• Clinical Compliance

    Highmark Health (St. Paul, MN)
    …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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  • MDS Coordinator - RN, Registered Nurse…

    Good Samaritan (Inver Grove Heights, MN)
    …in Nursing (ACEN), or National League for Nursing Commission for Nursing Education Accreditation (NLN CNEA). Minimum of two years' clinical experience preferred. ... rehabilitation services. This full-time 40 hours per week MDS Coordinator will be a part of our management team....to evaluate outcomes based on an integration among established clinical , financial and utilization data. Functions in structured and… more
    Good Samaritan (07/09/25)
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  • Case Manager, Registered Nurse - Oncology,…

    CVS Health (St. Paul, MN)
    …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 (St. Paul, MN)
    …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 factors… more
    CVS Health (06/19/25)
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