- 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 ... and established customer service program. 4. Monitor corporate clinical benchmarks, QI's, QM 's and other available consultant reports, corporate QA results, and… more
- CVS Health (Harrisburg, PA)
- …identification of disallowed billed charges through Internal Itemized Bill Review. This Nurse Coder position reviews hospital itemized bills to determine if all ... both internal payment policies and Medicare payment policies the Nurse Coder ensures all billed line items align with...facility claims. + Communicate with various levels of Network Management and Claims teams. + Consult with external supplier… more
- CVS Health (Columbus, OH)
- …3+ years of clinical experience required. + 2+ years of Utilization Management experience required + 2+ years' experience using personal computer, keyboard ... navigation, navigating multiple systems and applications; and using MS Office Suite applications (Teams, Outlook, Word, Excel, etc.). Preferred Qualifications + BSN degree preferred + Auditing experience + Managed care experience + Medicaid and/or Medicare… more
- US Tech Solutions (May, OK)
- …regulatory and accreditation requirements for member and/or provider issues. Works Potential Quality of Care cases across all lines of business (Commercial and ... support as required. **Responsibilities:** + Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit… more
- CVS Health (Plantation, FL)
- …Working schedule is Monday-Friday, 8am-5pm (ET). This position reports to the Potential Quality of Care (PQOC) nurse investigator team manager. This position is ... requirements for member and/or provider issues. Fundamental Components + Works Potential Quality of Care cases (Medical and Behavioral Health), along with Patient… more
- CVS Health (Columbus, OH)
- …* Serve as an incident reporting expert for Aetna Care Management .* Lead and demonstrate the How We Work Behaviors (specifically collaboration, ... incident reporting* Mentor the care team regarding best practice standards, quality of interventions, problem resolution and critical thinking and standard operating… 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 (Richmond, VA)
- …Qualifications - 3+ years of clinical experience required - 3+ years of Quality experience required - Virginia resident required - Licensed RN with current ... unrestricted state of Virginia licensure required - Must possess reliable transportation and be willing and able to travel approximately 10% of the time. Mileage is reimbursed per our company expense reimbursement policy - 1+ year of experience using Microsoft… more
- Elderwood (Buffalo, NY)
- …for trends or quality improvement opportunities, by routinely reviewing audits, nurse consultant visit reports, mock survey reports and investigations. + ... staff.Activity CFON + Reviews quality measures and quality data (CMS 5 Star, CASPER, QM /QI,... quality improvement opportunities, by routinely reviewing audits, nurse consultant visit reports, mock survey reports… more
- Ellis Medicine (Schenectady, NY)
- …pathway data, management , coordination, and communication. Responsible for quality management data, concurrent collection and intervention with departments. ... transfers. Understands the needs over continuum to plan best management plan. * Ensures effective concurrent Quality ...the systems in which we work. * Serves as nurse consultant for Social Worker cases with… more
- MyFlorida (Macclenny, FL)
- …the behavioral sciences and knowledgeable of and utilize the principles of Total Quality Management . Ability to assist in carrying out treatment and ... supervised and maintain documentation in unit. Serve as a consultant to the Registered Nurse , Licensed Practical...in good repair. Participate in, or designate a registered nurse representative to participate in, quality assurance… more
- Sutter Health (Santa Rosa, CA)
- …care delivery and quality improvement is required, including clinical care management and/or quality management . Knowledge of lean performance ... and facilitates the development, deployment, and monitoring of clinical quality improvement projects, patient safety improvement initiatives, and organization… more
- Albany Medical Center (Albany, NY)
- …The Nurse Manager utilizes the patient care framework that includes Total Quality Management , Shared Governance, and Primary nursing to assure patient care. ... Labor & Delivery - D6E Work Shift: Day (United States of America) The Nurse Manager has 24-hour responsibility, accountability, and authority for the management … more
- Albany Medical Center (Albany, NY)
- Department/Unit: Quality Management Work Shift: Day (United States of America) Salary range: $65,507 - $107,343 RN - Quality Specialist Quality ... Management Department Medical Affairs Division The Quality Specialist is responsible for providing guidance to department managers, teams and staff in the… more
- Lucile Packard Children's Hospital Stanford (Palo Alto, CA)
- …to meet the needs of diverse units. Demonstrates principles of Packard Quality Management System in achieving efficient, effective standard leaders work. ... clinical and nursing professional development expertise as an educator, leader, consultant , facilitator, change agent, and researcher to support the organization in… more
- Veterans Affairs, Veterans Health Administration (Lexington, KY)
- …expands. Plan, implement, carry out, and advise on various activities relative to quality management /improvement. Analyze and solve problems in a positive, goal ... reports: designing detailed charts and graphs; and conducting special management studies requiring written presentations of finding, recommendations, forecasts, and… more
- Albany Medical Center (Albany, NY)
- … Nurse Manager utilizes the patient care framework that includes Total Quality Management , Shared Governance, and Primary nursing to assure patient care. ... Care - D5E Work Shift: Day (United States of America) The Assistant Nurse Manager has responsibility, accountability, and authority for the management of… more
- Bassett Healthcare (Cooperstown, NY)
- …analysis, for the Board of Trustee meetings, Performance Improvement Board Meetings, Quality Management Council, Safety Action Council, the annual report and ... Safety Report with analysis of trends. Acts as a consultant to providers and staff members on all risk.... Serves as an expert resource for new risk management , quality management , legal affairs… more
- Covenant Health Inc. (Lenoir City, TN)
- Overview Registered Nurse , Manager, Quality Management PRN/OCC, Varied shifts Fort Loudoun Medical Center is equipped with a team of more than 200 doctors in ... and patients and serving as a clinical resource and consultant to the health care team. The RN Care...Job Title RN Care Mgr I ID 3535030 Facility Fort Loudon Medical Center Department Name QUALITY MANAGEMENT… more
- Cleveland Clinic (Cleveland, OH)
- …within the organization. Responsible for coordinating the implementation of the quality management program. Collaborates appropriately to support ongoing ... in educating and evaluating clinical and support department staff regarding quality management regulations and standards of care. + Supports medical… more