- CVS Health (Woonsocket, RI)
- …compassionate. And we do it all with heart, each and every day. **Position Summary** The Quality Management Nurse (QM Nurse ) supports Aetna Better Health ... ensuring compliance with regulatory and accreditation standards while driving healthcare quality initiatives. This role combines clinical expertise with quality … more
- US Tech Solutions (RI)
- …support as required. **Responsibilities:** + Reviews documentation and evaluates potential quality of care issues based on clinical policies and benefit ... Medicare/Medicaid knowledge. + MUST HAVE UM experience, inpatient utilization management review. + MUST HAVE 1 YEAR OF UTILIZATION... review. + MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG. + MUST HAVE… more
- CVS Health (Woonsocket, RI)
- …we do it all with heart, each and every day. **Position Summary** _Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and ... other products, services and/or programs + Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and… more
- Fujifilm (Providence, RI)
- …customers. + Ensure compliance with all applicable requirements of the company's quality management system. + Maintains effective communications and working ... **Position Overview** The Clinical Consultant , MI - I shall be responsible for... products and services. + Understand and apply appropriate quality management system processes. + Promote Company… more
- Oracle (Providence, RI)
- …Oracle's solutions. Using Oracle's implementation approach and methodology, the Clinical Consultant will assist in change management , help identify opportunities ... as we are to improving health equity and delivering quality care across the globe. If you're excited about...you've come to the right place. As a Clinical Consultant , you are responsible for driving the customer through… more
- Oracle (Providence, RI)
- …Oracle's solutions. Using Oracle's implementation approach and methodology, the Clinical Consultant will assist in change management , help identify opportunities ... as we are to improving health equity and delivering quality care across the globe. If you're excited about...you've come to the right place. As a Clinical Consultant , you are responsible for driving the customer through… more
- CVS Health (Woonsocket, RI)
- …to coordinate, document, and communicate all aspects of the utilization/benefit management program. + Conduct clinical reviews for adult inpatient behavioral health ... constituents in the coordination and administration of the utilization/benefit management function. + Gathers clinical information and applies the appropriate… more
- Elderwood (Wakefield, RI)
- …staff, other service providers, and consultants + Participation and promotion of Quality Management activities and programs for ongoing improvement in nursing ... the health and well-being of our residents by being responsible for: + Overall nurse staffing, staff training and development, and management of personnel in the… more
- Genesis Healthcare (Middletown, RI)
- …we are dedicated to improving the lives we touch through the delivery of high- quality care and exceptional service. As a leading provider in the long-term care ... Prevention and Control Program (IPCP) and functions as a practitioner, resource, consultant , educator and facilitator for staff in multiple locations focusing on the… more