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We are working with a great Healthcare Organization, that needs to add a: Quality Improvement Analyst II - 10487 to their award winning team. Description Position Purpose: Conduct review of delegated entities for compliance with quality, service performance and utilization, credentialing reviews and medical record audits. Perform community activities related to clinical initiatives such as health fairs and communicate with agencies and providers. Perform quality on site reviews of delegated....

- Chicago suburb, IL

Sr. Director, UM - Chicago Suburb Amazing growth continues with this national firm - award winning programs of care and a chance to TRULY make a difference for the medically undeserved population in Illinois. Benefits are excellent- career advancement opportunities are unlimited Director will join an already successful team and have oversight for referral management, telephonic utilization review, prior authorization functions, and case management programs and ensuring compliance government....


Director, Utlization - Medical Management - Harrisburg, PAUnique opportunity for an experienced leader to select and develop your own team. Generous relocation- excellent analytic tools and support. - Direct medical management program including UM, case management, QI and credentialing. - Develop department objectives and implement action plans to achieve objectives. - Evaluate and implement changes to medical service functions and performance. - Manage budget and forecast for strategic....


Acute Care Nurse Practitioner Thoracic Cardiovascular Surgery & Intermediate Care Unit opportunity is available at a leading university medical center located in beautiful central Virginia! Requirements:Education: Master's Degree in Nursing from an accredited School of Nursing.Experience: Prior experience as an NP or RN in a similar unit. Exceptional new NPs will be considered.License/Certification: Licensed (or eligible) to Practice as an RN and NP in Virginia. Licensed to prescribe....

- Onondaga County, NY

RN Case Manager Job Description Primary Functions: Our RN Case Managers will administer skilled nursing care to patients requiring professional nursing service per the physician’s orders and under the direction / supervision of the Director of Patient Services/Clinical Team Manager.The RN Case Manager will manage each patient’s care efficiently and effectively to achieve positive patient outcomes, and be responsible for the overall plan of care and the outcome of that care, including care....


With over 32 million members covered across 50 states, our client ensures delivery of the right test at the right time in the right place. Location: Glendale, CA Seeking a Board-Certified Oncologist and/or Hematologist to participate in pre-authorization and quality improvement solutions for our oncology and diagnostic imaging solutions. Physician Reviewers determine the medical necessity of outpatient requests using clinical appropriateness guidelines and health plan medical policy.....


With over 32 million members covered across 50 states, our client ensures delivery of the right test at the right time in the right place. Location: Glendale, CA Seeking a Board-Certified Oncologist and/or Hematologist to participate in pre-authorization and quality improvement solutions for our oncology and diagnostic imaging solutions. Physician Reviewers determine the medical necessity of outpatient requests using clinical appropriateness guidelines and health plan medical policy.....


TITLE: Charge Nurse RN(Registered Nurse) OB LOCATION: Chattanooga area, Tennessee Would you be interested in working for a healthcare leader in the region? Would you like to be in a position in a facility where you make a difference? The facility is centrally nestled between Nashville, Chattanooga, and Huntsville, AL. Its a few hours West of the Smokie Mountains and Northwest of Atlanta. So if you want to live in a rural community with low crime and enjoy the outdoors area that has mountains....

- Miles City, MT

TITLE: Director of Nursing LOCATION: MONTANA Would you like to live and work in an area where you can enjoy the outdoors and a low cost of living? The location is a picturesque town bordered by the beauty of the badlands, rolling hills, and the Yellowstone River. Are you interested in a career where you can have balance? Summary: The Hospital is seeking a an experienced Registered Nurse to provide Clinical Leadership to a 21 bed Critical Access Hospital. The Director of Nursing has overall....


TITLE: Director Behavioral Health Unit LOCATION: West of Casper, WY Would you be interested in living in an area with a historic downtown district with numerous art galleries, specialty shops and restaurants? How about a greenway that parallels the scenic Popo Agie River. It is the perfect place for people who love the outdoors as you can enjoy walking trails, rock climbing, mountain biking, fishing, horseback riding and camping. In the winter cross country skiing and snowmobiling are popular....

- Madison County, NY

RN Case Manager Job Description Primary Functions: Our RN Case Managers will administer skilled nursing care to patients requiring professional nursing service per the physician’s orders and under the direction / supervision of the Director of Patient Services/Clinical Team Manager.The RN Case Manager will manage each patient’s care efficiently and effectively to achieve positive patient outcomes, and be responsible for the overall plan of care and the outcome of that care, including care....

- Cortland, NY

RN Case Manager Job Description Primary Functions: Our RN Case Managers will administer skilled nursing care to patients requiring professional nursing service per the physician’s orders and under the direction / supervision of the Director of Patient Services/Clinical Team Manager.The RN Case Manager will manage each patient’s care efficiently and effectively to achieve positive patient outcomes, and be responsible for the overall plan of care and the outcome of that care, including care....


RN Case Manager Job Description Primary Functions: Our RN Case Managers will administer skilled nursing care to patients requiring professional nursing service per the physician’s orders and under the direction / supervision of the Director of Patient Services/Clinical Team Manager.The RN Case Manager will manage each patient’s care efficiently and effectively to achieve positive patient outcomes, and be responsible for the overall plan of care and the outcome of that care, including care....

- New York, NY

Develop new and grow existing relationships with key referral sources in NYC including: hospital discharge planners, social workers, case managers, and physicians, as well as community Assisted Living, and Rehab facilities.Developing referrals for private pay home careRequired QualificationsDemonstrated success in home health care sales perefer experience in private payCompetent organizational skillsExcellent oral/written communication and interpersonal skillsMust demonstrate the ability to....


Supervisor, UM - Bedford, NHInnovative health plan continues to expand. Supervisor will lead and mentor the UM staff, including identifying opportunities for process improvement. Benefits and perks are great – growth opportunities are unlimited!!! - Ensure appropriate usage of resources in order to facilitate the UM process - Ensure compliance within applicable state program guidelines - Evaluate compliance policies and procedures and analyze/recommend enhancements - Assist with ensuring....


This position will manage daily operations of clinical review and eligibility programs for with hands-on oversight for all operational areas for Clinical Support Services with a focus on UM and Behavioral Health programs Successful Candidate will have:Master’s degree in healthcare related degree. RN preferred but not required.Minimum 10 years of progressive operational leadership of a public and/or private sector healthcare entity with at least five years in a position of direct operational....

- Maitland or Sunrise, FL

Director, Case ManagementINNOVATIVE health plan truly values their nurses . The Director will be engaged in creating, defining and directing a complete Case Management Program across a diverse population.This will encompass needs analysis and planning; working with executive leadership to ensure targets are met for the annual operating plan; ensuring compliance with Corporate, State and NCQA standards. Director will be asked to develop and implement methods, policies and procedures to improve....


TITLE: RN ED area LOCATION: Missouri Are you looking for a new position where you can live and work in an area where you can make a difference and enjoy beautiful scenery and friendly people? Would you like to work in a hospital where you can but be part of a stable team that is a healthcare leader in the area. How about living in an area that is large enough to provide everything but small enough to where you could live in a lower cost and safer communities. Then this might just be the right....

- Sprinfgfield, OR

10 Immediate openings Full-time Critical Care/ICU RN opening with our talented ICU team! This is a wonderful opportunity for a nurse with two years of Critical Care/ICU experience to work in a general Intensive Care Unit with 42 beds. Sacred Heart Medical Center's ICU covers Med/Surge, Cardiac, Neuro & Trauma cases. You’ll get to participate in team building and in the future apply for our Rapid Response (Code Blue) Team. Join our talented team, we are dedicated to increasing patient....

- Battle Creek, MI area, MI

TITLE- Operating Room(OR) Technician LOCATION: Battle Creek, MI area Are you interested in making a difference in patient care? Are you looking for a facility that is interested in candidates that want to grow professionally but have not been given the opportunity? Would you like to work in a facility that serves several counties and can offer small town living with lots of outdoor activities and within short distance of larger cities like Kalamazoo, Lansing and Jackson? Then this could be an....

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Unless noted above, applicants MUST be authorized to work in the US without Visa Sponsorship. US citizens and Green Card holders ONLY. We do not provide relocation assistance for those living outside the continental US. Please only click apply if you meet the specific requirements of the job listing, you are able to work in the location listed, and are comfortable with the salary range indicated above. Thanks for your interest. We look forward to working with you.