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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....


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....

- St Louis, MO
new job!

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
new job!

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....

- Sunrise, FL
new job!

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....

- Columbia, SC
new job!

VP Medical Management | Health Services - South Carolina _____________________________________________________________________________________________ VP will be a part of strong & collaborative leadership team with the opportunity to be a key strategist in this market. Incredible growth opportunities and perks for this executive role GENEROUS relocation & competitive compensation. ** We are seeking an experienced leader with a proven background in an MCO/health plan/ACO. Direct and....


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....

- Las Vegas,, NV
new job!

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....

- Boca Raton, FL
new job!

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....

- Temecula, 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'....

- Endicott, NY
new job!

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!....

- San Diego, 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 DescriptionMental Health 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....

- Chesterfield, SC
new job!

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 candidates for Manager, Prior Authorization & Referrals. If overseeing day to day functions of the call center that provides preauthorization and referral services to physicians for plan members is your thing. ... then we need you on our team.Oversee preauthorization nurses and referral specialists in their day to day activities including management of talk times, service levels, abandonment rate, and other key quantitative/qualitative factorsDevelop, implement and....

- El Segundo, CA
new job!

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....

- 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.....

- Yakima, WA
new job!

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.....

- 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.....

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