• Quality Management Specialist II

    Emory Healthcare/Emory University (Atlanta, GA)
    …preferred based on various additional duties **PREFERRED QUALIFICATIONS:** + Currently licensed as a Registered Nurse in the state of Georgia + Minimum of five ... STS, and ACC) utilizing electronic processes and when indicated, concurrent chart reviews + Perform daily chart review...years experience as an RN with three years of recent experience in **cardiology**… more
    Emory Healthcare/Emory University (09/17/25)
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  • VP, Clinical Services

    Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
    …participates in all WC State Reporting and audits. Essential Qualifications + Currently licensed Registered Nurse ( RN ), Nurse Practitioner (NP), or ... monitoring, oversees all Clinical Services (CS) functions (prior authorization, concurrent review , appeals, case management, disease management, population… more
    Brighton Health Plan Solutions, LLC (10/08/25)
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  • Virtual Health Client Success Manager / Clinical…

    Penn State Health (Hershey, PA)
    …complete MSN within three (3) years of hire. + Licensed to practice as a RN Registered Nurse by the state of employment required. **PREFERRED ... the CDIS balances strategic thinking with hands-on support-managing multiple concurrent implementations, facilitating training sessions, mentoring peers, and leveraging… more
    Penn State Health (10/08/25)
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  • Manager, Clinical Care Coordination and Discharge…

    UPMC (York, PA)
    …Licensed Social Worker (LSW) OR Other Healthcare Professional Licenses for Discharge Planning OR Registered Nurse ( RN ) + Act 34 *Current licensure either in ... for timely and accurate documentation of appropriate data relating to concurrent denials. Assures regulatory compliance in determining denial of service and/or… more
    UPMC (09/19/25)
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  • Case Manager - Case Management

    Arnot Health (Elmira, NY)
    …Auth/Denial Management meetings EDUCATION: RN required. EXPERIENCE: NYS licensed Registered Nurse required. Bachelor's in nursing preferred. Must have ... Managers! MAIN FUNCTION: The Case Management (denial/prior auth) will review and appeal as appropriate for concurrent ...will review and appeal as appropriate for concurrent and retrospective authorization and denial activities for Arnot… more
    Arnot Health (08/08/25)
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  • Clinical Document Specialist III

    AdventHealth (Orlando, FL)
    …Department experience. + BSN and 3 years of Clinical Documentation Specialist experience + RN - Registered Nurse - State Licensure and/or Compact State ... stewardship in the management of resources entrusted to them. + Reviews concurrent medical record for compliance including completeness and accuracy for severity of… more
    AdventHealth (10/08/25)
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  • Clinical Document Spec II

    AdventHealth (Maitland, FL)
    …or Emergency Department experience. + Three plus of Clinical Documentation Specialist experience + RN - Registered Nurse - State Licensure and/or Compact ... stewardship in the management of resources entrusted to them. + Reviews concurrent medical record for compliance including completeness and accuracy for severity of… more
    AdventHealth (10/03/25)
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  • Infection Preventionist - Houston Methodist West

    Houston Methodist (Houston, TX)
    …Control (CBIC) within 3 years **AND** + If Bachelor degree in Nursing, must have: + * RN - Registered Nurse - Texas State Licensure. Compact Licensure - Must ... include the notification of and follow through with the Employee Health Nurse when such contacts have involved Hospital personnel.) **SERVICE ESSENTIAL FUNCTIONS** +… more
    Houston Methodist (09/24/25)
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  • Burn Performance Improvement Coordinator

    HCA Healthcare (Miami, FL)
    …Supt must be obtained within 30 days of employment start date + TNCC required + ( RN ) Registered Nurse + Associate Degree + BSN-preferred + **3-5 years ... nurses play a vital part. We know that every nurse 's path and purpose is unique. Do you want...and Qualifications** The Burn PI Coordinator performs retrospective and concurrent reviews of patient care records and assesses for… more
    HCA Healthcare (07/14/25)
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  • Medical Records Tech (Clinical Documentation…

    Veterans Affairs, Veterans Health Administration (Washington, DC)
    …for a detailed definition of mastery level certification. OR, Clinical experience, such as Registered Nurse ( RN ), Medical Doctor (MD), or Doctor of ... overall quality and completeness of clinical documentation. Inpatient CDI focuses on the concurrent review of patient records with an emphasis on improving… more
    Veterans Affairs, Veterans Health Administration (10/08/25)
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