• Health Plans Licensed Practical Nurse LPN Auditor

    Banner Health (AZ)
    …evaluate data, and write reports; to implement and track the effectiveness of process improvement ; to recognize risk management concerns; and to review and ... established AHCCCS standards for documentation in conjunction with the re-credentialing process . 3. Monitors and tracks Corrective Active Plans (CAPs), in… more
    Banner Health (11/27/25)
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  • RN Case Manager - Value Based Service Org - Full…

    University of Southern California (Alhambra, CA)
    …clinical and social work experience to ring an understanding of the clinical process of assessment, planning, implementation, and evaluation to the process of ... case management plan; and Educating the patient/family/caregiver about the case management process and evaluating their understanding of the process . Some of… more
    University of Southern California (11/19/25)
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  • Sr Mgr,MC Clinical SPM R22

    CVS Health (Richmond, VA)
    …operational, programs and/or system enhancements and is a key player in leading process improvement in these areas Evaluate and assess inputs regarding clinical ... a week. This leadership role reports to the Area Director (AD) and leads a team of NPs, PAs,...Develop intervention strategies and assess outcomes consistent with continuous process improvement Manage fiscal responsibilities to budget… more
    CVS Health (11/26/25)
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  • Manager, Case Management (Commercial Line…

    Excellus BlueCross BlueShield (Rochester, NY)
    …employee performance reviews, and staffing patterns, identifying areas needing improvement and initiates appropriate action including productivity monitoring and ... and prepares reports as necessary, including those related to Quality Improvement Plan activities. Provides presentations as they relate to specific functions… more
    Excellus BlueCross BlueShield (12/03/25)
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  • Utilization Review RN

    Community Health Systems (Naples, FL)
    …standard work, and policy/procedure development. + Partners with internal departments to promote process improvement and compliance with UR standards and KPIs. + ... who needs a reasonable accommodation for any part of the application or hiring process , contact the director of Human Resources at the facility to which… more
    Community Health Systems (11/20/25)
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  • Case Manager, Maternity (RN or LMSW)

    Excellus BlueCross BlueShield (Rochester, NY)
    …Accountabilities) + Handles all member clinical condition management programs. + Offers process improvement suggestions and participates in the solutions of more ... procedures per corporate and departmental policy. + Implements the Case Management Process per department policies, procedures and guidelines. The process more
    Excellus BlueCross BlueShield (11/26/25)
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  • Case Manager - Registered Dietician

    CDPHP (Latham, NY)
    …clinical condition management programs, within clinical area of expertise.[JW3] + Offers process improvement suggestions and participates in the solutions of ... procedures per corporate and departmental policy. + Implements the Case Management Process per department policies, procedures and guidelines. The process more
    CDPHP (11/25/25)
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  • Clinical Quality Assurance Specialist- SF Center-…

    Good Samaritan (Sioux Falls, SD)
    …the quality risk and risk score adjustment programs. Assist with the quality improvement review and audit related to potential quality risk issues and adverse events ... Will complete chart reviews, documentation of findings, referral for medical director review and required reporting. Will perform healthcare effectiveness data and… more
    Good Samaritan (10/18/25)
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  • Staff Physician - Primary Care (Kenosha CBOC)

    Veterans Affairs, Veterans Health Administration (Kenosha, WI)
    …or for McHenry CBOC, the s/he has delegated authority from the Clinical Director for Primary Care (DPC) with responsibility for their respective clinic(s), and in ... congressional inquiries, staff complaints or conflict, interdepartmental conflict, and process issues. - Responsible for innovative methods to optimize collaboration… more
    Veterans Affairs, Veterans Health Administration (10/16/25)
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  • Patient Services Representative

    Making Opportunity Count Inc (Fitchburg, MA)
    …Healthcare Pay Range: $20.43 to $27.64 per hour Reports To: Senior Director of Health Program Operations Supervisory Responsibilities: No Revision Date: 11/27/2024 ... appointments as indicated by the provider, checking for duplicates + Process referrals, diagnostic, and lab orders, ensuring specialist offices receive relevant… more
    Making Opportunity Count Inc (12/12/25)
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