• Appeals Manager

    BronxCare Health System (Bronx, NY)
    …assist the department's leadership develop strategies for denial prevention, improved utilization management , documentation of medical necessity and identify ... avoidable day and barriers to discharge processes pertaining to utilization management . - Liaisons and coordinates with...department physician advisors and clinical staff. Qualifications - NYS Registered Nurse required - The Appeal Manager… more
    BronxCare Health System (11/15/25)
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  • Clinical Documentation Specialist - Remote

    Trinity Health (Columbus, OH)
    …in lieu of an RN . + Licensure/Certification: Current license to practice as registered nurse in the State of Ohio. Registered Health Information ... Specialist (CCS) will be considered in lieu of a RN . + Experience: Minimum of 5 years acute care...5 years acute care medical or surgical experience required; Utilization /Case Management , managed care, or Clinical Documentation… more
    Trinity Health (12/24/25)
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  • Market Director Patient Care and Quality

    Dignity Health (Phoenix, AZ)
    …care services (eg state, federal, local regulations,etc.). **Required Licenses:** + Registered Nurse : Arizona ( RN :AZ). **Knowledge, Skills, Abilities ... Arizona is responsible for leading the design, coordination, implementation and management of ambulatory practices related to quality, safety and clinical practice… more
    Dignity Health (11/26/25)
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  • Physician/Medical Director

    STG International (Bloomington, IN)
    management /coordination of the clinic's day-to-day activity, in conjunction with the Registered Nurse ( RN )/CBOC Manager and VA Program's philosophy. + ... to ensure compliance and patient safety. + Participate in quality improvement, care management , risk management , peer review, utilization review, clinical… more
    STG International (12/19/25)
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  • Mgr Emergency Dept

    Community Health Systems (Valparaiso, IN)
    …platforms, healthcare software systems, and data analysis tools. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact ... Emergency Department oversees daily operations, nursing care delivery, and staff management within the Emergency Department. This role focuses on fostering a… more
    Community Health Systems (11/12/25)
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  • Director of Inpatient Oncology Services

    Emory Healthcare/Emory University (Atlanta, GA)
    …Healthcare Operating Unit or PGP practice area, the **Director of Patient Care Services ( Registered Nurse / RN )** will lead and manage clinical operations ... optimize patient care and service efficiency. + Ensure cost-effective resource utilization and monitor functional unit nursing budgets. + Standardize policies,… more
    Emory Healthcare/Emory University (09/30/25)
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  • Aetna Commercial Clinical Program Consultant…

    CVS Health (Austin, TX)
    …is highly valued by internal partners and customers. **Required Qualifications** + Active, unrestricted registered nurse ( RN ) license + Minimum 5 years of ... As a CPC, you will collaborate closely with account teams, care management , Regional Analytic Consulting, and key enterprise partners to support customer objectives.… more
    CVS Health (12/26/25)
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  • Director of Cardiovascular Services

    Community Health Systems (Tucson, AZ)
    …and Certifications** + RCIS - Registered Cardiovascular Invasive Specialist required or + RN - Registered Nurse - State Licensure and/or Compact State ... maintain efficient operations and regulatory compliance. + Oversees inventory management , including ordering, storage, and utilization of...related field preferred + 5-7 years of cath lab RN or technician experience required + 3-5 years of… more
    Community Health Systems (12/04/25)
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  • CISC Care Coordinator, Licensed

    Magellan Health Services (Carlsbad, NM)
    …LPN - Licensed Practical Nurse - Care Mgmt, PSY - Psychologist - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care Mgmt ... Magellan Credentialing criteria. 2+ years' post-licensure clinical experience. Experience in utilization management , quality assurance, home or facility care,… more
    Magellan Health Services (11/19/25)
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  • Patient Placement Specialist

    Parkview Health (Fort Wayne, IN)
    …recognition program + Ask about our Hotel Program! Qualifications: + Valid Indiana Registered Nurse license required. + Additional certifications may be required ... bed tracking, scheduling, and ED software preferred. Experience in pre-certification, utilization , or case management desirable. Previous coding experience… more
    Parkview Health (11/18/25)
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