- Centene Corporation (Trenton, NJ)
- …setting to determine overall health and appropriate level of care + Reviews quality and continuity of care by reviewing acuity level, resource consumption, length of ... discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in… more
- Albany Medical Center (Albany, NY)
- …America) Salary Range: $71,612.39 - $110,999.20 Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. * Completes ... Utilization Management and Quality Screening for assigned patients.* Applies MCG criteria to monitor appropriateness of admissions and continued stays, and documents… more
- HCA Healthcare (Nashville, TN)
- …and Qualifications** The Quality Nurse Coordinator coordinates and facilitates Quality /Peer Review Committee in conjunction with the VP of Quality ... we encourage you to apply for our Quality Nurse Coordinator opening. We promptly review all applications. Highly qualified candidates will be contacted for… more
- US Tech Solutions (May, OK)
- …development and ongoing implementation of QM Work Plan activities. . Improve quality products and services, by using measurement and analysis to process, evaluate ... to meet QM objectives Responsibilities: . Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations.… more
- Centene Corporation (New York, NY)
- …benefit coverage. Provides recommendations to the appropriate medical team to promote quality and cost effectiveness of medical care. + Performs medical necessity ... criteria + Works with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care +… more
- Veterans Affairs, Veterans Health Administration (Colorado Springs, CO)
- Summary The Quality Management (QM) Consultant-Regulatory Compliance Registered Nurse (RN) demonstrates leadership, experience, and creative approaches to ... improvement in quality of-care outcomes. The QM Consultant-Regulatory Compliance demonstrates performance...and point of contact for policy management and external accreditation/ review procedures and activities. Accrediting bodies and review… more
- Veterans Affairs, Veterans Health Administration (Fort Harrison, MT)
- Summary The Registered Nurse (RN) Quality Management (QM) Performance Measures Consultant will function as an advanced clinician and execute position ... utilized for tracking and trending for process improvement for accreditation/external review functions, performance measures, patient safety, and quality … more
- Huron Consulting Group (Chicago, IL)
- …for planning, organizing, developing, and directing implementation of the Utilization Review Plan and the overall operation of the Utilization Management Department ... to coordinate and integrate utilization management activities, using continuous quality improvement initiatives to promote positive patient outcomes. Coordinates… more
- Veterans Affairs, Veterans Health Administration (Portland, OR)
- …both within city limits and in the nearby Columbia River Gorge. The Nurse Quality Management Consultant (QMC) is assigned responsibility for their assigned ... VA Health Care System (VAPORHCS), Portland, Oregon, is hiring a Registered Nurse (RN) Quality Management Consultant (QMC) who demonstrates leadership,… more
- Dignity Health (Chandler, AZ)
- …the Director of Care Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective use of ... resources; promote quality patient care; assist with patient care management; comply...and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted… more
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