- Evolent (Santa Fe, NM)
- …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 (Farmington, NM)
- …or federal surveys. + Participates in the completion of the FMS Administrative Clinical Review . **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + The physical ... requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory… more
- Fresenius Medical Center (Albuquerque, NM)
- **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 (Roswell, NM)
- **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
- Veterans Affairs, Veterans Health Administration (Albuquerque, NM)
- …but not limited to family medicine, internal medicine, and all clinical subspecialties. Demonstrates proficiency with computer-based chart review , documentation, ... to join our team. We are seeking a full-time Nurse Practitioner with prescriptive authority to function as part...the Veterans Affairs (VA) mission. The NP provides advanced clinical practice, consultation, and management. The NP practices to… more
- Fresenius Medical Center (Albuquerque, NM)
- …regulations at: https://content.intranet.fmcna.com/regulatory-affairs/wp-content/uploads/sites/46/2019/05/Pre-Licensed- Nurse -50-State- Review ... of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a...transcribes, and enters physician lab orders accurately into the Medical Information System. + Ensures appropriate preparation of lab… more
- Veterans Affairs, Veterans Health Administration (Albuquerque, NM)
- …is seeking qualified applicants to join our team. We are seeking a full-time Nurse Practitioner with prescriptive authority to function as part of ACS - Primary ... are determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. The… more
- Veterans Affairs, Veterans Health Administration (Raton, NM)
- …seeking qualified applicants to join our team. We are seeking a full-time Nurse Practitioner with prescriptive authority to function as part of the Raton Community ... the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible...to join our team. We are seeking a full-time Nurse Practitioner with prescriptive authority to function as part… more
- Fresenius Medical Center (Albuquerque, NM)
- …to the Inpatient Program Manager, appropriately credentialed physician, patient hospital primary nurse and others as indicated. + Delivers safe, effective care in a ... May be assigned to in-center patient care on an as needed basis + Review and comply with the Code of Business Conduct and all applicable company policies… more
- Humana (Santa Fe, NM)
- …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