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- Harrisburg, PA
new job!

Director, Utilization Management Job descriptionPosition Purpose: Oversee 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. Oversee the operations of the referral management, telephonic utilization review, prior authorization, and case management functions. Support and perform case....

- Corpus Christi, TX
new job!

Nurse Practitioner / Physician Assistant Our client delivers home based primary care, working with home health and hospice agencies to ensure patients receive continuity of care in the home environment. Our clients’ in-home physicians, Nurse Practitioners and Physician Assistants collaborate with agencies to establish in-home treatment plans and certify the need for services. Our client partners with home health agencies, collaborates with independent and assisted living communities, and works

- Maitland or Sunrise, FL
new job!

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....

- Milwaukee, WI
new job!

Case Manager II - RN Innovative health plan truly values their nurses. This health plan has received numerous awards for their programs of care ! They offer generous benefits and PLENTY of opportunity to grow in your career RN will coordinate continuum of care for select members with complex medical and/or behavioral health conditions to ensure they receive the highest quality most effective care while maintaining cost effectiveness. Activity will include advanced review of admissions through....

- Ft Lauderdale, FL
new job!

VP of Quality - Ft Lauderdale, FL Drive success in quality through process improvement activities for more efficient and streamlined workflow. VP is responsible for all activities related to NCQA Accreditation and HEDIS performance ensuring highest level of accreditation. OPPORTUNITY FOR EQUITY !!! SENIOR LEDAERSHIP role in a LARGE market. STRONG GROWTH potential- multiple product lines- GREAT relocation! -Manage all aspects of HEDIS improvement activities, including outreach, incentives, data

- SEATTLE, TACOMA, or YAKIM, WA
new job!

CARE MANAGER II (RN) - SEATTLE, TACOMA, or YAKIMAINNOVATIVE health plan is known for award winning programs of care. Join a growing team with exceptional leadership!Plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care. Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider....


Director, Clinical Behavioral Health | Behavioral Health SME - TACOMA/SeattleTruly make a difference in healthcare in this community as part of this innovative health plan. KEY leader will develop a high performing, fully integrated medical management team, working in collaboration with the VP and peer Medical Management Directors. If you are a behavioral health SME who understands managed care, this may be THE opportunity to accelerate your career.-Director will oversee clinical functions in....


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....


We are in search of a RN with 5 years clinical experience in Cardiovascular Surgery. Since this is a Manager role, the qualified candidate should have 3 years of management, Supervisory experience. Demonstrated clinical nursing leadership as a Charge/Senior RN. A BSN is required and it is a plus if you have a Master’s degree. Must have CVOR experience What is great about this role?Our client is offering relocation within the state of California and in addition to a robust 6 figure salary, you....


Registered Nurse (RN) Home Infusion Clinical Sales Liaison As part of the sales team working closely with the Sales Account Executive and the Regional Sales Manager the goal is to grow the business by recognizing opportunities to expand relationships with existing referral sources and partner with the medical community to understand their patient’s needs for a safe and smooth transition home. Support and assist physicians, social workers, discharge planners and other referral sources to....


Registered Nurse (RN) Home Infusion Clinical Sales Liaison As part of the sales team working closely with the Sales Account Executive and the Regional Sales Manager the goal is to grow the business by recognizing opportunities to expand relationships with existing referral sources and partner with the medical community to understand their patient’s needs for a safe and smooth transition home. Support and assist physicians, social workers, discharge planners and other referral sources to....


WORK FROM HOME! MINIMUM $10,000 SIGN-ON BONUS PAID UP FRONT WITH FIRST MONTH'S SALARY, PLUS RELOCATION OFFERED - SUPERB BENEFITS REGIONAL NURSE MANAGER/DIRECTOR FOR 4 SKILLED NURSING FACILITIES IN PORTLAND, OREGON REGION. ------------------------------------------------------------------------------------------------------ Based in the Portland, Oregon region, either at Corporate HQ or from home, the Regional Nurse Manager/Director will have general oversight of 4 state-of-the-art Skilled....

- WA STATE AND OREGON, OR

SIGN-ON BONUS OF UP TO $20,000 + RELOCATION ALLOWANCE AND SUPERB BENEFITS IMMEDIATE NEED FOR GERIATRIC NURSE MANAGERS AND SENIOR CARE FACILITY EXECUTIVE ADMINISTRATORS The employer owns over 100 Skilled Nursing and Long Term / Senior Care facilities in California, WA state, Oregon and Idaho, where at any time there are several Senior and mid-level nurse manager openings. These positions pay $90K to $150K base salary + annual bonus + up to $20K SIGN-ON BONUS as well as generous....


LEAVE THE TRAFFIC AND CITY STRESS BEHIND! COME TO BEAUTIFUL EASTERN WASHINGTON STATE. IT'S ALL ABOUT LIFESTYLE: Fresh air, little traffic, low crime, family friendly, fabulous pristine landscapes and a wonderful 4-season climate. This laid-back, cozy community on the HISTORIC SNAKE RIVER, near HELL'S CANYON National Recreation Area and an easy drive to the fabulous BLUE MOUNTAINS of SE WA STATE AND OREGON, boasts white water rafting, miles of hiking trails, resort ski areas and outdoor....


Provides disciplined and principled leadership, clear direction, establishment of priorities, coordination, and evaluation of the care and service for assigned Specialty Services in the Georgia Region enhancing the organization's ability to increase market share. Under the direction and leadership of the Sr Dir, Specialty Care Operations supports, from a strategic direction the design and implementation of the internalization of specialty services with the objective of delivering high quality....

- 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....

- East of Columbus, OH

TITLE: RN Emergency Services ManagerLOCATION: OhioAre 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 multiple outpatient care....


TITLE: Nurse Practitioner Behavioral Health LOCATION: OHIO An opportunity to work in northern Ohio for an established healthcare system. SUMMARY The Nurse Practitioner will function as part of a highly qualified team within the Behavioral Health Program. Provides clinical patient care in accordance with hospital policy for Psychiatric/Medication Services, utilization review, case management, quality management, and compliance programs to the extent that is medically reasonable and appropriate....

- Roosevelt, UT

Title: Director of Surgical Services Location: Roosevelt, UT Are you interested in making a difference? Would you like to work in a facility that serves a large area of eastern Utah and can offer small town living with a population of 30K located between Salt Lake City and Denver. This area is an outdoor paradise with a reservoir and the mountains on your doorstep with activities to include Fishing, hunting, biking, hiking, golfing, water sports, cross country skiing, snowmobiling and white....


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....

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