- Molina Healthcare (Ridgeland, MS)
- …Responsible for partnering with MHI RQES and VP Stars in developing the local Medicare Stars work plan and executes on interventions that will improve CAHPS, HEDIS ... SKILLS & ABILITIES** : + Minimum 10 years experience in quality compliance /HEDIS operations, customer service or provider service in a managed care setting… more
- BrightSpring Health Services (Austin, TX)
- …Graduate of an accredited school/college with current registration of practice as a Registered Professional Nurse + Excellent communicator with ability to handle ... meetings + Demonstrating fiscal accountability by monitoring operations to ensure compliance with Company policies and procedures, state licensure and regulations,… more
- Northwell Health (Lake Success, NY)
- …within 5 years of employment date. *Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications ... of care provided. Responsible for concurrent inpatient medical record reviews for Medicare , Medicaid and all commercial payers. Generates queries and have follow up… more
- St Croix Hospice (Moberly, MO)
- …then come work where you matter. Nurse Practitioner Position Overview The Nurse Practitioner (NP) is a registered professional nurse with advanced ... referral sources to support program growth. Additional Responsibilities + Ensures compliance with Medicare , Medicaid, and state/federal hospice regulations. +… more
- Beth Israel Lahey Health (Plymouth, MA)
- …plans and acts as a liaison between ED and post-acute providers + Ensure compliance with Medicare , Code 44, and reimbursement regulations + Address social ... plays a vital role in ensuring seamless, patient-centered care. ** RN - Utilization Review** This role is ideal for...* Integrate clinical and reimbursement knowledge for optimal outcomes ** RN Case Manager - Emergency Department UR & Discharge… more
- Covenant Health Inc. (Knoxville, TN)
- …care to an assigned group of homebound patients under the supervision of a Registered Nurse ; administers care with other disciplines. The LPN/LVN reports to the ... Overview Licensed Practical Nurse , Home Health Up to $4,000 Sign on...orders before administering medications. + Has working knowledge of Medicare guidelines, and performs in compliance with… more
- Jet Health (Englewood, CO)
- …team members and lead the team to exceed expectations and patient satisfaction. Qualifications: + Registered Nurse ( RN ) with an active license in the state ... program to ensure accuracy and regulatory fulfillment of timely documentation. + Compliance :Focus on Medicare Quality Measures and other industry standards to… more
- The County of Los Angeles (Los Angeles, CA)
- …or Medical Service Coordinator, CCS.** -OR- OPTION II: Two (2) years of experience as a registered nurse , of which one year must be in the treatment of chronic ... + A current, active license to practice as a Registered Nurse issued by the California Board...be involved. SPECIAL REQUIREMENTS INFORMATION: * An Utilization Review Nurse is an RN that has Case… more
- State of Michigan (MI)
- …Map NOTE: Interview and hiring preference may be given to applicants with registered nurse qualifications and experience. The use of artificial intelligence (AI) ... and certification activities on behalf of the Centers for Medicare and Medicaid Services (CMS). The health care surveyor...associate's degree, Michigan license in good standing as a registered nurse , and two years of … more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- …Apply View Benefits (https://www.jobapscloud.com/CT/jobs/?b=Benefits) + + + + Introduction Are you a Registered Nurse ( RN ) interested in a career where you ... LICENSE, PLEASE: + Review the eligibility and documentation requirements (https://portal.ct.gov/DPH/Practitioner-Licensing--Investigations/ Registered - Nurse / RN -Licensure-by-Endorsement) for CT license by… more