- Houston Methodist (Houston, TX)
- …This position has achieved an expert level at all objectives delineated in the Utilization Review Nurse and Utilization Review Specialist Nurse job roles ... At Houston Methodist, the Sr Utilization Review Specialist Nurse (URSN) position is...to department staff in communicating medical information required by external review entities, managed care contractors, insurers,… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... concurrent medical record review for medical necessity and level of care using...relationships with patients, families, interdisciplinary team members, payers, and external case managers; listens and responds to the ideas… more
- Veterans Affairs, Veterans Health Administration (Milwaukee, WI)
- …led by the QSV Department including: Infection Control, Performance Improvement, Quality Management, Accreditation, External Review , Patient Safety, ... Summary The Quality , Safety and Value Nurse Manger...Commission on Cancer, VACO Program Office reviews, and other external review entities. The QSV NM initiates… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …mentorship, _development,_ and leadership programs + And more **Description** The **Utilization Review (UR) Specialist** is a Registered Nurse responsible for ... to the provider team, Interdisciplinary Care Team, and patient to explain external UR regulations. + Provides effective and efficient proactive communication to… more
- US Tech Solutions (Chicago, IL)
- …experience with Utilization Review ? + Do you have an Active Registered Nurse License? **About US Tech Solutions:** US Tech Solutions is a global staff ... development and ongoing implementation of QM Work Plan activities. + Improve quality products and services, by using measurement and analysis to process, evaluate… more
- US Tech Solutions (May, OK)
- …development and ongoing implementation of QM Work Plan activities. . Improve quality products and services, by using measurement and analysis to process, evaluate ... to meet QM objectives Responsibilities: . Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations.… more
- Veterans Affairs, Veterans Health Administration (Walla Walla, WA)
- Summary The QM/HRO Consultant is assigned responsibility for their assigned quality management program area activities for the VA Medical Center and all off-site ... identify potential risks and issues, collaborate with staff both internal and external to ensure necessary requirements are appropriately documented and met, and… more
- Veterans Affairs, Veterans Health Administration (Tuscaloosa, AL)
- …a comprehensive quality management program area. Responsibilities The Quality Management Consultant Registered Nurse : Completes orientation according to ... professional behaviors that promote cooperation and teamwork with internal and external customers. Participates in unit based educational activities and continuing… more
- Beth Israel Lahey Health (Cambridge, MA)
- …and improve patient outcomes. The nurse works with clinical staff to review clinical charts, interpret data, and implement quality improvement initiatives to ... Director of Quality & Patient Safety, the Quality and Patient Safety nurse specialist plays...+ Reviews medical records to collect data for reporting quality measures, including both concurrent medical record review… more
- Bon Secours Mercy Health (Paducah, KY)
- …accreditation, and certification surveys in successful completion. + Prepares and submits quality reports as required by external agencies and payors.Facilitates ... improvement committees and projects as needed. + Supports Medical Staff Quality and Peer Review . + Promotes practices that detect, mitigate or prevent harm using… more
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