• RN Pt Safety and Quality

    Kaleida Health (Bradford, PA)
    ** RN Pt Safety and Quality** **Location:** Bradford Regional Medical Cntr Location of Job: US:PA:Bradford Work Type: Per-Diem Shift 1 **Job Description** Works ... collaboratively with the Director of Quality Measures to analyze research data to...evidence based medicine responses to regulatory and organizational initiatives. ** Education And Credentials** Bachelor's Degree in nursing preferred. Pennsylvania… more
    Kaleida Health (12/24/25)
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  • Senior RN Peer Review Specialist

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …be based on several factors including, but limited to, relevant education , qualifications, certifications, experience, skills, performance, shift, travel ... (CPR) Team, the Peer Review Specialist works closely with CPR's Director and Clinical Lead, Operations Lead, Senior Credentialing Manager/ Compliance Consultant,… more
    Blue Cross Blue Shield of Massachusetts (12/25/25)
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  • Care Manager RN - Utilization Management…

    Highmark Health (Harrisburg, PA)
    …rapport and relationships. + Develop and sustain positive working relationships with internal and external customers. + Utilize outcomes data to improve ongoing care ... management services. + Other duties as assigned or requested ** EDUCATION ** **Required** + None **Substitutions** + None **Preferred** + Bachelor's Degree in Nursing… more
    Highmark Health (12/18/25)
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  • Manager, Quality and Patient Safety ( RN )

    WMCHealth (Suffern, NY)
    …( RN ) Company: Good Samaritan Hospital City/State: Suffern, NY Category: Executive /Management Department : General Quality Assurance Union: NO Position: Full ... Mar 03, 2025 Hiring Range: $52.40 - $66.33 Apply Now External Applicant link Internal Applicant link Job Details: The Manager of Quality and Patient Safety provides… more
    WMCHealth (12/12/25)
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  • RN Delegated Care Management Monitor…

    Elevance Health (Raleigh, NC)
    …Carolina residency is required.** **HOURS** **: General business hours, Monday through Friday.** ** TRAVEL ** **: Travel within these regions may be required. When ... and cost-effective. + Coordinate care between delegated care management and internal resources, including social determinants of health, to meet the member's… more
    Elevance Health (12/18/25)
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  • Utilization Management Reviewer, RN…

    Excellus BlueCross BlueShield (Rochester, NY)
    …(PH) medical and healthcare services for members, ensuring compliance with internal and external standards set by regulatory and accreditation entities. Refers ... appropriate cases to the Medical Director for review. Refer to and work closely with...schedule, as required, to meet departmental time frames. Per department needs, may be responsible for additional hours. Essential… more
    Excellus BlueCross BlueShield (10/07/25)
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  • Internal Case Manager / OT - SLP - PT

    BrightSpring Health Services (San Antonio, TX)
    …to the patient and reports hours/subsequent changes to the local leadership ( Executive Director / Director of Clinical Management/Program Manager).. Negotiates ... Minimum of Bachelor's degree in Allied Health (OT, PT SLP), Registered Nurse , Human Services, orRehabilitation Counseling/Psychologyand. Maintains relevant… more
    BrightSpring Health Services (12/19/25)
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  • Manager, Prior Authorization Utilization…

    CVS Health (Baton Rouge, LA)
    …accreditation standards (eg, CMS, NCQA, URAC). + Collaborate with internal and external stakeholders-including clinical leadership, operations, IT, and regulatory ... and appeals as needed. + Contribute to policy and procedure development, staff education , and change management efforts. + Foster a culture of continuous learning,… more
    CVS Health (12/21/25)
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  • Director , Home Health ( RN ) - Home…

    Guthrie (Vestal, NY)
    …communities. Guthrie Medical Education Programs include General Surgery, Internal Medicine, Emergency Medicine, Family Medicine, Anesthesiology and ... planning, developing, implementing, and evaluating services, programs, and activities. Education , License & Cert: Bachelors' Degree required, Masters' Degree… more
    Guthrie (11/11/25)
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  • Heart and Vascular Service Line / Unit Charge…

    Emory Healthcare/Emory University (Atlanta, GA)
    …care makes each day unique, allowing your clinical knowledge to grow quickly. RN Clinician Charge Plans, coordinates and directs the daily operations of a specific ... Collaboration 1. Supervises staff and facilitates communication with physicians and internal administrators to provide optimal patient and family-centered care. 2.… more
    Emory Healthcare/Emory University (12/03/25)
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