• Call Center Quality Assurance Specialist

    AssistRx (Orlando, FL)
    …and/or financial access programs preferred. + Bilingual - Spanish preferred. + Bachelor's Degree or Registered Nurse (BSN or RN ) a plus. + COMPETENCIES: + ... system data entry quality. Within this role, the Quality Assurance Specialist serves customers by identifying, analyzing, and developing improvements in… more
    AssistRx (11/11/25)
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  • Behavioral Health Specialist - Pediatric…

    Highmark Health (Albany, NY)
    …Degree if licensed Behavioral Health Professional **Substitutions** + None **Preferred** + If Registered Nurse ( RN ), BSN or MSN preferred **EXPERIENCE** ... plan for regular telephonic contact with each member to review progress and assess the potential for additional needs....**LICENSES AND CERTIFICATIONS** **Required** Any of the following: + Registered Nurse ( RN ) + Licensed… more
    Highmark Health (11/01/25)
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  • Utilization Management Specialist (Remote)

    CareFirst (Baltimore, MD)
    …experience is required in addition to the required work experience. **Licenses/Certifications:** + RN - Registered Nurse - State Licensure And/or Compact ... **PURPOSE:** Utilizing key principles of utilization management, the Utilization Review Specialist will perform prospective, concurrent and retrospective… more
    CareFirst (10/29/25)
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  • Utilization Review Specialist

    WestCare Foundation (Henderson, NV)
    …recommendations and communicate this information effectively + Call in intakes and/or peer to peers and get the patients appropriate level of care authorized ... Certifications/Licenses: + None required Education: + Associates or Bachelors level LPN or RN and/or Bachelors or Masters level CADC/LADC with 2 years utilization … more
    WestCare Foundation (11/13/25)
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  • Ambulatory CDI Specialist - Coding

    Hawaii Pacific Health (Honolulu, HI)
    …Qualifications:** Must meet education requirements for Hawai'i State licensing. Current Hawai'i Registered Nurse ( RN ) or Licensed Practical Nurse ... secure and in compliance with Federal and State laws and regulations. The Specialist is responsible for the delivery of clinical documentation improvement (CDI) … more
    Hawaii Pacific Health (11/26/25)
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  • Clinical Nurse Leader RN , Emergency…

    Rush University Medical Center (Chicago, IL)
    …The CNL provides insight regarding the microsystem for collaboration with the Clinical Nurse Specialist (CNS) on macrosystem processes and outcomes. The CNL and ... **Other information:** **Required Job Qualifications:** * Current State of Illinois Professional Registered Nurse licensure * Graduate degree in nursing * o… more
    Rush University Medical Center (11/20/25)
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  • Quality Specialist Oncology

    Banner Health (Gilbert, AZ)
    …demonstrated excellence in interpersonal and written communication skills. PREFERRED QUALIFICATIONS Registered Nurse ( RN ) license preferred. Certified ... is home to nearly 200 active clinical trials. Prior RN Experience Required in this role **Schedule** : Exempt,...accrediting agencies such as JCAHO, CMS, DHS, and the peer review organizations. 5. Acts as consultant… more
    Banner Health (11/15/25)
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  • OR Surgical Specialist

    UPMC (Erie, PA)
    …both didactic and skills demonstration components, completed within 30 days of hire. + Current Registered Nurse ( RN ) license in the state of employment or a ... and full call and holiday requirements Each OR Surgical Specialist will assist with one of the following surgical...to healthcare team members and actively participates in nursing peer review , including evaluation of core surgical… more
    UPMC (11/12/25)
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  • Performance Improvement Specialist

    Houston Methodist (Sugar Land, TX)
    …decision support or similar information analysis role **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact ... At Houston Methodist, the Performance Improvement Specialist is responsible for the development of performance...design to hardwire patient safety processes. + Conducts record review for performance improvement, peer review more
    Houston Methodist (10/23/25)
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  • RN

    UnityPoint Health (Sioux City, IA)
    …+ Current licensure in good standing to practice as a Registered Nurse in Iowa. + Successfully completes Certified Specialist in Poison Information (CSPI) ... high-level customer service at every level. + Conduct daily peer case review and uses results of...efforts as assigned. + Maintains status as a Certified Specialist in Poison Information (CSPI). + Participates in training… more
    UnityPoint Health (09/24/25)
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