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- Los Angeles, CA
new job!

Reporting into the Sr. V.P of Clinical Operations, this position will be in charge of overseeing, managing 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 within the organization Individual will participate in the development, implementation and maintenance of all programs to ensure that patient care maximizes quality and continuity by utilization of appropriate resources and....

- Indianapolis, IN
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.....

- Fort Wayne, IN
new job!

Excellent opportunity for an Anesthesiologist to join our established company and growing practice located in NE Indiana. This group provides services at hospitals and surgical centers in the Fort Wayne area. The facility is accepting board certified or board eligible applicants. This position will require an IN license. If you do not currently hold a license in IN, we can help you with the process. Fort Wayne was voted the lowest cost of living in America in 2017 and provides an excellent....

- Reading, PA
new job!

Job Description: Our client is in the process of opening a new Pediatric Emergency Department and are looking for several RN's and RN Managers who will care for children with all levels of illness and traumatic injuries. Their new facility will have a great support services including Radiology, a Lab, Pharmacy and NICU Qualifications:At least one year of experience of Pediatric Emergency Department experienceCurrent RN license

- Honolulu, HI
new job!

Reporting to the Manager of Peds/PICU , this position provides nursing care services to patients and families in our Inpatient Pediatrics floor and Pediatric Intensive Care unit of the Medical Center. We are a 13-bed unit with 2 PICU rooms. Nursing care is supported by inpatient pediatricians and our PICU intensivists. The team also encompasses Child Life Services for collaboration of family centered care. Essential Functions: - Practices professional nursing and delegates nursing tasks to....

- Maryland Heights, MO
new job!

Nationwide Search for Vice President, Quality & Process Improvement (Health Plan) (RN, CPHQ) Position Purpose: As the senior leader, reporting to the Chief Medical Director, you will be responsible for developing and overseeing the quality improvement functions.. To be part of the leadership team to lead and direct process improvement activities, streamline the workflow for a more efficient process. To oversee business processes related to risk adjustment and quality improvement activities

- Mishawaka, IN
new job!

If you are a RN with at least 1-3 years Cath Lab experience, we are interested in speaking with you about our client’s need in the Mishawaka, IN/ South Bend region. If you are a new grad.... our client is willing to invest the time to train you! Our client facility is located centrally of Chicago, Detroit, Indianapolis and 3 miles from Michigan State Line. This is a college community experiencing economic growth and offers diverse living choices for anyone who is single or has a family. Top....

- Irvine, CA
new job!

The candidate is responsible for expeditiously developing and processing raw material and product documentation to meet quality requirements within timelines established for product launch and/or timely project completion.The Master Specifications and Documentation department interacts with various Pharmaceutical groups within the organization and departments such as Quality, Global Pharmaceutical Technology, Regulatory Affairs, Operations, Manufacturing (all sites), Procurement (Sourcing),....


The specialist will work with a team of medical information professionals to capture unsolicited medical inquiries from health care professionals, consumers, and corporate business partners. Also, research and respond to requests for scientific/medical information using various search and retrieval techniques and medical literature database (product label, published and unpublished studies) to develop a medical/scientific response that is accurate, fair balanced, complete and delivered in a....


Nationwide Search for Actuary and Associate Actuary (Individual Market) for Chicago, Milwaukee, and Calabasas Job descriptionPosition Purpose: Conduct analysis, pricing and risk assessment to estimate financial outcomes. Apply knowledge of mathematics, probability, statistics, principles of finance and business to calculate financial outcomesDevelop probability tables based on analysis of statistical data and other pertinent informationReview insurance plans and calculate required premium....

- Winston Salem, NC
new job!

Looking for a busy, fast-paced unit to broaden your nursing skills? Want to join a team that works well together, supportive leadership and excellent partnership with physicians? We are hiring in the following units. General Surgery Orthopedics Neuroscience Renal/Dialysis MedSurg Pulmonary The Registered Nurse serves as a leader of the healthcare team at Novant Health by establishing an authentic personalized relationship with the patient and their chosen support system, collaborating with....

- Chesterfield, MO
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.....

- San Antonio, TX
new job!

Registered Nurse (RN) Home Infusion Sales As part of the sales team working 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 facilitate appropriate home infusion candidates being discharged from area hospitals. Conduct initial....

- Fort Wayne, IN
new job!

Excellent opportunity for an Anesthesiologist to join our established company and growing practice located in NE Indiana. This group provides services at hospitals and surgical centers throughout the region. The facility is accepting board certified or board eligible applicants. This position will require an IN license. If you do not currently hold a license in IN, we can help you with the process. Fort Wayne was voted the lowest cost of living in America in 2017 and provides a welcoming....


Seeking: 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 the....


Job Title: Specialty Pharmacy Director Location: Baltimore, MD PRINCIPAL ACCOUNTABILITIES: The position reports directly to the Senior Director of the Pharmacy Evaluation & Oversight and is a critical leadership position within the unit responsible for understanding the specialty marketplace, opportunities for utilization management, and cost containment. The Director of Specialty Pharmacy will interact frequently with the EVP of Medical Affairs, the CEO, and other senior leaders across....


Nationwide Search for a high-level nurse leader with a decade of medical management experience to lead a strong dynamic team part of a Fortune 100 growing enterprise. 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. Must have Managed care NCQA/HEDIS Medicare/Medicaid/Exchange Managing Direct Reports....


Job description This position reports to the Director of Provider Contracting & Network Management to support the contracting activities of the Medical Group and Health Plan. Responsibilities include managing outside medical cost through contracting initiatives, analysis of financial reports and trends in the marketplace covering IPAs, PHOs, hospitals, and key specialty services. Contractual arrangements will be complex and comprehensive, needing a depth of understanding of managed care;....


Many opportunities for advancement with this Fortune 100 Enterprise for the right candidate that posses a decade of leadership in network development and provider relations/contract management in a managed care environment! Job descriptionDirect the provider network and contracting activities leading all aspects of provider network strategy including, access analysis, network operations and support decision makers with analysis related to reimbursement and unit cost management. Oversee the....


TITLE: RN-Director Womens Services LOCATION: Carlin, NV Would you like to work in a facility that will allow you to have work/life balance? This area is not like Las Vegas or Reno. It offers the mountains, skiing, scenic bikeways, lakes and rivers. It also offers a vibrant community that has theater, galleries and some cowboy country all in a town of 35,000 population. Summary: The Director of Women's Services is a Registered Nurse that will manage a busy 15 bed Women’s Services Department.....

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