- Evolent (Boise, ID)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as... medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all… more
- Fresenius Medical Center (Coeur D Alene, ID)
- **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
- Molina Healthcare (Nampa, ID)
- **Job Description** **Job Summary** The Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring ... Michigan RN license is required. **Job Duties** + Facilitates clinical / medical reviews of retrospective medical ...nursing experience, including at least 1 year of utilization review , medical claims review , long-term… more
- Trinity Health (Boise, ID)
- …resources as indicated. **Requirements** : + Current, unrestricted Physician Assistant or Nurse Practitioner medical license in Idaho and Oregon; valid ... Part time **Shift:** **Description:** **Location: Hospital-based at Saint Alphonsus Regional Medical Center.** **Status** : .5 FTE **Schedule** : Friday through… more
- HCA Healthcare (Idaho Falls, ID)
- …some benefits may vary by location._** **Job Summary and Qualifications** The HCA Nurse Residency Program at Eastern Idaho Regional Medical Center provides you ... organization that invests in you?_ **At** **Eastern Idaho Regional Medical Center** **, you come first!** HCA Healthcare is...growth and development of our future nurses! The **HCA Nurse Residency Program** is a year-long program designed to… more
- Veterans Affairs, Veterans Health Administration (Boise, ID)
- …thinking skills. Possesses intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical ... for managing the care of the Veteran throughout the consult process. Supports the medical center's mission to improve timely access to care, ensure Veterans who want… more
- Humana (Boise, ID)
- …and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis ... independent determination of the appropriate courses of action. The Nurse Auditor 2 validates and interprets medical ...coding experience to conduct a clinical validation review of the inpatient medical record to… more
- Cardinal Health (Boise, ID)
- …both scheduled outbound calls and inbound call queue. + Meets regularly with Clinical Supervisor and/or Senior Nurse , Individualized Care to discuss feedback ... who need them-faster.** **_What Individualized Care contributes to Cardinal Health_** Clinical Operations is responsible for providing clinical specialties… more
- Trinity Health (Boise, ID)
- …Forbes as one of **America's Best Large Employers for 2025** , is looking for a ** Nurse Unit Supervisor** to join our team at our Level II Trauma Center in **Boise, ... . This position will be located at our Regional Medical Center (https://www.saintalphonsus.org/location/saint-alphonsus-regional- medical -center) off I-184 and Curtis… more
- Datavant (Boise, ID)
- …years of CDI experience + 3+ years of clinical experience in an academic medical center + Registered Nurse license, Bachelor's degree in Nursing + CCDS or ... realize our bold vision for healthcare. **What We're Looking For:** As a Clinical Documentation Quality Improvement (CDQI) Specialist, you will play a pivotal role… more