- Houston Methodist (Houston, TX)
- …Officer (IBFCSM) **AND** + CPPS - Certified Professional in Patient Safety (IHI) **AND** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure ... At Houston Methodist, the Quality Outcomes Specialist position is responsible for assessing and facilitating...to accreditation standards and regulatory agency requirements. Conducts record review for performance improvement, peer review… more
- Molina Healthcare (Tucson, AZ)
- …quality monitoring audits, credentialing and recredentialing, quality of care concerns, and peer review . * Demonstrates understanding of requirements of the ... in a managed care setting, or equivalent experience * Registered Nurse . License must be active and...health experience (depends on state/contractual requirements). * Quality auditing, peer review , and process improvement experience. *… more
- WMCHealth (Poughkeepsie, NY)
- …criteria established by the medical staff and the NYS DOH. + Initiates the peer review process by reviewing cases identified through the screening (mortalities, ... Quality Improvement Specialist - RN Company: MidHudson Regional Hospital...+ BSN preferred. LICENSES/CERTIFICATIONS Licensed in NYS as a Registered Professional Nurse OTHER + If applicable,… more
- Community Health Systems (Franklin, TN)
- …Knowledge of HIPAA regulations and patient confidentiality standards. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or ... **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating...concurrent denials by submitting reconsiderations or coordinating peer -to- peer reviews. + Communicates effectively with utilization review… more
- Albany Medical Center (Albany, NY)
- …program + Prepare the case summaries for the Trauma M&M meetings, Trauma Multidisciplinary Peer Review Committee Meetings, and other PI forums + Scribe the ... minutes of the Trauma M&M and Trauma Multidisciplinary Peer Review Committee meetings to reflect thorough discussion including analysis of the events,… more
- BriteLife Recovery (Englewood, NJ)
- What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is responsible ... for overseeing and coordinating all aspects of utilization review and insurance authorization for clients receiving substance use disorder (SUD) treatment at… more
- University of Southern California (Los Angeles, CA)
- …years' experience as Nurse Navigator or Oncology preferred Required Licenses/Certifications: + Req Registered Nurse - RN (CA DCA) + Req Basic Life ... The Coordinator/Navigator position is a Registered Nurse with recognized leadership abilities...the patient. This position helps to facilitate appointments with specialist and support services, provides patient and site-specific education… more
- UPMC (Pittsburgh, PA)
- …Our Surgical Team at UPMC Presbyterian! UPMC Presbyterian is seeking a dedicated Full-Time Registered Nurse - OR Surgical Specialist to join our ... every shift both impactful and rewarding. The OR Surgical Specialist is a Registered Nurse ...specialized resource. + Provides constructive feedback and participates in peer review and specialty team performance. +… more
- UPMC (Pittsburgh, PA)
- …Certificate of a WOCN board-certified WOCNEP preferred **Licensure, Certifications, and Clearances:** + Registered Nurse ( RN ) + Current licensure either in ... **What can you Expect as a Wound Care Program Specialist ?** The Wound Care Specialist applies the...members of the healthcare team and participates in the peer review process. You will promote change… more
- University of Southern California (Alhambra, CA)
- …principles. + Pref Skills and knowledge on the following software: Cerner and Craneware + Pref Registered Nurse - RN (CA Board of Registered Nursing) + ... center of clinical charge capture, the Revenue Integrity (RI) Specialist provides leadership to the daily CDM maintenance workflow...to date. Assists the Revenue Cycle in annual coding review and processing of updates. + Reviews and process… more