- Ozarks Medical Center (West Plains, MO)
- …manages claims and insured/uninsured losses; and facilitates physician peer review (including OPPE/FPPE) in collaboration with Medical Staff leadership. The ... The Risk Manager leads the health system's integrated program for medical malpractice/ claims management, enterprise risk management, patient safety, and… more
- Dignity Health (Long Beach, CA)
- …10% of salary for this position.** Our ideal candidate will be a Registered Nurse (RN) with experience in patient safety and risk management for a general acute-care ... Manager of Patient Safety and Risk at St. Mary Medical Center, you will oversee the facility's Patient Safety...outcomes, and safer patient care. You will also coordinate claim team requests and collaborate with other key stakeholders… more
- Sedgwick (Cedar Rapids, IA)
- … review of referred claims ; documents decision rationale; and completes medical review of all claims to ensure information substantiates disability. ... + Provides clear and appropriate follow-up recommendations for ongoing medical management of claims ; ensures appropriate recommendations...change the duties of the position at any time. \# nurse Sedgwick is an Equal Opportunity Employer and a… more
- Virtua Health (Mount Laurel, NJ)
- …If you live or work in South Jersey, exceptional care is all around. Our medical and surgical experts are among the best in the country. We assembled more than ... over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques… more
- Molina Healthcare (San Jose, CA)
- …retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. * Attends or chairs committees as required such as ... JOB DESCRIPTION Job Summary Provides medical oversight and expertise in appropriateness and ...officer. * Evaluates authorization requests in timely support of nurse reviewers, reviews cases requiring concurrent review … more
- CVS Health (Frankfort, KY)
- …do it all with heart, each and every day. **Position Summary** The Complex Nurse Case Manager is responsible for assessing members through regular and consistent in ... implement and coordinate all case management activities with members to evaluate the medical and psychosocial needs of the member to facilitate and support the… more
- Molina Healthcare (Idaho City, ID)
- …retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees as required such as ... Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial… more
- State of Colorado (Pueblo, CO)
- …as directed by the Nurse Manager + Attends weekly nursing rounds or read/ review and understand information in the weekly NEC minutes to be aware of nursing ... new information, changes in policy/procedure/instructions etc. + Reports ALL claims of harassment/workplace violence, alerts public safety/charge RN/ Nurse … more
- The County of Los Angeles (Los Angeles, CA)
- …(CDU), DHS hospitals are training sites for physicians completing their Graduate Medical Education in nearly every medical specialty and subspecialty. In ... its direct clinical services, DHS also runs the Emergency Medical Services (EMS) Agency and the County's 911 emergency...of another member of the team, such as the nurse or cardiovascular technician, when that member is unavailable.… more
- The County of Los Angeles (Los Angeles, CA)
- …staff when assigned to a district office, providing technical and administrative review of reports submitted pertaining to areas affecting the quality of total ... and evaluates the activities of survey teams providing technical and administrative review pertaining to areas affecting total patient care such as nursing,… more