• Sr Specialist | PI - Quality & Safety…

    Sharp HealthCare (San Diego, CA)
    …in Patient Safety (CPPS) - Certification Board for Professionals in Patient Safety; California Registered Nurse ( RN ) - CA Board of Registered ... Will Do** The purpose of the Sr. Performance Improvement Specialist is to improve clinical outcomes including responsibilities relating...Board for Professionals in Patient Safety -PREFERRED + California Registered Nurse ( RN ) - CA… more
    Sharp HealthCare (12/14/25)
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  • RN Care Mgr II

    Covenant Health Inc. (Sevierville, TN)
    Overview Registered Nurse Care Manager, Continuum of Care PRN, Variable Hours & Shift LeConte Medical Center Overview: LeConte Medical Center is a part of ... + Provides care management services within the scope of practice as a registered nurse meeting all required standards both legal and regulatory. Education:… more
    Covenant Health Inc. (01/07/26)
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  • Clinical Rehab Specialist PRN

    HCA Healthcare (Largo, FL)
    …verbal instructions, PC skills **What qualifications you will need:** + Bachelors Degree + ( RN ) Registered Nurse , or (OT) Occupational Therapist, or (LPT) ... and personal growth, we encourage you to apply for our Clinical Rehab Specialist PRN opening. We review all applications. Qualified candidates will be… more
    HCA Healthcare (12/04/25)
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  • Senior Clinical Nurse Specialist

    Immigration and Customs Enforcement (Washington, DC)
    …Qualifications-Licenses and Certifications Required: a. Nursing License- Must be a Registered Nurse ( RN ).i. Maintains current/documented professional ... ensuring needed interpretation and/or translations services are available. d. The correctional registered nurse practices ethically per the Code of Ethics for… more
    Immigration and Customs Enforcement (11/06/25)
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  • DRG Specialist

    UPMC (Pittsburgh, PA)
    … Health Information Administrator OR Registered Health Information Technician (RHIT) OR Registered Nurse ( RN ) + Act 34 *Current licensure either in ... Purpose: Review clinical documentation within the medical record to... (CCS) OR Certified Professional Coder (CPC) OR Certified Registered Nurse Practitioner OR Doctor of Medicine… more
    UPMC (01/07/26)
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  • Commercial Review Specialist I

    SUNY Upstate Medical University (Syracuse, NY)
    …including PC, Windows, Microsoft applications, Zoom/WebEx platforms, etc. Preferred Qualifications: Utilization management or utilization review experience, ... contracts with reimbursement entities. This is achieved through a thorough chart review and utilization of first-level screening criteria to ensure patients… more
    SUNY Upstate Medical University (11/18/25)
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  • CDI Specialist

    UPMC (Pittsburgh, PA)
    …used in substitution of the aforementioned certifications and licensure. + Certified Coding Specialist (CCS) OR Certified Registered Nurse Practitioner OR ... Documentation Improvement (CDI) experience. + Background in Quality Assurance, Utilization Review , or Quality Insights. + Advanced...OR Registered Health Information Technician (RHIT) OR Registered Nurse ( RN ) + Act… more
    UPMC (12/31/25)
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  • Payment Integrity Nurse Coder RN III

    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
    LA Care Health Plan (10/23/25)
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  • RN Clinical Appeals Nurse Remote

    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
    Molina Healthcare (01/02/26)
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  • Clinical Nurse Specialist

    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
    University of Southern California (12/18/25)
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