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- Baltimore, MD
new job!

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.....

- Sacramento, CA
new job!

Seeking an Executive leader committed to the medical management function, who thrives on coaching and mentoring a large organization, has a creative and visionary style of leadership with excellent communication skills Are you looking for an opportunity to shine and have ideas that can make a positive impact on programs of care management? Do you have creative ideas and want to work with a GREAT Team? The Director will work closely with the Medical Informatics team to identify trends that need

- Irvine, CA
new job!

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 part-time or full-time opportunity and works around your schedule. Job DescriptionHealth Home healthcare nurses provide one-on-one care for patients in their homes and may involve wound care, medication management, medication administration, hands-on care to patients, intravenous therapy lines, observing and monitoring patients'....


Regional Nurse Clinical Sales Leader - Midwest Representing a multi-state Region reporting to the Vice President of Sales supporting the sales initiatives as an expert in IV infusion services. Identify and retain new physicians, hospitals, payors and consumer opportunities to grow parenteral nutrition and cardiac infusion therapies and contribute to the growth of existing business. Strategic analysis of market and implement programs accordingly that support business growth. Up to 50% travel in

- Ottawa, OH
new job!

Summary:Reports to Manager, Human Resources and is responsible for supporting the HR Department through; management, compliance and enforcement of human resource related policies, procedures, and programs. Also, reporting, analysis, training development, implementation and facilitation, employee relation problem resolution, investigations, performance management, health and wellness compliance, and communication using various methods. A significant portion of incumbent’s duties are performed....

- Pittsburgh, PA
new job!

This Chief Nurse officer / CNO will be responsible for overseeing all day to day nursing functions for LIFE Pittsburgh. They will lead, manage and direct 6 nurse managers and up to 20 nurses. They will have the responsibility to lead the strategic clinical direction of the organization in a very team oriented approach. This is an excellent opportunity for Director level nursing person who can look at the big picture strategically while leading by example with their feet on the ground. We are....

- Tigard, OR
new job!

Seeking RN leader with strong management and organizational skills to manage utilization function of fast growing organization. Develop, implement, and execute utilization management programs to provide appropriate medical resources, best care practices and decrease financial costs.Provide reports on work function activities for statistical and financial tracking purposes to identify utilization trends and process improvement strategiesReview data analytics of services, expenditures,....

- Baton Rouge, LA
new job!

Exclusive, Nationwide Search for a strong dynamic high-level nurse leader with a decade of medical management experience. This highly visible role will involve presenting to key stakeholders, coordinating with the medical management, quality improvement, and credentialing teams to support the strategies, vision, and policies of the health plan organization. Direct and coordinate activities of department and aid the chief officer of the health plan and appropriate corporate staff in formulating

- Santa Monica, CA
new job!

Nationwide Search for RN, BSN, MSN Leader with experience in Complex Case Management, Disease Management, Utilization Management, Care Management, Quality in a managed care setting with at least 5-7 years experience. Job description OVERVIEW OF POSITION: Responsible for the oversight, management and optimization of all CQI, UM and Care Management activities as they relate to inpatient, social service, home health, DME and other healthcare delivery programs for the enterprise. Participates in....


Nurse Practitioner or Physician Assistant opportunity at a primary care/family practice located in a picturesque community in affordable upstate New York. Join a financially stable healthcare organization affiliated with a teaching hospital and enjoy top benefits and competitive compensation! Relocation assistance and other perks! Requirements: Certification as an NP or PA, with NY license or eligible. Ability to work independently. New grads welcome and receive tuition repayment! Please email

- Binghamton, NY
new job!

Nurse Practitioner or Physician Assistant Urology opportunity in upstate NY! This position is in a teaching hospital system with high marks in employee satisfaction. Great pay and benefits, including relocation assistance. New grads welcome and receive tuition repayment - no strings!! Requirements: FNP must have current licensure in NY State as an RN and a current NY State license as a Nurse Practitioner. PA must have NCCPA certification and NY State license. Beautiful rolling hills, major....

- Binghamton, NY
new job!

Palliative Care Nurse Practitioner opportunity in upstate NY! This position is in a teaching hospital with high marks in employee satisfaction. Overview: Perform health and physical assessments, followup rounding on patients, symptom management, family meetings, interdisciplinary collaboration, etc. Great pay and benefits, including relocation assistance. Requirements: Must have current licensure in NY State as an RN and a current NY State license as a Nurse Practitioner. Beautiful rolling....


Physician Assistant, ENT opportunity in upstate NY! This practice is affiliated with a teaching hospital system with high marks in employee satisfaction. Great pay and benefits, including relocation assistance. New grads welcome and receive tuition repayment - no strings!! Requirements: Valid NYS Physician Assistant license (or eligible) and current certificate of registration from the NCCPA. Beautiful rolling hills, major university, lakes and rivers, parks and trails, small-city environment,

- Dayton, OH

Our client is a Faith based not-for profit health system rated as among the Top 10 in the country. Highly patient centric and collaborative environmentRN-Ohio License or willingness to obtainHospital OR experience, preferably trauma casesMinimum of two years RN-OR Circulating experienceVariety of cases and complexity with one or more of the following, (i.e., ortho total joint/hip, neuro-spine/crany, robotics, heart, general, etc.)Open to working 10's or 12's (either first, second or third....


Clinical Manager for Case Management | Care Coordination – MILWAUKEE Health Plan Manage and develop clinical team of licensed medical and behavioral health clinicians, ensuring quality of care for individuals with both behavioral health and medical conditions. This team has oversight for the Case Management and Care Coordination services and activities for members. Manage clinical services including oversight of clinical policies and procedures and daily activities of integrated care....


VP of Medical Management | Health Services - (RN) - Milwaukee, WI Milwaukee... on the shores of Lake Michigan...you will find it is a very comfortable place to enjoy life...rich in historical and cultural attractions, and the perfect place for exploring the outdoors. Company offers generous relocation & perks, including TUITION & stock optionsJoin an already successful leadership team as they continue to improve outcomes and quality in WI. VP will establish and implement the strategic....

- St Louis, MO

VP, QUALITY - MCO - St Louis EXCEPTIONAL leadership team - GENEROUS RelocationWorking closely with the Chief Medical Director and the CEO, VP will oversee all related activities for Quality Improvement functions. Lead and direct process improvement activities for more efficient and streamlined workflow. Oversee the business processes related to risk adjustment and quality improvement for assigned products and plans.Responsible for all activities related to National Committee for Quality....

- 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....


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....


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....

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