- LA Care Health Plan (Los Angeles, CA)
- …of Microsoft Office suite, including Word, Excel and PowerPoint. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and unrestricted ... Payment Integrity Nurse Coder RN III Job Category:...policies within the claim adjudication process through medical record review for Payment Integrity and Utilization Management… more
- Molina Healthcare (WI)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support... licensure, Diagnosis-Related Group (DRG) experience, 2 years of Utilization Review and/or Medical Claims Review… more
- University of Southern California (Los Angeles, CA)
- …be obtained within 12 months of hire and maintain renewal. Required Licenses/Certifications: + Req Registered Nurse - RN (CA Board of Registered Nursing) ... The Clinical Nurse Specialist serves as a resource/consultant...Integrate research and evidence based practice into the development, review and revision of patient education materials. Identifies and… more
- Albany Medical Center (Albany, NY)
- …Work Shift: Day (United States of America) Salary Range: $83,200.00 - $128,960.00 Registered Nurse ( RN ) - Full Time Pediatric Endocrine Department ... advanced practice provider (APP) and the supervision of the Nurse Manager ( RN ) and/or Nurse ...or APP and documents results in EHR + Performs review and triage of incoming test results, patient requests… more
- Covenant Health Inc. (Harriman, TN)
- …duties + Provides care management services within the scope of practice as a registered nurse meeting all required standards both legal and regulatory + In ... Overview RN Care Manager, Continuum of Care PRN/OCC, Variable...that will meet identified needs. + Facilitates timely documentation review with the Clinical Documentation Improvement (CDI) specialist… more
- Covenant Health Inc. (Harriman, TN)
- …requested. + Provides care management services within the scope of practice as a registered nurse meeting all required standards both legal and regulatory. + In ... Overview RN Care Manager, Continuum of Care PRN/OCC, Variable...that will meet identified needs. + Facilitates timely documentation review with the Clinical Documentation Improvement (CDI) specialist… more
- LA Care Health Plan (Los Angeles, CA)
- …Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese. Licenses/Certifications Required Registered Nurse ( RN );current and unrestricted California ... Care Management Specialist II Job Category: Clinical Department: Care Management...health risk assessment (HRA), risk stratification, predictive modeling, provider's utilization review vendors, members, Call Center, claims… more
- State of Georgia (Fulton County, GA)
- …. Knowledge of DATEP, NTP, ARMHP, and/or CLA services . Experience as a Registered Nurse /LPN, or licensed/certified professional in a related field or setting . ... Intake and Triage Specialist - Atlanta Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/75267/other-jobs-matching/location-only)...Experience in utilization review and/or quality assurance in a… more
- Cleveland Clinic (Cleveland, OH)
- …the ideal future caregiver include: + Master's Degree + Current licensure as a Registered Nurse ( RN ) + Certified Professional in Healthcare Quality (CPHQ) ... leader in patient safety. As a Safety Quality and Patient Experience (SQPE) Specialist , you will direct our safety, quality and patient experience work. In this… more
- Cleveland Clinic (Vero Beach, FL)
- …for the ideal future caregiver include: + Master's Degree + Licensure as a Registered Nurse ( RN ) + Clinical experience (will offset three years ... healthcare experience, including physical, educational, emotional and spiritual needs. As SQPE Specialist II, you play an essential part in this mission by ensuring… more