- Rush University Medical Center (Chicago, IL)
- …may vary depending on the circumstances of each case. **Summary:** The Clinical Consulting Specialist is a nurse with expertise within a specialized area of ... best practices, policies, strategic goals and RUSHICARE values. The Clinical Consulting Specialist role is a member of the nursing leadership team and demonstrates… more
- Carle Health (Champaign, IL)
- …patient care outcomes. The incumbent will have a deep understanding of utilization review and case management principles, case management best practices, ... experience 2+ years Responsibilities Maintain current knowledge of case management and utilization review trends including the entire continuum of care within… more
- Molina Healthcare (NE)
- **Job Description** **Job Summary** The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring alignment ... Appeals and Grievances department. We are seeking a Registered Nurse with previous Appeals experience. The candidate must have...clinical nursing experience, including at least 1 year of utilization review , medical claims review ,… more
- HCA Healthcare (Largo, FL)
- …and personal growth, we encourage you to apply for our Clinical Rehab Specialist PRN opening. We review all applications. Qualified candidates will be ... **Introduction** Do you have the PRN career opportunities as a(an) Clinical Rehab Specialist PRN you want with your current employer? We have an exciting opportunity… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …characteristic. Blue Cross and Blue Shield of Minnesota Position Title: RN Specialist Complex Case Management - Transplant Location: Remote Career Area: Health ... for Transplant Management! Utilizing key principles of case management, the RN Specialist will research and analyze the member's health needs and healthcare cost… more
- Deloitte (Los Angeles, CA)
- …registered nurse , physician, physician assistant, case manager, clinical documentation specialist , utilization review , informatics RN, Quality, DRG ... Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk...Nurse (RN) license required + Certified Clinical Documentation Specialist - CCDS (inpatient) certification required. + A minimum… more
- HCA Healthcare (Nashville, TN)
- …join an organization that invests in you as a(an) Expanse Professional Development Specialist ? At HealthTrust, you come first. HCA Healthcare has committed up to ... to make a difference. We are looking for a dedicated Expanse Professional Development Specialist like you to be a part of our team. **Job Summary and… more
- State of Georgia (Fulton County, GA)
- …or licensed/certified professional in a related field or setting . Experience in utilization review and/or quality assurance in a healthcare setting . Experience ... Intake and Triage Specialist - Atlanta Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/74385/other-jobs-matching/location-only) Regulatory… more
- DePaul (Rochester, NY)
- …trends for reporting and follow-up consultation and training. + Responsible for Utilization Record Review functions to include Individual record audits, ... Overview The Quality Management Specialist works with the Quality Management Department to provide the highest achievable quality of services to the individuals we… more
- Nuvance Health (Danbury, CT)
- …the time of review . If unable to resolve, escalate to the PA and Utilization Review (UR) Leadership. * Coordinate with the care team in changing patient ... in Milliman and InterQual Guidelines required * Minimum of 2-3 years experience as Utilization Management Nurse in an acute care setting required, minimum of 4… more