- 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
- 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
- HCA Healthcare (Nashville, TN)
- …and external reviews and monitor for potential compliance risks. + Perform reviews of claims data and clinical records to ensure compliance. + Identify and ... monitor for potential compliance risks. - Perform reviews of claims data and/or clinical records to ensure... Health Information Technician/Administrator, Certified Coding Specialist (CCS), HCCA, clinical ( RN , LPN, PT, or other … 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
- Baylor Scott & White Health (Plano, 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
- Alight (IN)
- **Medical Nurse Consultant :** The Nurse Consultant functions as a member of our Clinical Center of Excellence and serves as a clinical consult ... in clinical guidelines in this industry, the Nurse Consultant facilitates medically sound decisions and... claims within their scope of licensure and clinical expertise. **You have** + Registered … more
- UPMC (Pittsburgh, PA)
- …very sensitive and confidential information. **Licensure, Certifications, and Clearances:** + Pharmacist OR Registered Nurse ( RN ) + Act 34 *Current licensure ... Management, the role involves systematically managing potential and actual claims . Analyzing clinical data is crucial for... or healthcare setting along with a pharmacist or RN license, this could be the next step in… more
- Baystate Health (Springfield, MA)
- …standards from TJC, CMS, and other relevant agencies. **Preferred Qualifications:** + Clinical licensure (eg, RN , MD, DO) highly preferred. + Certified ... expert knowledge in federal, state and TJC standards and clinical and operational expertise to achieve and maintain a...not limited to, functioning as an expert resource and consultant to the organization, as a liaison between the… more
- Catholic Health Services (Roslyn, NY)
- …support to the Director Risk Management & Regulatory Affairs Qualifications Must possess an active clinical license: RN , NP, PA or MD. Minimum 3 years of ... corrective actions plans Responsible for professional liability discovery Attends claims litigation meeting Coordinates, investigates, trends and disseminates safety… more
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