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Manager, Medical Management - Appleton, WI Provide leadership for experienced clinical team in growing satellite office (12 direct reports), Manager will be responsible for managing a complete program of medical management in accordance with the mission, philosophy, and objectives of plan. Oversight includes both UM and CM. Manager will implement changes to medical service functions and performance in relation to company mission, philosophy objectives and policies, as directed. Manage budgets....


Sr Director, Provider Contracting – Columbus, OHIO Great manager – highly motivated team –relocation offered. Growing health plan needs a strong communicator with a deep knowledge of value- based contracting and proven ability to build relationships with providers and senior leadership. Drive the development and implementation of network contracting and network development. · Direct the evaluation, review, negotiations and ongoing management of product-specific contracts and amendments between

- Indianapolis, IN

Director, UM - Indianapolis, IN Amazing growth continues with this national firm - award winning programs of care and a chance to TRULY make a difference for the medically underserved population in INDIANA. 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 and....


Senior Director, Quality – FLORIDA _____________________________________________________________________ Incredible growth potential - generous relocation to SUNNY Florida! If you enjoy taking the lead in NCQA accreditation - this may be the new job for you! Sr Director will utilize proven success in moving the needle by directing process improvement activities to improve and streamline workflows across the Florida market. Responsible for NCQA and HEDIS performance. Ensure health plan is....


Nurse Director / Critical Care / DON Las Vegas, NV, USAResponsible for the 24-hour management of multiple departments which may include: ICU, CCU, MICU, IMC, Respiratory Therapy Department, and Central Telemetry units assuring facility meets the established standard of care.Education: Graduate of an accredited school of Nursing. BSN Experience:Minimum of three (3) years clinical experience and a minimum of five (5) years progressive management experience preferred.Technical:Computer....


Are you a RN specialized in Surgical Services / Operating Room showing career progression taking on more leadership duties? Are you ready to move into a leadership role? If you have answered yes to these questions, please read on to see if you meet the requirements for consideration:Bachelor of Science in nursing (BSN)Current Oregon (RN) licenseCurrent Basic Life Support (BLS) at time of hireAmerican Heart Association Basic Life Support (AHA-BLS) for Healthcare Provider within 6 months of....


Are you a RN with a strong background in Perioperative Services? Do you currently have at least some first line management experience? If yes, please read on to see if you meet the requirements:You should have some level of management experience overseeing the overall management and leadership of the OR, PACU, Endoscopy and ECT units. If you have oversight expereince with at least 2 of these units we would still be interested in speking with you.RN Washington licenseBasic Life Support....


Our client located in Northwest Louisiana is in need of adding a Board Certified or Board Eligible Internal Medicine Hospitalist. Our client serves the residents in northwest Louisiana and the neighboring cities in the states of Arkansas and Texas. Today the health system includes four hospitals as well as a retirement community and a full range of support services. Here is an overview of what a typical day would look like for you in this role: * 15 shifts per month ( 5 day, 5 swing and 5....


Our client located in northwest Louisiana is in need of adding 2 more Family Practice Physicians to rotate among their urgent care centers. Our client serves the residents in northwest Louisiana and the neighboring cities in the states of Arkansas and Texas. Today the health system includes four hospitals as well as a retirement community and a full range of support services. Some questions to ask yourself to see if you are a match for what our client is looking for: Are you an experienced....


Our firm is in search of an Acute Care RN who meets the following qualifications to be working in a Rehab unit with focus on Neuro:FL RN License required (BSN or Associate’s degree)Acute Care RN experience required3 years experience with Brain Injury preferredBLS (American Heart Association)NIH Stroke Certification within 60 days of hireThese are high acuity patients. Strong acute care experience is very important especially as it pertains to brain injury working in an acute care hospital....


Work when you want!!! Join our fantastic home health company. We are growing and looking for the best of the best nurses to care for our wonderful patients. This is a contract to hire opportunity and works around your schedule. Job DescriptionHealth Home healthcare speech therapists provide speech therapy to various home health patients. Patients may be able to perform other activities but need speech therapy. Part of your responsibilities may be to educate staff on the value of speech....

- Endicott, NY

RN job opportunities at senior living center in upstate NY that has been nationally recognized with awards for excellence in customer service, practice and quality. This facility offers full nursing care, assisted living and private apartments in a lovely residential neighborhood. Competitive salary, shift pay and excellent benefits, including health insurance, paid time off, bonus and education incentives. Relocation assistance! Schedule: Full time and part time. Part time includes benefits!....


Job Title: Senior IT Business Consultant(Healthcare) Location: Gratiot, OH Are you considering a career change? Looking for a smaller community(25K population), that offers a low cost of living(18% lower than US average) and plenty of activities in the area but is within an hour of a large city. If so, an opportunity to work with an integrated health care system based in east central Ohio is looking for someone to join their team. The system is a not-for-profit and has over 300 physicians and....


Supervisor of Inpatient Coding opportunitiy at a teaching hospital system in upstate New York. Overview: Contribute to the flow within the HIM Department by assuring each inpatient record is optimally coded, attested to, billed and paid with the proper DRG/APC. Oversee clinical documentation improvement, working with physicians, care management and nursing. Customers served include HIM Department, Finance, Physicians, and Third Party Payors, Quality Management, Nursing,....


We are in search of a Family Medicine Physician for a corporate site focused on worksite-based health and wellness center serving company employees. This is located 66 miles to Charlotte, NC. 95 miles to Greensboro, NC. This is a very quaint town and a wonderful place to raise children. Here you can dine in one of their fine eating establishments or shop in our quaint downtown village or sprawling highway 9. Follow in Dizzy Gillespie's footsteps, kayak on Lake Juniper, hike and bike in the....


Seeking local RN leaders with Case Management experience to Manage the day to day operations of the case management department for this healthcare enterprise. Review analyzes of activities, costs, operations, and forecast data to determine progress toward stated goals and statistical/financial purposes. Promote compliance with federal and state regulations and contractual agreements. Develop, implement and maintain compliance with policies and procedures regarding medical case management.....


Nationwide Search for the Best in Class of Contract Negotiators in Value-Based and Hospital Contracting. This national leader in healthcare, a Fortune 100 company which provides innovative solutions to over 12 million members, believes their most important assets are its employees. Join their team and help transform the health of the communities they serve, one person at a time. This starts with you, from your benefits to your retirement plan and reaches outwards to community support and....


Exclusive Search for Regional Medical Director to serve as liaison for the health plan. Responsibilities and focus to ensure that all the opportunities are highlighted through detailed reporting to the leadership building creditable and trusting relationships with stakeholders regarding performance metrics and serving as the clinical lead with large employer groups in the bid process. Manage assigned departments or functions with an emphasis on execution, outcomes, continual improvement and....


Exclusive Nationwide Search for Senior Medical Director to Assist the Chief Medical Officer (CMO) to direct and coordinate the medical affairs functions for the business enterprise. Oversee the denials and appeals department. May manage other medical directors. Medical Leadership Provide medical leadership for all utilization management, pharmacy, case management, disease management, cost containment, and medical quality improvement activities. Perform medical review activities pertaining to....


Nationwide Search for Director, Utilization Management (RN) for large Fortune 100 enterprise. Job descriptionOversee operations of the referral management, telephonic utilization review, prior authorization functions, and case management programs. Ensure compliance government and contractual guidelines and the mission, philosophy, and objectives of Corporate and the health plan. Support and perform case management, disease management, and on-site concurrent review functions as necessary.....

41-60 of 256 results