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CorVel is seeking a Quality Assurance Nurse with experience in worker’s compensation to conduct utilization review and case management quality assurance audits.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
* Develop, implement and provide ongoing quality assurance calibration of processes both managed and delivered at the operational level.
* Educate and equip operations with performance ...

Job Description:
* Responsible for the review and evaluation of clinical information and documentation.
* Reviews documentation and interprets data obtained from clinical records or systems to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and/or provider issues.
* Independently coordinates the clinical resolution ...

Department:
39732 Accountable Care Admin - Care Transition and Support Programs
Status:
Full time
Benefits Eligible:
Yes
Hou rs Per Week:
40
Schedule Details/Additional Information:
This is a remote work from home position
There are 2-4 onsite meetings annually
Monday - Friday 0800-1630
Must have High Speed Internet
Preferred candidate will have 5 years in ...

Overview
About us:
Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. We believe our individual ...

Overview
About us:
Fallon Health is a company that cares. We prioritize our members-always-making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation's top health plans for member experience, service, and clinical quality. We believe our individual di...

Overview
Are you looking for a place where you can make a genuine difference in our patient’s lives?
With over 20 locations and growing, Bridge Home Health & Hospice’s culture of love for our patients and employees is the top priority. Our commitment to our Core Values allows us to be the provider and employer of choice. We embrace a diverse workforce and understand that our employees are key...

Job Type
Full-time
Description
Valor Healthcare is looking for a Quality Assurance program manager to join our proposal team for a government contract to support the Global Nurse Advice Line (NAL) which is a service to Military Health System (MHS) eligible beneficiaries.
Position Summary
The Global NAL will provide access to telehealth registered nurses for triage services, self-care advice, a...

Valor Healthcare is looking for a Quality Assurance program manager to join our proposal team for a government contract to support the Global Nurse Advice Line (NAL) which is a service to Military Health System (MHS) eligible beneficiaries.
Position Summary
The Global NAL will provide access to telehealth registered nurses for triage services, self-care advice, and general health inquiries 2...

The registered nurse in this position assumes responsibility for:
• Leading caregivers in the integration and translation of research findings into practice.
• Leading nursing and interprofessional research studies within the division, service area, and ministries as requested.
• Teaching and leading innovative educational programs including practices of clinical scholarship to support a c...

Overview
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
At Bridgeport Hospital, we are committed to providing quality medical care and treatment that is...

Overview
To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
At Bridgeport Hospital, we are committed to providing quality medical care and treatment that is...

Job Introduction
Maximus is currently hiring for Sr. Regional Nurse Managers to support the New York Independent Assessor Program (NYIA). The NYIA Program serves the State of New York by conducting UAS assessments to determine eligibility for community-based long-term services. The Sr. Regional Nurse Manager will have the opportunity to lead and support a team of Nurse Managers who are on the...

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Essential Functions: * Under general guidance form Senior Quality Practice Advisors and management, educate...

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose: Plans, organizes, and monitors quality related projects to deliver defined requirements ...

Join Community Community Health Network was created by our neighbors, for our neighbors. Over 60 years later, “community” is still the heart of our organization. It means providing our neighbors with the best care possible, backed by state-of-the-art technology. It means getting involved in the communities we serve through volunteer opportunities and benefits initiatives. It means ensuring our ...

Ascend Learning is a national leader in data driven, online educational solutions for learners, educators and employers in high-growth, licensure-driven professions spanning healthcare, fitness and wellness, skilled trades, insurance, and financial services. We are passionate about accelerating learning while impacting job readiness, employment success and employee retention with the belief tha...

Ascend Learning is a national leader in data driven, online educational solutions for learners, educators and employers in high-growth, licensure-driven professions spanning healthcare, fitness and wellness, skilled trades, insurance, and financial services. We are passionate about accelerating learning while impacting job readiness, employment success and employee retention with the belief tha...

Valor Healthcare is looking for a senior program manager to join our proposal team for a government contract to support the Global Nurse Advice Line (NAL) which is a service to Military Health System (MHS) eligible beneficiaries.
Position Summary
The Global NAL will provide access to telehealth registered nurses for triage services, self-care advice, and general health inquiries 24 hours a ...

Overview
Qualifications
Minimum Qualifications:
Enrolled in a Board approved nursing education program
Obtained approval and competency validation of Board approved nursing skills from the nursing educational program
Licensure, Registration, Certification:
Student Practical Nurse Apprentice 2 requires the following:
* Meets all Student Practical Nurse Apprentice 1 requirements
...

Job Introduction
Maximus is currently seeking Quality Assurance Clinical Analysts to support the Independent Practitioner Panel (IPP) Program, which completes assessment reviews and issues practitioner orders for New Yorkers who qualify for long-term in-home care. The QA Clinical Analyst is responsible for reviewing assessments to ensure accuracy and consistency and collaborating with other pr...