- CVS Health (Sacramento, CA)
- …for conducting oversight of external entities that are contracted to perform clinical functions on Aetna's behalf. + Monitor and track delegated entities compliance ... and other regulatory compliance initiatives. **Required Qualifications** + One of the following clinical licenses is required: LPN, LVN, or RN + Must reside in… more
- UNC Health Care (Chapel Hill, NC)
- …applications. Functions as primary liaison between technical, operational and clinical managers, users and information systems to facilitate capacity related ... solutions. Analyzes and implements capacity driven solutions assisting clinical and operational users through optimization of scheduling templates. Description of… more
- Deloitte (Rosslyn, VA)
- …modernized EHR System + Facilitate successful EHR design and build efforts for clinical and/or business domain groups + Cerner Implementation and PMO Support + ... Collaborate on Clinical Workflow Analysis Deloitte's Government and Public Services (GPS)...Assessments + 3 or more years of experience with Clinical Workflow Analysis + Strong understanding of Health Information… more
- Healthfirst (NY)
- Job Description In the Clinical Performance Optimization team, you will work with process improvements, project go-lives, and reporting/analytics. This is a critical ... multiple departments Minimum Qualifications: + Undergraduate students must be a junior or senior at an accredited institution or have graduated within 12 months of… more
- CVS Health (Lansing, MI)
- …candidate will coordinate the identification of potential claim editing & clinical program enhancements to ensure compliance with Federal and State Legislation. ... policy space. They will use DRG coding knowledge to provide Prepay DRG clinical coding consultations. **Skill in:** + Effective Verbal and Written Communication +… more
- Health Care Service Corporation (Philadelphia, PA)
- …care services in conjunction with the physician treatment plan. Utilizes clinical skills to assess, plan, implement, implement, coordinates, monitor and evaluates ... options and services to facilitate appropriate healthcare outcomes for customers. **Required Job Qualifications:** + Current Licensure as a registered nurse, in the state of residence in good standing. + Associates degree, diploma, or BS in Nursing + Three to… more
- CVS Health (Blue Bell, PA)
- …specialty programs. Connect with the budgeting and forecasting process for the Aetna Clinical Solutions. + Provide holistic, end to end view and insights and ... observations into overall performance of programs including program ROIs. + Participate in development and/or collaboration with key business partners on additional analytical tools and dashboards to provide early insights into potential outcomes and savings.… more
- Rush Copley Medical Center (Aurora, IL)
- …reporting structures. **Required Job Qualifications:** + Bachelor's degree in Computer Science, Clinical , or a related field is required. + Minimum of 5 years ... of revenue-cycle and hospital-based Epic reporting experience is required. + Current Epic certification in Clarity or Caboodle data models and Revenue Data Model are required. + Demonstrated advanced proficiency in writing SQL queries and stored procedures for… more
- CVS Health (Tallahassee, FL)
- …quality improvement activities, and quality program evaluation - Measure adherence to clinical and preventive health guidelines - Assists in the development and ... implementation of QM projects and activities - Converts results of data analysis into meaningful business information to disseminate conclusions about the overall function of the department - Support quality committees execution and reporting to quality… more
- CareFirst (Baltimore, MD)
- …to Medicaid and/or Medicare processing. Participate in workgroup projects around clinical editing. Create, maintain and communicate policies as need to support. ... + Use statistical analysis on large amounts of data to develop detailed financial impact analyses as part of financial models for negotiations with professional and institutional providers. Participate in negotiations with high profile providers to provide… more