- HCA Healthcare (Caldwell, ID)
- …our multi-generational nursing family. We partner with our Nurses at West Valley Medical Center! **Job Summary and Qualifications** The RN Occupational Health is ... Heart Association Basic Life Support + Certified Occupational Health Nurse (COHN) preferred **Benefits** West Valley Medical ...career path, we encourage you to apply for our RN Employee Health opening. We review all… more
- Eastern Connecticut Health Network (Vernon, CT)
- …role is essential to the quality metrics of the agency. EDUCATION/ EXPERIENCE: + A Registered Nurse or Physical Therapist licensed in the State + Experience in ... and demonstrates the provision of skilled services. + Completes medical record review of patient records in...expectations + Ultimately responsible for the readiness of the claim for final release to billing. + The CDS… more
- Veterans Affairs, Veterans Health Administration (Lebanon, PA)
- …will also function as the Agency Medical Officer (AMO) and as the Medical Review Officer(MRO) who will review all employee screenings and intakes. ... ePerformance and credentialing reviews for 2 PA's and 2 RN 's. In addition to the regular duties of this...(1) Those approved by the Accreditation Council for Graduate Medical Education (ACGME), b) OR [(2) Those approved by… more
- CVS Health (New Albany, OH)
- …do it all with heart, each and every day. **Position Summary** **This Case Manager RN position is 100% remote and the employee can live in any state.** **Normal ... (1-2 times per quarter).** Typical training hours are Monday-Friday 8-4:30 EST. Nurse Care Manager is responsible for telephonically and/or face to face assessing,… more
- Centene Corporation (Lansing, MI)
- …Licensed Marital and Family Therapist (LMFT), Licensed Certified Social Worker (LCSW), Licensed Registered Nurse ( RN ), Acute Care Nurse Practitioner ... equivalent work experience within a managed care environment related to HEDIS record review , quality improvement, medical coding or transferable skill sets that… more
- Trinity Health (Syracuse, NY)
- …strongly preferred). + Master's degree preferred. + Certification (CPHRM) is preferred. + Registered Nurse preferred. + Ideally, the candidate will have 3-5 ... for the overall patient safety and clinical risk management functions related to review and response to reported events. Responds to crisis situations that have… more
- Houston Methodist (The Woodlands, TX)
- …assigned patient population, under the direct supervision of a Physician, APP and/or Registered Nurse . This position oversees appropriate scope of practice, (ie ... patients visiting the clinic under the direct supervision of a Physician, Registered Nurse , or clinic leadership procedures. Complete pre-visit planning workflow… more
- Elevance Health (Dearborn, MI)
- …Give referral and/or make referral appointment as circumstances warrant. + Review for medical appropriateness psychiatric/substance abuse cases utilizing ... practice that is relevant to the clinical area under review . + Provide reviews for predetermination of medical...+ Conduct business in a professional manner. + Troubleshoot claims issues. + Investigate and research to resolve customer… more
- WMCHealth (Poughkeepsie, NY)
- …related to medical staff PI + Screens cases to identify issues for physician review , using criteria established by the medical staff and the NYS DOH. + ... a potential lawsuit, etc.) and alerts the department director, medical staff leadership, and claims manager. +...+ BSN preferred. LICENSES/CERTIFICATIONS Licensed in NYS as a Registered Professional Nurse OTHER + If applicable,… more
- US Tech Solutions (Columbia, SC)
- …to elicit behavior change and increase member program engagement. + Performs medical or behavioral review /authorization process. Ensures coverage for appropriate ... **Duration: 3+ Months Contract (Possible Extension)** **Job Description:** + Must be an RN in SC and have an active and unrestricted SC RN license. +… more