- Community Health Systems (Fort Wayne, IN)
- …education experience required + Experience in ICU/Critical Care, case management, utilization review , quality, or inpatient coding preferred **Knowledge, Skills ... **Job Summary** The Clinical Documentation Improvement (CDI) Specialist Lead provides advanced support for CDI activities within the facility, ensuring the accuracy,… more
- Trinity Health (Maywood, IL)
- …through a thorough understanding of Milliman and InterQual criteria, conducts concurrent utilization review . Interacts with insurers, third party payors, and ... Day Shift **Description:** **Great opportunity for a Clinical Documentation Specialist RN to work in an organization that focuses...a lasting impact. Full Time - 8-5pm (days), Registered Nurse (RN) and 3 - 5 years of experience… more
- CommonSpirit Health (Centennial, CO)
- …as a Registered Nurse . 3 years with progressive experience in utilization review , preferred. Prior experience writing clinical denial appeal letters ... indicated through research and coordination of completion of medical records and utilization review processes. Identifies areas for documentation and/or process… more
- Houston Methodist (WA)
- …caring for adults in an acute care hospital setting is required; coding and utilization review experience preferred + For Medical School graduate - One year ... At Houston Methodist, the Clinical Documentation Specialist is responsible for improving the overall quality...**LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure and/or Compact State Licensure… more
- LA Care Health Plan (Los Angeles, CA)
- …by health risk assessment (HRA), risk stratification, predictive modeling, provider's utilization review vendors, members, Call Center, claims staff, Health ... Care Management Specialist II, D-SNP Team (12 month Assignment) Job...Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Licenses/Certifications Required Registered Nurse (RN);current and unrestricted California License OR Licensed Clinical… more
- Cleveland Clinic (Weston, FL)
- …of Quality and Safety. As a Safety, Quality, and Patient Experience (SQPE) Specialist I, you will direct safety, quality and patient experience activities within ... to ensure compliance and strong performance across safety, quality, utilization and patient experience metrics and support implementation of requirements… more
- Trinity Health (Columbus, OH)
- …time **Shift:** Day Shift **Description:** **Position Purpose:** Clinical Documentation Specialist utilizes advanced clinical and coding expertise to direct efforts ... accuracy, and integrity of medical record documentation through extensive record review . Through extensive interaction with physicians and other members of the… more
- Hackensack Meridian Health (Red Bank, NJ)
- …ED inpatient admissions and observations as specified by the facility's Utilization Management/ Review Committee for documentation completeness and compliance ... experience. **Licenses and Certifications Required:** + Current state Registered Nurse license. + Certified Clinical Documentation Specialist (CCDS)… more
- Veterans Affairs, Veterans Health Administration (Georgetown, DE)
- …and Experience, and Dimension criteria must be met to qualify for Advanced Practice Nurse (Clinical Nurse Specialist ) II: Exception to Licensure for Graduate ... teamwork, high quality care, patient satisfaction, positive outcomes, appropriate utilization of resources and cost-effective services. The Nurse...of the Nurse II, as a Graduate Nurse Technician Clinical Nurse Specialist … more
- University of Utah (Salt Lake City, UT)
- Details **Open Date** 11/19/2025 **Requisition Number** PRN43626B **Job Title** PS Clinical Nurse Specialist **Working Title** PS Clinical Research Nurse ... Rate Range** 47600 to 74609.60 **Close Date** 02/17/2026 **Priority Review Date (Note - Posting may close at any...required of employees assigned to the job. The Clinical Nurse Specialist makes decisions independently and in… more