- George C. Grape Community Hospital (Hamburg, IA)
- Quality /Utilization Review Nurse Position Summary: The Quality /Utilization Review Nurse is responsible for evaluating the medical necessity, ... with insurance providers for pre-certifications, continued stay reviews, and authorizations. * Quality Assurance : o Monitor compliance with hospital quality … more
- PruittHealth (Norcross, GA)
- **HomeHealth Quality Assurance QA Consultant position - Hybrid and Travel opportunity!** **JOB PURPOSE:** The Quality Assurance (QA) Consultant for Home ... + Knowledge of emergency and disaster preparedness. + Exceptional knowledge of quality assurance and performance improvement and data analytics. **MINIMUM… more
- AssistRx (Orlando, FL)
- …well as system data entry quality . Within this role, the Quality Assurance Specialist serves customers by identifying, analyzing, and developing improvements ... productivity, quality , internal team relationships, and customer service. The Quality Assurance Specialist regularly provides support to the department… more
- Good Samaritan (Sioux Falls, SD)
- …to the quality risk and risk score adjustment programs. Assist with the quality improvement review and audit related to potential quality risk issues ... (CPHQ) or medical coding certification preferred, but not required. Quality improvement/ assurance personnel with nursing backgrounds can maintain their… more
- Hackensack Meridian Health (Edison, NJ)
- …mission to transform healthcare and serve as a leader of positive change. The ** Quality Assurance Coordinator** evaluates patient care quality by using ... also supports the medical staff quality program and medical staff quality review committees and requires effective communication and collaboration with… more
- University of Rochester (Rochester, NY)
- …preferred - Clinical chart review and abstraction experience preferred - Quality Assurance and Process Improvement (QA/PI) experience preferred LICENSES AND ... of strict inclusion/exclusion criteria and protocols. Performs meticulous chart review and enters clinical data into the quality...CERTIFICATIONS - RN - Registered Nurse - State Licensure and/or Compact State Licensure Current… more
- Carle Health (Champaign, IL)
- …with Behavioral Health leadership to implement and monitor behavioral health quality assurance / quality improvement activities, identifies and monitors ... and reports on various data indicators and implements and tracks quality improvement activities. Additionally, this position will develop clinical trainings and… more
- STG International (Rockville, MD)
- …and external customers. Exam Processing Quality and Safety + Ensure case review processing timeframes and quality assurance parameters are met as ... STGi is currently seeking a Registered Nurse -Case Review Specialist . The position...scheduling, appropriate management and processing of all medical records, Quality Assurance (QA) checks are completed ,… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …positive with all customers and fellow employees. + Adheres to established quality assurance standards and MagnaCare policies and procedures. Essential ... and Case Management services for Workers' Compensation. The Workers' Compensation Nurse Case Reviewer collaborates with medical care providers, employers,… more
- Ventura County (Ventura, CA)
- …including two (2) years of full-time experience in Case Management, Disease Management, Quality Assurance , HEDIS and/or Utilization Review . NECESSARY SPECIAL ... Describe your full-time registered nursing experience with case management, disease management, quality assurance , and/or utilization review . In your… more