• Fire Dept. Quality and Clinical Coordinator…

    Sarasota County Government (Sarasota, FL)
    …Improvement measures in collaboration with EMS billing. + Manage ambulance billing compliance with Medicare , Medicaid, and private insurers while ensuring HIPAA ... EMS quality improvement programs, patient care documentation, and regulatory compliance . This role manages operational and administrative responsibilities, including… more
    Sarasota County Government (10/02/25)
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  • Clinical Documentation Specialist - Health…

    Hawaii Pacific Health (Lihue, HI)
    …hour **Category:** Health Information Management **Minimum qualifications:** Current Hawai'i Registered Nurse License. Bachelor's degree and/or equivalent ... work to improve the overall quality of medical record documentation to ensure compliance with Medicare and Medicaid (CMS) guidelines and to expedite… more
    Hawaii Pacific Health (09/05/25)
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  • UM Prior Authorization Review Nurse

    UCLA Health (Los Angeles, CA)
    Description At UCLA Health, the Utilization Management (UM) Review Nurse plays a vital role in ensuring the delivery of high-quality, evidence-based care. This ... to prior authorization requests for medical services. The UM Review Nurse applies clinical judgment, regulatory standards, and established guidelines to determine… more
    UCLA Health (10/03/25)
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  • RN Wound Ostomy - CMPG Wound Care Center

    Carle Health (Peoria, IL)
    …provides consultation to acute care patient care units Qualifications Certifications: Licensed Registered Professional Nurse ( RN ) - Illinois Department of ... care. + Evaluates patient/family cultural needs to promote comfort and compliance to prescribed regimens. + Evaluates patient/family cognitive skills and adjusts… more
    Carle Health (10/01/25)
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  • AVP of Operations

    Gentiva (Jeffersonville, IN)
    …assurance across multiple hospice sites. + **Ensure Regulatory Excellence:** Maintain compliance with Medicare , state licensing, accreditation, and federal ... hospice operations. This high-impact leadership role will ensure regulatory compliance , strategic growth, quality care delivery, and community engagement across… more
    Gentiva (09/25/25)
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  • Inpatient Concurrent Review RN

    Dignity Health (Woodland, CA)
    …review for appropriate level of care and medical necessity using InterQual and Medicare criteria. This position will work closely with the hospitalist team, Dignity ... Non-coverage (HINN) and Advance Beneficiary Notice of Noncoverage (ABN) to include compliance monitoring. - When barriers are identified assists the patient family… more
    Dignity Health (10/02/25)
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  • MDS - Nurse Assessment Coordinator…

    National Health Care Associates (Glens Falls, NY)
    …$95,000.00 /Hr. **-** **What You'll Bring:** **Qualifications of a MDS Coordinator / Nurse Assessment Coordinator include:** + Valid state RN nursing license + ... Great **What You'll Do:** As an MDS Coordinator / Nurse Assessment Coordinator, you will complete and assure the...+ Ensure the highest level of revenue integrity and compliance to all state and federal regulations for MDS… more
    National Health Care Associates (09/27/25)
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  • MDS - Nurse Assessment Coordinator…

    National Health Care Associates (Wethersfield, CT)
    …of our residents **-** **What You'll Bring:** **Qualifications of a MDS Coordinator / Nurse Assessment Coordinator include:** + Valid state RN nursing license + ... reimbursed.** **What You'll Do:** As an MDS Coordinator / Nurse Assessment Coordinator, you will complete and assure the...+ Ensure the highest level of revenue integrity and compliance to all state and federal regulations for MDS… more
    National Health Care Associates (09/19/25)
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  • Part Time Weekend Hospice Admissions RN

    Serenity Hospice Care (Trenton, NJ)
    …Serenity Hospice is looking to add a dedicated and compassionate Admissions Nurse to delivering exceptional care, comfort and support to patients. They will ... assessments to determine hospice eligibility based on clinical criteria and Medicare guidelines. + Clearly and compassionately explain hospice philosophy, services,… more
    Serenity Hospice Care (09/13/25)
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  • RN Case Manager Emergency, Allegheny…

    Highmark Health (Pittsburgh, PA)
    …unique processing arrangements including Federal Employee Program (FEP) and Medicare Advantage. **ESSENTIAL RESPONSIBILITIES** + Coordinates the clinical care with ... degree + 3 years in a clinical nursing role + Current State of PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact… more
    Highmark Health (09/13/25)
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