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Job DescriptionAt Cincinnati Children’s, we come to work with one goal: to make children’s health better. We believe in a holistic team approach, both in caring for patients and their families, and... read more

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Cleveland Clinic is currently seeking a CNS for a position our main campus cardiovascular ICU in Cleveland, Ohio. Critical Care experience is required for this position. This... read more

Job Summary:The Clinical Appeals Nurse is responsible for processing clinical appeals and attending state hearings within compliance and regulatory standards, clinical guidelines, and contractual... read more

Job Summary:Clinical Care Reviewer II is responsible for processing medical necessity reviews for appropriateness of authorization for health care services, assisting with discharge planning... read more

Job DescriptionJob SummaryMolina Healthcare Services (HCS) Department works with members, providers, and multidisciplinary team members to assess, facilitate, plan, and coordinate an integrated... read more

Job Summary:The Associate Vice President, Care Management is responsible for the strategic leadership and operational oversight of health plan and clinical services. This role involves developing... read more

Job Summary:The Team Lead, Clinical Care Review is responsible for providing direct oversight of Clinical Care Review (CCR) employees and overseeing day-to-day workflow within the CCR... read more

Job Summary:Provider Performance Liaisons (PPLs) will develop partnerships with providers to close identified gaps in care and achieve targeted thresholds in Alternative Payment Model (APM)... read more

Job Responsibilities
Compliance - Patient Services Staff - Sustain a working understanding of regulatory requirements and accreditation standards. Support leadership in Compliance efforts to meet... read more

Job Responsibilities
Compliance - Patient Services Staff - Sustain a working understanding of regulatory requirements and accreditation standards. Support leadership in Compliance efforts to meet... read more