- Mohawk Valley Health System (Utica, NY)
- …the supervision and mentoring of the case management staff to ensure quality , efficient and comprehensive care to our diverse member population. Provides direct ... oversight of the case manager's daily operations of utilization review practice, processes and procedures ensuring accurate member care needs are met and documented… more
- Guthrie (Sayre, PA)
- …will lead the establishment and ongoing facilitation of system wide Clinical Quality Value Analysis processes and structures to drive sustainable and significant ... and supply chain performance through the oversight of the technology review , evaluation, selection, and implementation process. Proven success executing project… more
- Banner Health (Tucson, AZ)
- …and employees to excel in the performance of their roles, provide quality patient care and ensure patient safety throughout the organization. 2. Demonstrates ... plans and strategies. Provides leadership and oversight in the collection, review and analysis of data performed by other centralized/corporate functions. This… more
- Howard University Hospital (Washington, DC)
- …DC area, Howard University Hospital has a world-renowned reputation for high- quality , patient-centric care. Howard University Hospital is the nation's only teaching ... the applicant's relevant job experience and the requirements of the position) Review the preference card and ensure that all supplies, instruments, equipment,… more
- Sea Mar Community Health Centers (Seattle, WA)
- …founded in 1978, is a community-based organization committed to providing quality , comprehensive health, human, housing, educational and cultural services to diverse ... This position requires that the applicant posses a Registered Nurse License in the State of Washington. The Home...(RN). + Prepare recommendations for hiring and termination for review and approval by the Home Health Administrator. +… more
- Virtua Health (Voorhees, NJ)
- …Responsible for document capture of paper records (including prepping, scanning, indexing, quality review , etc.) into document management system (OnBase), and ... of original documents ensuring all records are securely maintained. Performs final quality control review of paper documents prior to destruction. Ensures… more
- PruittHealth (Atlanta, GA)
- …Assist patients to achieve optimal health status utilizing the most cost-effective quality resources through application of model of care practice guidelines and ... for each patient based on a thorough history and clinical record review , including the attending physician's plan, the recommendations of national guidelines, social… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Services (CMS), Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation standards, as appropriate to the member's case ... for opportunities to educate, support, coach, coordinate care and review treatment options, through collaboration with providers and community-based resources.… more
- Travelers Insurance Company (Walnut Creek, CA)
- …negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. Provides ... + Proactively review Claim File Analysis (CFA) for adherence to quality standards and trend analysis. + Utilizes diary management system to ensure that… more
- WMCHealth (Valhalla, NY)
- …2025 Hiring Range: $176,014 to $200,802 Apply Now External Applicant link (https://pm.healthcaresource.com/cs/wmc1/#/preApply/29368) Internal Applicant link Job ... of all service lines, patient throughput, and standards of clinical practice, quality , education, and clinical operation. The Sr. Director recommends to the Vice… more