• Medical Review & Appeals Director (Hybrid)

    CareFirst (Baltimore, MD)
    …**Knowledge, Skills and Abilities (KSAs)** + Knowledge of NCQA requirements of utilization review, Case Management standards and guidelines, appeal rights and ... multiple strategic clinical projects that span organizational boundaries, responsible for management of corporate care cost directives and goals. + Provides… more
    CareFirst (01/06/26)
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  • SQPE Specialist I

    Cleveland Clinic (Cleveland, OH)
    …compliance with all standards and favorable performance on safety, quality, utilization , and experience metrics. + Participate in engraining the safety, quality, ... when a deviation in standard practice has occurred. + Act as a consultant in educating and evaluating clinical and support department staff regarding quality … more
    Cleveland Clinic (12/11/25)
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  • Sepsis Coordinator

    Cleveland Clinic (Garfield Heights, OH)
    …compliance with all standards and favorable performance on safety, quality, utilization , and experience metrics. + Participate in engraining the safety, quality, ... when a deviation in standard practice has occurred. + Act as a consultant in educating and evaluating clinical and support department staff regarding quality … more
    Cleveland Clinic (10/16/25)
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  • RN Heart Failure HF Navigator

    Corewell Health (St. Joseph, MI)
    …between the settings. Manages projects and programs related to clinical management , performing quality improvement activities to measure program processes and ... Provides ongoing review and development of educational materials related to clinical management . + Case manages the population both in the inpatient and/or… more
    Corewell Health (12/12/25)
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  • SQPE Specialist I

    Cleveland Clinic (Stuart, FL)
    …compliance with all standards and favorable performance on safety, quality, utilization , and experience metrics. + Participate in engraining the safety, quality, ... data and participate in improvement strategy development. + Act as a consultant in educating and evaluating clinical and support department staff regarding quality… more
    Cleveland Clinic (10/29/25)
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  • Supervisor, Nursing - Nursing Administration - Per…

    Guthrie (Binghamton, NY)
    …skills. B. Serves as an advocate for patients and family in the clinical management of care. Confers with leadership team and professional staff to enhance delivery ... role in staffing and scheduling of personnel, considering appropriate utilization of personnel considering scope of practice, competencies, patient needs… more
    Guthrie (12/23/25)
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  • Physician (Home Based Primary Care)

    Veterans Affairs, Veterans Health Administration (San Antonio, TX)
    …critical lab/diagnostic test result notifications in a timely manner Clinical Management including direct and indirect patient care: ensure all required encounters ... the new focus on the Medical Home and Patient Centric Care, Utilization , Quality and Patient Safety oversight, process improvement (system redesign). The… more
    Veterans Affairs, Veterans Health Administration (01/06/26)
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  • Director of Nursing (RN)

    Wellpath (Pompano Beach, FL)
    …the organization's Code of Conduct. + Demonstrates knowledge of risk management , clinical precautions, infection control, fall prevention, utilization of ... improvement activities,providesdirect supervision, and serves as a resource and consultant to nursing staff. + Monitorssafety issues,evaluateservicedeliveryand staff growth,… more
    Wellpath (12/24/25)
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