- The County of Los Angeles (Los Angeles, CA)
- …Requirements SELECTION REQUIREMENTS: Option I: Five (5) years of experience as a Registered Nurse including two (2) years of experience in an administrative*, ... HEALTH FACILITIES CONSULTANT , NURSING Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2307969) Apply HEALTH FACILITIES...university AND four (4) years of experience as a Registered Nurse including two (2) years of… more
- Lincoln Financial (Hagatna, GU)
- …75214 **The Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be ... reviewing, analyzing, and interpreting medical information available for disability claims . In this role you will act as a...for** Education * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license… more
- NHS Management, LLC (Fayetteville, AR)
- …the successes they experience along the way. We are in search of a qualified Regional Nurse Consultant : The Regional Nurse Consultant will be responsible ... policies and established customer service program. 4. Monitor corporate clinical benchmarks, QI's, QM's and other available consultant...Holidays and Paid Vacation Requirements + Must be a Registered Nurse in good standing + Previous… more
- HCA Healthcare (Nashville, TN)
- …and external reviews and monitor for potential compliance risks. + Perform reviews of claims data and clinical records to ensure compliance. + Identify and ... monitor for potential compliance risks. - Perform reviews of claims data and/or clinical records to ensure... Health Information Technician/Administrator, Certified Coding Specialist (CCS), HCCA, clinical ( RN , LPN, PT, or other … more
- US Tech Solutions (Chesapeake, VA)
- …healthcare costs and improve healthcare program/operational efficiency involving clinical issues Determines medical necessity/ appropriateness Facilitates optimal ... enable decision making at most appropriate level **Duties:** + Nurse Case Manager is responsible for face to face...policies and programs are comprised of network management and clinical coverage policies. + Through the use of … more
- Baylor Scott & White Health (Plano, TX)
- … experience. Or, an Associate's Degree in a healthcare field and six years of clinical experience. Or, an RN with less than a Bachelor's Degree and six ... patient harm. If organizational risk is found, the Corporate claims manager will review the event further. The CRM...years of clinical experience. + TX RN license if… more
- Alight (IN)
- **Medical Nurse Consultant :** The Nurse Consultant functions as a member of our Clinical Center of Excellence and serves as a clinical consult ... in clinical guidelines in this industry, the Nurse Consultant facilitates medically sound decisions and... claims within their scope of licensure and clinical expertise. **You have** + Registered … more
- UPMC (Pittsburgh, PA)
- …very sensitive and confidential information. **Licensure, Certifications, and Clearances:** + Pharmacist OR Registered Nurse ( RN ) + Act 34 *Current licensure ... Management, the role involves systematically managing potential and actual claims . Analyzing clinical data is crucial for... or healthcare setting along with a pharmacist or RN license, this could be the next step in… more
- HCA Healthcare (Nashville, TN)
- …and experience in multiple markets/divisions is a plus + Legal Nurse Consultant Certified (LNCC) preferred + Registered Nurse - Currently licensed ... in the pursuit of payment on unpaid and underpaid claims . Additionally, the Nurse Subject Matter Advisor...of similar claim issues. **Major Responsibilities:** + Conducts comprehensive clinical record reviews and detailed claims analyses.… more
- HCA Healthcare (Hopewell, VA)
- …of Science in Nursing or related field - Required Master of Science - Preferred Registered Nurse License in state in which he or she practices - Required ... Division Vice President of Quality, Division Chief Medical Officer, Division Claims Administrator, HCA Patient Safety Organization and General Counsel as… more
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