- Centene Corporation (New York, NY)
- …an active New York State nursing License.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service and appropriate ... benefit coverage. Provides recommendations to the appropriate medical team to promote quality and cost effectiveness of medical care. + Performs medical necessity… more
- ManpowerGroup (Austin, TX)
- We're seeking a dedicated and detail-oriented **Registered Nurse (RN)** to join a dynamic healthcare partnership team supporting Medicaid services in Texas. This is ... a non-clinical, **remote** -review role focused on ** prior authorization** and **utilization management** -ideal for RNs who thrive in a collaborative, analytical… more
- Molina Healthcare (Idaho Falls, ID)
- …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of ... and eligibility for requested treatments and/or procedures. + Conducts prior authorization reviews to determine financial responsibility for Molina Healthcare… more
- Veterans Affairs, Veterans Health Administration (Louisville, KY)
- …System, Louisville, Kentucky is currently recruiting for a Registered Nurse - Quality Management Consultant Louisville, Kentucky 603. Responsibilities The ... Quality Management (QM) Consultant Registered Nurse (RN) demonstrates leadership, experience, and creative approaches to...Nursing may have opportunity to become registered as a nurse with a state licensing board prior … more
- Veterans Affairs, Veterans Health Administration (Colorado Springs, CO)
- Summary The Registered Nurse Quality Management (QM) Consultant- Regulatory Compliance Coordinator is a full-time confidential consultant/program manager in the ... 19 Inspection Teams, and Ascellon. Responsibilities https://www.youtube.com/watch?v=EGW4PMZvJto The Registered Nurse Quality Management (QM) Consultant- Regulatory Compliance… more
- CVS Health (Oklahoma City, OK)
- …a **fully remote role** with a requirement to **reside in Oklahoma** . The nurse in this position uses clinical expertise in a collaborative process to assess, plan, ... to additional programs or services. Nurses also contribute to improving the quality and effectiveness of healthcare services and benefit utilization. This position… more
- Veterans Affairs, Veterans Health Administration (Albany, NY)
- Summary The Albany VAMC is looking to fill (1) Registered Nurse - ACCREDITATION QUALITY SPECIALIST This job announcement is open only for current, full time, ... with driving requirements for this position. Responsibilities The Registered Nurse Accreditation Quality Specialist executes leadership that...Nursing may have opportunity to become registered as a nurse with a state licensing board prior … more
- Veterans Affairs, Veterans Health Administration (Minneapolis, MN)
- Summary The Registered Nurse - Quality , Safety & Value Consultant Patient Safety is accountable to Quality , Safety & Value (QSV) Leadership at the Minneapolis ... thirteen Outpatient Community Clinics as assigned. Responsibilities The Registered Nurse - Quality , Safety & Value Consultant Patient...Nursing may have opportunity to become registered as a nurse with a state licensing board prior … more
- Veterans Affairs, Veterans Health Administration (Leeds, MA)
- …a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program. ... Summary This Registered Nurse position is in Nursing Service at the...subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested… more
- Veterans Affairs, Veterans Health Administration (Walla Walla, WA)
- …a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program. ... Summary The QM/HRO Consultant is assigned responsibility for their assigned quality management program area activities for the VA Medical Center and all off-site… more