- Centers for Independence (Waukesha, WI)
- **Registered Nurse Clinician - CRC Waukesha** **Job Details** **Job Location** CRC Waukesha - Waukesha, WI **Position Type** Full Time **Education Level** Bachelor's ... educational and policy materials in clinical field manuals. 16. Write and review consumer incident reports and ensure proper follow-up. Ensure Director receives a… more
- Walworth County (Elkhorn, WI)
- …Selection Process Formal Walworth County Electronic Application Education & Experience Review Verification of Registered Nurse License Oral Department Interview ... experience with medical terminology. Certificates, Licenses, Registrations Wisconsin Registered Nurse license through WI Department of Safety and Professional… more
- Fresenius Medical Center (Brookfield, WI)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... including efficient utilization of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and on-site state or… more
- Evolent (Madison, WI)
- …The Specialty Appeal nurses work with a group of nurses, providing appeal intake review for one dedicated client. They interact with coordinators who set up the ... appeal, Physicians and other Clinicians who review the appeal, and managers for direction and leadership. The Appeals teamwork strategies and opportunities for… more
- CenterWell (Madison, WI)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... focuses on excellent service to others. **Required Qualifications** + Active RN license + Possession of or ability to obtain Compact Nursing License + A minimum of three years clinical RN experience; + Prior clinical experience, managed care experience, **OR**… more
- CenterWell (Madison, WI)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... focuses on excellent service to others. **Preferred Locations:** Daytona, FL, Louisville, KY, San Antonio, TX **Use your skills to make an impact** **Role Essentials** + Active RN license + Possession of or ability to obtain Compact Nursing License + A minimum… more
- SSM Health (Fond Du Lac, WI)
- …leadership and applies clinical knowledge to ensure the medical staff peer review process is effective in evaluating issues related to professional practice. ... data trending, reports and analysis for medical staff leadership and peer review committee consistent with established guidelines. Manages the physician peer … more
- Molina Healthcare (Green Bay, WI)
- …State Plan. **JOB QUALIFICATIONS** **Required Education** Any of the following: Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR a ... field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3 years of hospital or medical clinic… more
- CVS Health (Madison, WI)
- …guiding the team in determining correct coding and appropriate documentation during the review of medical records. This role requires a strong focus on meeting ... projects. + Ensure staff provide detailed written summaries of medical record review findings and ensure the team articulates findings effectively to investigators,… more
- Centene Corporation (Madison, WI)
- …health clinicians preferred. Behavioral health clinical knowledge and ability to review and/or assess ABA Treatment Plans required. Knowledge of ABA services ... and BH utilization review process required. Experience working with providers and healthcare...Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required… more