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Contract Quality Review Nurse jobs

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UTILIZATION REVIEW NURSE, RN

Professional certification in CM preferred. Associate's degree required. Current Florida nursing license required. Must be able to read, write in, speak and understand English. Experience: Minimum of 5 years of clinical experience...

CompanyUf Health Central Florida
AddressLeesburg, FL
CategoryEducation/Training
Job typeFull-time
Date Posted yesterday See detail

Utilization Review Nurse, RN

Uf Health Central Florida

Leesburg, FL

Professional certification in CM preferred. Associate's degree required. Current Florida nursing license required. Must be able to read, write in, speak and understand English. Experience: Minimum of 5 years of clinical experience...

yesterday seen See more...

Nurse (Chief Quality Management) Temporary

Department Of Veterans Affairs

Portland, OR

Competitive

Transforms established practices to cultivate a culture of inquiry and innovation for the future. Routinely identifies and objectively analyzes and advances strategic plans and actions related to healthcare, quality, and safety is...

2 days ago seen See more...

Insurance Premium Auditor/Quality Reviewer (1099) - Stamford, CT

Sedgwick

Stamford, CT

Physical Ideal for complex or large accounts, test audit states, new businesses or businesses undergoing changes in operations or scope. Virtual Meets the requirements for a physical audit and offers a cost-effective option in...

a week ago seen See more...

Quality Assurance Nurse

Paradigm Healthcare

Cleveland, OH

$40 - $50 an hour

Geriatrics. Wound Care. Acute care. Long term care. Day shift. Extended hours. Holidays. On call. Overtime. Monday to Friday. Weekends as needed. Cleveland, OH: Relocate before starting work (Required)....

5 days ago seen See more...

Registered Nurse Clinical Denials & Appeals Reviewer

Administrative Regional Training Cntr

Buffalo, NY

$36.19 - $54.29 an hour

Registered Nurse with a current New York State license Bachelor of Science Nursing degree Holds, or will obtain within one (1) year of hire, one of the following (or similar) credentials: Certified Documentation Specialist, Certif...

7 days ago seen See more...

Clinical Review Nurse I - Medicare Part B (US)

Elevance Health

Atlanta, GA

Assesses the necessity and reasonableness of the items supplied in a valid claim through the use of medical policy and other materials. . Requires AS in nursing and minimum of 1 year of clinical experience; or any combination of...

2 weeks ago seen See more...

Chart Reviewer Registered Nurse

Unizon Taskforce Technology

Bronx, NY

$60 - $70 an hour

Use clinical knowledge to review medical charts for accuracy and sequencing of diagnosis to those assigned from Consultation reports, History and Physical reports, Operative reports, Progress reports, Discharge reports including c...

a week ago seen See more...

Insurance Premium Auditor/Quality Reviewer (1099) - Peoria, IL

Sedgwick

Peoria, IL

$64.7K - $82K a year

Physical Ideal for complex or large accounts, test audit states, new businesses or businesses undergoing changes in operations or scope. Virtual Meets the requirements for a physical audit and offers a cost-effective option in...

3 weeks ago seen See more...

Registered Nurse - Quality Management Specialist

Department Of Veterans Affairs

North Chicago, IL

Competitive

The QMS is assigned responsibility for their assigned Quality Management program area activities for the Medical Center and all off-site locations. The QMS demonstrates performance that improves the care for a group of patients. T...

2 weeks ago seen See more...

Clinical Nurse Review - II

Progressive Technology Solutions

Owings Mills, MD

$35 - $39 an hour

8 hour shift. Owings Mills, MD 21117: Relocate before starting work (Required)....

2 weeks ago seen See more...

Registered Nurse - Utilization Review Coordinator

Exeter Hospital

Exeter, NH

$71.6K - $90.7K a year

1-3 years experience RN license - NH or other Compact State. Utilization Management Certified within 1 year of hire. Reviews all admissions and provides clinical information to third party payors as required by contracts. Maintain...

2 weeks ago seen See more...

Registered Nurse - Quality Management Consultant (SAIL/EPRP/Process Improvement)

Department Of Veterans Affairs

Walla Walla, WA

Competitive

Leading effort to identify SAIL/EPRP challenges, priorities for improvement, and opportunities for disseminating and sustaining best practices. Leading project SAIL/EPRP teams through designed brainstorming sessions to develop sol...

2 weeks ago seen See more...

Medical Review Nurse

Provider Resources, Inc.

Fargo, ND

$51.7K - $65.4K a year

Understand and represent PRI?s mission, vision, and values to all internal and external customers. Engage clients in appropriate communication that manages client expectations and builds a collaborative relationship with the clien...

3 weeks ago seen See more...

Insurance Premium Auditor/Quality Reviewer (1099) - Trenton, NJ

Sedgwick

Trenton, NJ

$64.8K - $82.1K a year

Physical Ideal for complex or large accounts, test audit states, new businesses or businesses undergoing changes in operations or scope. Virtual Meets the requirements for a physical audit and offers a cost-effective option in...

3 weeks ago seen See more...

Quality and Patient Safety (QPS) Registered Nurse

Department Of Veterans Affairs

Richmond, VA

Competitive

Collects data, monitors staff compliance with relevant policies, directives, and standards, provides reports detailing trends. Provides direct staff support to all services in planning, designing, integrating, implementing, modify...

3 weeks ago seen See more...

Registered Nurse (RN) Quality Advisor

Olmsted Medical Center

Rochester, MN

$74.6K - $94.4K a year

Medical Insurance. Dental Insurance. Vision Insurance. Basic Life Insurance. Tuition Reimbursement. Employer Paid Short-Term Disability and Long-Term Disability. Adoption Assistance Plan. Minnesota Registered Nurse required. Proce...

3 weeks ago seen See more...

Registered Nurse - Deputy Chief of Quality Management

Department Of Veterans Affairs

New Orleans, LA

Competitive

Assumes a leadership role in facilitating regulatory compliance for internal and external oversight bodies (i.e., The Joint Commission (TJC), Commission on Accreditation of Rehabilitation Facilities (CARF), Veterans Health Adminis...

3 weeks ago seen See more...

Quality Review Manager - New York, United States - VNS Health

Vns Health

New York, NY

Attractive sign-on bonus and referral bonus opportunities. Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays. Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life...

4 weeks ago seen See more...

Insurance Premium Auditor/Quality Reviewer (1099) - Akron, OH

Sedgwick

Akron, OH

$62.9K - $79.6K a year

Physical Ideal for complex or large accounts, test audit states, new businesses or businesses undergoing changes in operations or scope. Virtual Meets the requirements for a physical audit and offers a cost-effective option in...

4 weeks ago seen See more...

Insurance Premium Auditor/Quality Reviewer (1099) - Nashua, NH

Sedgwick

Nashua, NH

$64.7K - $81.9K a year

Physical Ideal for complex or large accounts, test audit states, new businesses or businesses undergoing changes in operations or scope. Virtual Meets the requirements for a physical audit and offers a cost-effective option in...

4 weeks ago seen See more...

Clinical Review Nurse - Prior Authorization

Bcforward

Indianapolis, IN

Clinical Review Nurse - Prior AuthorizationBC Forward is looking for Clinical Review Nurse - Prior Authorization (Remote Work) Position Title: Clinical Review Nurse - Prior Authorization (Remote Work) Locations: Remote IN (Local t...

2 months ago seen See more...

Sr. Biodefense Regulated Quality Review Specialist

Alakaina Family Of Companies

Frederick, MD

Work with Chief, RRA, study directors, principal investigators, and other key staff to perform Quality Reviews of documents and records associated with nonclinical studies, to include those conducted under FDA Good Laboratory Prac...

2 months ago seen See more...

Registered Nurse- Risk Manager Clinical Reviewer

Department Of Veterans Affairs

Martinsburg, WV

Competitive

Demonstrates knowledge in the interpretation and application of accrediting body standards and other agency requirements. Assists with monitoring of various aspects of care provided to Veterans and the analysis and interpretation...

4 weeks ago seen See more...

Quality Management Nurse I

University Health

San Antonio, TX

POSITION SUMMARY/RESPONSIBILITIESCoordinates and collaborates with Community First Health Plans, Inc. (Community First), various departments to ensure that contractual, regulatory, and accreditation requirements, including Nationa...

4 weeks ago seen See more...

Deputy Chief Quality Patient Safety Nurse

Department Of Veterans Affairs

Phoenix, AZ

Competitive

Planning, designing, integrating, implementing, modifying, and administering the enterprise risk management and quality management programs with the focus on evaluating and continuously improving services provided for the Veteran...

a month ago seen See more...

*Quality Management Nurse Consultant

Adecco

Woonsocket, RI

$ 36.2 - $ 39.11 / Hour

Reviews documentation and evaluates the necessity of provider requests, but applying national and state based criterion, thus conducting Medical Necessity Review.. Staff may be required to contact the providers of record, vendor...

a month ago seen See more...

Registered Nurse - Utilization Review

Ascension

Jacksonville, FL

Department: Utilization Management Schedule: Part Time, Every Saturday and Sunday, 7am - 7pm Hospital: Ascension St. Vincents Riverside Location: Jacksonville, FL Review admissions and service requests within assigned unit for pr...

2 months ago seen See more...

Registered Nurse Community Care Quality Improvement Coordinator

Department Of Veterans Affairs

Olin, NC

Competitive

Manages core Quality Management activities to include preparation and submission of needed data analysis for internal and external reviewers. Works closely and collaboratively with other staff within VACC and outside of the Health...

2 months ago seen See more...

Quality Analyst - Medical Bill Review (Remote) 2023-1273

Managed Care Advisors

Orlando, FL

* Provides input to SGS managers and teams regarding analysis, updates, and recommendations for modifications for procedures and processes to continually improve operations and protocols. Citizenship * Prior to hiring and training...

2 months ago seen See more...

REMOTE Registered Nurse (Utilization Review/MEDCOMPASS EXP REQUIRED)

A-Line Staffing Solutions

Atlanta, GA

Start Date: ASAP/TBD. Potential for Direct Hire?: YTBD. $36.21 p/hr, paid biweekly. Benefits are available after 90 days and include health, optical, dental, life, and short-term disability insurance. To be eligible for benefits y...

2 months ago seen See more...

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