- OhioHealth (Mansfield, OH)
- …/or to provide shadowing experiences for students. **Minimum Qualifications:** Bachelor's Degree: Nursing (Required) RN - Registered Nurse - Ohio Board of ... **Job Description Summary:** Given that the organization self-insures for professional liability claims , it is essential that the Sr Consultant Risk Management… more
- The County of Los Angeles (Los Angeles, CA)
- …Requirements SELECTION REQUIREMENTS: Option I: Five (5) years of experience as a Registered Nurse including two (2) years of experience in an administrative*, ... HEALTH FACILITIES CONSULTANT , NURSING Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2307969) Apply HEALTH FACILITIES...university AND four (4) years of experience as a Registered Nurse including two (2) years of… more
- UNUM (Chattanooga, TN)
- …Help us help others, and join Team Unum today! **General Summary:** The clinical consultant is responsible for reviewing, analyzing and interpreting medical ... information. Works collaboratively with claims professionals, on-site physicians and other resources in multiple...**Job Specifications** + Associate Degree in Nursing and active RN License is required but BS degree strongly preferred… more
- CVS Health (Raleigh, NC)
- …3+ years of clinical experience in a healthcare setting. + 2+ years as a Registered Nurse ( RN ) or License Practical Nurse / License Vocational ... and compliance with regulatory and accreditation requirements. + Apply clinical criteria and policies to member/provider claims ...Nurse . + Active, current, and unrestricted RN /LVP/LPN license in the state of residence. + Proficiency… more
- NHS Management, LLC (Fayetteville, AR)
- …the successes they experience along the way. We are in search of a qualified Regional Nurse Consultant : The Regional Nurse Consultant will be responsible ... policies and established customer service program. 4. Monitor corporate clinical benchmarks, QI's, QM's and other available consultant...Holidays and Paid Vacation Requirements + Must be a Registered Nurse in good standing + Previous… more
- US Tech Solutions (Chesapeake, VA)
- …healthcare costs and improve healthcare program/operational efficiency involving clinical issues Determines medical necessity/ appropriateness Facilitates optimal ... enable decision making at most appropriate level **Duties:** + Nurse Case Manager is responsible for face to face...policies and programs are comprised of network management and clinical coverage policies. + Through the use of … more
- Tufts Medicine (Boston, MA)
- …**Minimum Qualifications** **:** 1. Bachelor's degree in Pharmacy or Nursing. 2. Licensed Pharmacist, Registered Nurse ( RN ), or Licensed Practical Nurse ... The Clinical Liaison serves as an expert clinical consultant to hospital staff and ...information needed for effective back-office administration (eg, authorization processes, claims accuracy) related to new patient on-boarding and the… more
- CareFirst (Baltimore, MD)
- …strategies to improve individual and team-based performance as needed. **Licenses/Certifications** : + RN - Registered Nurse - State Licensure And/or Compact ... **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Supervisor directs and coordinates the accurate...Case Manager Upon Hire Preferred + LNCC - Legal Nurse Consultant Certified Upon Hire Preferred Salary… more
- Baylor Scott & White Health (College Station, TX)
- … experience. Or, an Associate's Degree in a healthcare field and six years of clinical experience. Or, an RN with less than a Bachelor's Degree and six ... patient harm. If organizational risk is found, the Corporate claims manager will review the event further. The CRM...years of clinical experience. + TX RN license if… more
- Elevance Health (Dearborn, MI)
- …inconsistent with the CBA, the CBA provisions will prevail._** The ** Clinical Care Manager II** provides assessments, referrals, and counseling. Conducts telephone ... assessments, collecting sufficient clinical information to make appropriate referral and certification decision...+ Conduct business in a professional manner. + Troubleshoot claims issues. + Investigate and research to resolve customer… more