• Quality Management Clinical Nurse

    UCLA Health (Los Angeles, CA)
    Description The Quality Management Clinical Nurse Specialist is responsible for conducting comprehensive facility site reviews (FSRs) to ensure compliance with ... involves evaluation clinical practices, identifying areas for improvement, and implementing quality improvement initiatives to enhance patient care and safety. In… more
    UCLA Health (03/12/25)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW NURSE ... performance of subordinate supervisors and reviews their evaluations of Utilization Review Nurses; counsels subordinates on their performance . + Develops… more
    The County of Los Angeles (03/30/25)
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  • Medical Bill Review Senior Nurse

    Zurich NA (Schaumburg, IL)
    …management has access to up to date and accurate information to understand medical bill review performance . + Mentor lower level medical bill review staff ... Medical Bill Review Senior Nurse 123154 Zurich Insurance...quickly, accurately and in a professional manner. + Meet quality standards by adhering to Best Practices and participating… more
    Zurich NA (05/09/25)
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  • Utilization Review Nurse

    CDPHP (Albany, NY)
    …these values and invites you to be a part of that experience. The Utilization Review (UR) Nurse is responsible for the clinical review and documentation ... physician-founded, member-focused, and community-based not-for-profit health plan that offers high- quality affordable health insurance to members throughout New York.… more
    CDPHP (05/09/25)
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  • Utilization Review Nurse (RN)…

    Ascension Health (Baltimore, MD)
    …functions for assigned sites. + Collaborate with the director to develop and implement quality review programs and key performance indicators for all ... based on factors including, but not limited to, experience, skills, education, performance and salary range at the time of the offer._ **Responsibilities** Manage… more
    Ascension Health (03/26/25)
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  • UM Prior Authorization Review Nurse

    UCLA Health (Los Angeles, CA)
    Description At UCLA Health, the Utilization Management (UM) Review Nurse plays a vital role in ensuring the delivery of high- quality , evidence-based care. ... documentation related to prior authorization requests for medical services. The UM Review Nurse applies clinical judgment, regulatory standards, and established… more
    UCLA Health (04/22/25)
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  • Utilization Management Review Nurse

    AmeriHealth Caritas (Dover, DE)
    …Medicaid industry standards. + Maintain productivity and efficiency by meeting established performance metrics, turnaround times, and quality standards in a ... When necessary, cases are escalated to the Medical Director for further review . The reviewer independently applies medical and behavioral health guidelines to… more
    AmeriHealth Caritas (04/29/25)
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  • Facility Site Review Nurse (Remote)

    Molina Healthcare (Los Angeles, CA)
    **JOB DESCRIPTION** **Job Summary** Molina's Quality Improvement function oversees, plans, and implements new and existing healthcare quality improvement ... programs; ensures maintenance of programs for members in accordance with prescribed quality standards; conducts data collection, reporting and monitoring for key … more
    Molina Healthcare (04/20/25)
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  • RN - Registered Nurse Performance

    Geisinger (Bloomsburg, PA)
    …and overseeing field staff and infusion suites. The Registered Nurse Performance Improvement Coordinator evaluates the quality of health care rendered by ... Top 8 Most Innovative Healthcare Systems in Becker's Hospital Review , we're working to create a national model for...lasting career with impact. Join us as a Registered Nurse Performance Improvement Coordinator to strengthen that… more
    Geisinger (03/07/25)
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  • Quality Assurance Nurse Consultant

    State of Colorado (Denver, CO)
    QUALITY ASSURANCE NURSE CONSULTANT Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4910301) Apply  QUALITY ASSURANCE NURSE ... in Colorado. It bestows a streamlined and efficient government approach to support quality care while minimizing the burden on providers so that they can focus… more
    State of Colorado (04/26/25)
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