• Clinical Advisor , RN

    CareFirst (Baltimore, MD)
    …2 years demonstrated experience with healthcare data analysis. **Licenses/Certifications Required:** + RN - Registered Nurse - State Licensure And/or Compact ... **_CANDIDATES MUST BE LOCAL TO MD, DC, VA_** **PURPOSE:** The Clinical Advisor 's role is multifaceted, involving data analytics, client facing presentations, and… more
    CareFirst (01/08/26)
    - Save Job - Related Jobs - Block Source
  • Clinical Documentation Integrity…

    Beth Israel Lahey Health (Burlington, MA)
    …States for consideration** The Clinical Documentation Improvement (CDI) Specialist Registered Nurse ( RN ) assists with the appropriate identification ... (SOI), Risk of Morality (ROM), during an inpatient hospitalization. CDI Specialist RN initiates concurrent queries to providers as supported by medical record… more
    Beth Israel Lahey Health (10/30/25)
    - Save Job - Related Jobs - Block Source
  • Behavioral Health Physician Advisor

    Carle Health (Champaign, IL)
    …Chief Medical Officer and works with our Utilization Management RN team, Clinical Denials Management team and the Physician Advisor Team which is comprised ... FTE and 100% Virtual) + The Behavioral Health Physician Advisor is responsible for conducting clinical case...Health Physician Advisor is responsible for conducting clinical case reviews referred by the Utilization Management Team,… more
    Carle Health (12/20/25)
    - Save Job - Related Jobs - Block Source
  • QAPI Clinical Service Ln Mgr ( RN

    UTMB Health (Galveston, TX)
    QAPI Clinical Service Ln Mgr ( RN ) Partial Remote (Sealy Heart & Vasc. Inst. - Galveston) **Galveston, Texas, United States** Nursing & Care Management UTMB ... REGISTRATIONS OR CERTIFICATIONS** Required: Valid state of Texas Professional Nursing ( RN ) license or clinical program professional registration Preferred: Six… more
    UTMB Health (01/09/26)
    - Save Job - Related Jobs - Block Source
  • Behavioral Health Care Advisor - Substance…

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …* Attend community events to engage with members. Required Skills and Experience * Registered nurse with current MN license and with no restrictions or ... Blue Cross and Blue Shield of Minnesota Position Title: Behavioral Health Care Advisor - Substance Use Disorders Location: Remote Career Area: Health Services… more
    Blue Cross and Blue Shield of Minnesota (12/17/25)
    - Save Job - Related Jobs - Block Source
  • Quality - Practice Transformation Advisor

    CVS Health (Springfield, IL)
    …Office products and VPN. Preferred: ▪ Licensed Allied Health Professional or Licensed Registered Nurse ▪ Coding or Sales background ▪ Certified Six Sigma ... and every day. APPLICANTS MUST RESIDE IN ILLINOIS The Quality Practice Transformation Advisor plays a critical role in supporting the highest standards of practice… more
    CVS Health (01/01/26)
    - Save Job - Related Jobs - Block Source
  • Clinical Denials Prevention & Appeals…

    Nuvance Health (Danbury, CT)
    *Description* *FULL TIME DAY SHIFTS- VARIABLE HOURS / WEEKEND ROTATIONS REQUIRED* * *Hybrid/ Remote * * *Summary:* The purpose of the Denial Prevention Nurse is to ... in preventing payment denials by providing timely and accurate clinical information to all payers, while ensuring compliance with...case still does not meet, send to the Physician Advisor (PA) for a second level review. * Forward… more
    Nuvance Health (12/10/25)
    - Save Job - Related Jobs - Block Source
  • Associate Quality Practice Advisor

    Centene Corporation (Lansing, MI)
    …Licensed Marital and Family Therapist (LMFT), Licensed Certified Social Worker (LCSW), Licensed Registered Nurse ( RN ), Acute Care Nurse Practitioner ... + Partners with physicians/physician staff to find ways to encourage member clinical participation in wellness and education. + Provides resources and educational… more
    Centene Corporation (01/06/26)
    - Save Job - Related Jobs - Block Source
  • HEDIS - Quality Practice Advisor

    Centene Corporation (Springfield, IL)
    …including a fresh perspective on workplace flexibility. NOTE: This is a hybrid remote role that meets directly with provider groups based in the Chicago area ... can provide support. + Develops, enhances and maintains provider clinical relationship across product lines. + Maintains Quality KPI...following required: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN , APRN, HCQM, CHP, CPHQ, CPC, CPC-A or CBCS… more
    Centene Corporation (01/06/26)
    - Save Job - Related Jobs - Block Source
  • Quality Practice Advisor

    Centene Corporation (Omaha, NE)
    …where Centene can provide support. + Develops, enhances and maintains provider clinical relationship across product lines. + Maintains Quality KPI and maintains good ... following required: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN , APRN, HCQM, CHP, CPHQ, CPC, CPC-A or CBCS...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
    Centene Corporation (01/09/26)
    - Save Job - Related Jobs - Block Source
  • Clinical Documentation Specialist Auditor…

    UNC Health Care (Chapel Hill, NC)
    …Association) certification - AAPC (American Academy of Professional Coders) certification - RN ( Registered Nurse ) license - LPN (Licensed Practical ... we serve. Summary: This positon trains and audits Inpatient and Outpatient Clinical Documentation Specialists (CDS) across all HCS entities that are owned or… more
    UNC Health Care (12/31/25)
    - Save Job - Related Jobs - Block Source
  • Staff Clinical Consultant

    Oracle (Frankfort, KY)
    clinical healthcare information technology (HCIT) work experience * Professional license required: Registered Nurse - State Board * Work in accordance with ... human, you've come to the right place. As a Clinical Consultant, you are responsible for driving the customer...100% travel.** We look forward to hearing from you! \# remote **Responsibilities** An experienced professional who is a domain… more
    Oracle (01/06/26)
    - Save Job - Related Jobs - Block Source
  • Adjunct Faculty Psychiatric Nursing/…

    Rowan College at Burlington County (Mount Laurel, NJ)
    Adjunct Faculty Psychiatric Nursing/ Clinical Print (https://www.schooljobs.com/careers/rcbcedu/jobs/newprint/2425383) Apply  Adjunct Faculty Psychiatric Nursing/ ... guidelines established by OIR. Specific Duties and Responsibilities Facilitate Nursing Clinical Instruction + Supervise and evaluate student progress in nursing… more
    Rowan College at Burlington County (12/04/25)
    - Save Job - Related Jobs - Block Source
  • Nurse Navigator Parkview

    UCHealth (Pueblo, CO)
    …Nursing program if less than 3 years experience. + State licensure as a Registered Nurse ( RN ). Relevant life support certification as determined at ... onsite role and does not offer a hybrid or remote option Summary: Serves as a patient advocate, liaison,...option Summary: Serves as a patient advocate, liaison, and advisor /educator to assist patients with navigating the continuum of… more
    UCHealth (12/20/25)
    - Save Job - Related Jobs - Block Source
  • Long Term Care Benefits Planner I/II (Rochester…

    Excellus BlueCross BlueShield (Rochester, NY)
    …opportunities. Level I: + Three (3) years combined experience in insurance and/or a clinical setting. + Active NYS RN License or bachelor's degree in social ... Rochester, NY Office. The LTC Benefits Planner (Personal Care Advisor ) has the responsibility of evaluating and managing those...work or related field. In lieu of an RN or bachelor's degree, an associate's degree or LPN… more
    Excellus BlueCross BlueShield (01/09/26)
    - Save Job - Related Jobs - Block Source
  • Vice President, Quality Management

    Centene Corporation (Raleigh, NC)
    …consistency of best practices for all members and providers. + Acts as advisor and consultant to business unit leadership on processed and outcomes related to ... and oversees the Delegated Oversight Department and ensures delegated provider and clinical vendor performance are in compliance. + Leads and participates in… more
    Centene Corporation (01/09/26)
    - Save Job - Related Jobs - Block Source
  • Theory Course Coordinator for the DNP…

    Johns Hopkins University (Baltimore, MD)
    …role ($5,000-5,200- Clinical Instructor) ($3,500-$7,000 Theory or Clinical Course Coordinator) ($1,750-$3,500- Co-Coordinator) ($3,500 Project Advisor ) ... learning and if applicable promote integration of content into any associated clinical course. The TCC must incorporate evidence-based practice into teaching and… more
    Johns Hopkins University (12/13/25)
    - Save Job - Related Jobs - Block Source