and/or change in patient condition directly to the registered nurse or supervisor. + Observe patient and conduct machine...activities. + Enters all treatment data into the designated clinical application in an accurate and timely manner. +… more
- Datavant (Augusta, ME)
- …Prevention Specialist is to effectively defend utilization of available health services, review of admissions for medical necessity and necessity of continued ... necessity criteria and standards of care, along with clinical knowledge and expertise successfully. Ideal candidate should be...to author appeal letter Identification of referrals to the medical director for review + Select appropriate… more
- CVS Health (Augusta, ME)
- …and is knowledgeable in clinically appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health and/or medical conditions ... it all with heart, each and every day. **Position Summary** Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit… more
- Veterans Affairs, Veterans Health Administration (Togus, ME)
- …by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Contact VHA EDRP Program Support ###@va.gov, for ... care patients. The Assistant Primary Care Service Line Manager will have Clinical and Administrative Responsibilities for the CBOC's. All physicians comply with… more
- Veterans Affairs, Veterans Health Administration (Togus, ME)
- …VHA Education Loan Repayment Services program office after EDRP application review . Former EDRP participants are ineligible to apply. Responsibilities In conjunction ... with the surgical or medical attending physician and other consultants, the Pulmonologist/Intensivist (hereafter PI) directs the care of all patients in the… more
- Northern Light Health (Belfast, ME)
- …improve mental health, and in conjunction with the primary care provider, improve medical health to adults with serious and persistent mental illness and children ... providers in support of client's treatment plan, including, but not limited to BHH Nurse Care Managers and Peer Support staff, in a regular and professional manner +… more