- Evolent (Dover, DE)
- …scheduled. + Determines medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all review ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks… more
- Fresenius Medical Center (Wilmington, DE)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture...a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in… more
- Humana (Dover, DE)
- …Manager, Fraud and Waste Investigator: Nurse Audit/ Review performs clinical audit/validation processes to ensure that medical record documentation and ... approach, resources, schedules and goals. The Manager, Fraud and Waste Investigator: Nurse Audit/ Review validates and interprets medical documentation to… more
- Veterans Affairs, Veterans Health Administration (Wilmington, DE)
- Summary The Wilmington VA Medical Center is looking to hire a full-time Advanced Practice Nurse ( Nurse Practitioner) -Neurology. The Full Time Neurology NP ... requested by attending neurology physician Attend bimonthly meetings to review patient progress/troubleshoot Collaborate with attending neurology physician to meet… more
- Sunrise Senior Living (Wilmington, DE)
- …NAME** Sunrise of Wilmington **Job ID** 2025-225450 **JOB OVERVIEW** The Wellness Nurse is responsible for monitoring the health and well-being of our residents ... administration, communication with resident support services and families, and maintaining clinical quality assurance while leading and demonstrating the Mission for… more
- CVS Health (Dover, DE)
- …benefit overall claim management. + Using a holistic approach, consults with clinical colleagues, supervisors, Medical Directors and/or other programs to ... in the US with virtual training.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993,… more
- Highmark Health (Dover, DE)
- …facilities and providers for care-coordination. + Participate in rounds with the Medical Director. + Review documentation and processes for consistent practice, ... hospice, public health, or assisted living **Or** + Registered Nurse or Licensed Practical Nurse and 2...with developmental disabilities population + Two years in home clinical or case management experience + Medicare and Medicaid… more
- BioLife Plasma Services (Newark, DE)
- …You will report to the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. BioLife ... of laboratory test results, and donor notification of unsuitable test results. The Medical Support Specialist (Plasma Center Nurse ) works under the guidance of… more
- Surgery Care Affiliates (Newark, DE)
- …do it. Each decision we make is rooted in seven core values: + Clinical quality + Integrity + Service excellence + Teamwork + Accountability + Continuous improvement ... package to support your health, well-being, and financial future. Our offerings include medical , dental, and vision coverage, 401k plan with company match, paid time… more
- Cardinal Health (Dover, DE)
- …to ensure a positive and satisfactory experience for all customers. The Supervisor, Clinical Operations monitors nurse to patient contact quality and provides ... manufacturers to rethink the reach and impact of their products. The Supervisor, Clinical Operations provides management and clinical oversight to a team of… more