Clinical Coding Analyst RN, Consultant Blue Cross and Blue Shield AssociationClinical Coding Analyst RN, ConsultantBaltimore, MDIn this role you will be supporting the FCR team in addition to a small clinical coder team of 2 clinical coders who will be responsible for performing in-depth quality audits of hospital claims to support ICD-10-CM and ICD-10 PCS codes as well as EDC (Emergency Department Coding), MS-DRG and APR-DRG reviews based on clinical determination. Acts as a resource and helps to validate post claim DRG downgrade denials related to coding and clinical determination to support appeal strategy, tracking by disease, payer and denial activity and works with teams to create transparency and improvements to mitigate and prevent denials.
CTO TOC LPN Care Manager MedStar HealthCTO TOC LPN Care ManagerBaltimore, MD$61,838–$111,259 / yearReview of Discharge instructions and Medication ReconciliationAttributed beneficiaries receive a follow up interaction from the TOC Care manager coordinator within 2 business days for hospital discharge and within one week for Emergency Department (ED) discharges; Coordinates referral management for attributed beneficiaries seeking care from high-volume and/or high-cost specialists as well as EDs and hospitals; Facilitates connection to services for patients who may benefit from behavioral health services including: patients with serious mental illness patients with substance use disorders' patients with depression anxiety or other mental health conditions patients with behavioral and social risk factors and BH issues patients with multiple co-morbidities and BH issues; elevates patients requiring longitudinal / ongoing care management needs following discharge to the CTO Lead Care manager MDPCP Social needs teams and or MDPCP Amb pharmacist where appropriateCompletes general assessment for barriers or needs including any Social Determinants of Health (SDoH) and makes referrals as appropriateAssesses plans implements monitors and evaluates options and services to meet health needs of attributed beneficiaries up to 30days following In patient discharge or Emergency room visit. Ensures daily telephonic patient communication to help to close gaps in care and provide up-to-date healthcare information helping to facilitate the members understanding of his/her health status using available reports including quality m page and HIE CRISP to ensure relevant medical history/encounter are accessible in EMR.Facilitates ongoing communication amongst practice and care team by participating in huddles hosting regular conference calls in-person meetings or coordinating regular email updates to ensure alignment of activity discuss new developments and exchange information.
Utilization Management Nurse Consultant CVS Health CorpUtilization Management Nurse ConsultantWork At Home-Maryland, MD$32.01–$68.55 / hourCommunicates with providers and other parties to facilitate care/treatment Identifies members for referral opportunities to integrate with other products, services and/or programs Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function. Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.
NewNurse (Educator) United States ArmyNurse (Educator)Washington, DC$90,823–$118,072 / yearIn addition to meeting the basic requirements above, to qualify for this position you must also meet the qualification requirements listed below: GS-12 Specialized Experience: A minimum of one full year of specialized experience which includes providing graduate-level education and training in public health to seasoned medical professionals, including Physicians, Advanced Practice Providers, Registered Nurses, Environmental Science and Nuclear Medicine Officers, Audiologists, Veterinarians, and Senior Enlisted Soldiers. FOREIGN EDUCATION: If you are using education completed in foreign colleges or universities to meet the qualification requirements, you must show the education credentials have been evaluated by a private organization that specializes in interpretation of foreign education programs and such education has been deemed equivalent to that gained in an accredited U.S. education program; or full credit has been given for the courses at a U.S. accredited college or university.
Pulmonologist AscensionPulmonologistBaltimore, Maryland$350,899–$412,318 / yearFull timeDeliver balanced, full-spectrum pulmonary care across a structured 4-week rotation, spending three weeks dedicated to manageable outpatient clinic days (12–15 patients) and one week focused on efficient inpatient hospital consultations and specialized procedures. Offering a desirable 1:4 rotation that balances structured clinic weeks with dedicated inpatient consultation, this role features resident teaching and access to advanced tech like Robotic Bronchoscopy and EBUS.
Risk Management Consultant MedStar Health Research InstituteRisk Management ConsultantWashington, DC$82,617–$157,352 / yearEngages in an Enterprise Risk Management approach to reducing risk exposure by collaborating with both clinical and non-clinical service lines to guide and assist them with risk assessments and responding to their liability issues. The Consultant maintains an understanding of patient safety and risk management practices and serves as coordinator and consultant for review of patient safety events and evaluation of litigation exposure as well as interfaces with claims management staff and legal defense counsel regarding claims and the professional liability program.
Risk Management Consultant MedStar HealthRisk Management ConsultantWashington, DC$82,617–$157,352 / yearFull timeEngages in an Enterprise Risk Management approach to reducing risk exposure by collaborating with both clinical and non-clinical service lines to guide and assist them with risk assessments and responding to their liability issues. The Consultant maintains an understanding of patient safety and risk management practices and serves as coordinator and consultant for review of patient safety events and evaluation of litigation exposure as well as interfaces with claims management staff and legal defense counsel regarding claims and the professional liability program.
Transplant Care Facilitator Johns Hopkins HospitalTransplant Care FacilitatorBaltimore, MDPatient Care Process: Regularly reviews patient's file for appropriate paperwork, completeness and accurately (medical records, lab results, prior to patient's visit according to departmental guidelines. We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices.
Case Management Specialist CVS Health CorpCase Management SpecialistMD$21.10–$40.90 / hourAs an essential member of our Special Needs Plan (SNP) care team, the telephonic Care Manager Specialist (CMS) plays a key role in coordinating the care of our members, particularly those with social determinants of health (SDoH) needs and stable health conditions. The CMS collaborates closely with the Registered Nurse Care Manager, Care Coordinator, Social Worker, and other interdisciplinary care team participants to support the member in maintaining optimal health.
RN - CVOR – Surgery – Lodi, CA HiredFirstRN - CVOR – Surgery – Lodi, CALodi, CA$81.38–$84.38Call is 1-2 days per week with 1 weekend a month minimum. · Shift Details: Day Shift, $125 IF THEY CAN START 12/22 /5 8's with call.
RN - CVICU – Medical ICU – Lodi, CA HiredFirstRN - CVICU – Medical ICU – Lodi, CALodi, CA$71.25–$74.25Shift Details: Night Shift/36-48 hours. RN - CVICU – Medical ICU – Lodi, CA.
Licensed Psychiatric Nurse Practitioner (LPNP) HeadwayLicensed Psychiatric Nurse Practitioner (LPNP)Stockton, CA$144–$222 / hourWe make it easy for mental health providers to take insurance by credentialing you with the nation’s largest networks, handling billing and admin paperwork, and helping you earn more stable income with higher rates. Whether you want to see patients alongside a full-time job or grow a full-time practice, Headway makes it easy to accept insurance, boost your earnings, and focus on care - without the administrative burden.
Licensed Psychiatric Nurse Practitioner (Remote) HeadwayLicensed Psychiatric Nurse Practitioner (Remote)Stockton, CARemote$144–$222 / hourWe make it easy for mental health providers to take insurance by credentialing you with the nation’s largest networks, handling billing and admin paperwork, and helping you earn more stable income with higher rates. Whether you want to see patients alongside a full-time job or grow a full-time practice, Headway makes it easy to accept insurance, boost your earnings, and focus on care - without the administrative burden.
Licensed Psychiatric Nurse Practitioner (Virtual) HeadwayLicensed Psychiatric Nurse Practitioner (Virtual)Stockton, CA$144–$222 / hourWe make it easy for mental health providers to take insurance by credentialing you with the nation’s largest networks, handling billing and admin paperwork, and helping you earn more stable income with higher rates. Whether you want to see patients alongside a full-time job or grow a full-time practice, Headway makes it easy to accept insurance, boost your earnings, and focus on care - without the administrative burden.
NewTravel Nurse RN - Telemetry - $2,445 per week Cross Country NursesTravel Nurse RN - Telemetry - $2,445 per weekModesto, CARequired Qualifications: CA Registered Nurse (RN) license with valid certification in Advanced Cardiovascular Life Support (ACLS), Basic Life Support (BLS), and National Institute of Health Stroke Scale (NIHSS); 2 years of experience in telemetry or cardiac care; EPIC electronic medical record system experience; valid CA licensure uploaded within the last 2 weeks; hepatitis B vaccination or immunity required. Submittal Requirements: Valid CA RN license uploaded within last 2 weeks, applicable certifications with expiration dates, two references obtained within the last year, and successful completion of onboarding modules within 3-5 days of contract signing.
NewRN - Rehab 3B Healthcare, IncRN - RehabLodi, CAJob Requirements: Education and Work Experience: Bachelor's Degree in Nursing (BSN): Preferred Acute care facility experience: Preferred Licenses/Certifications: Registered Nurse (RN) licensure in the state of practice: Required Cardiopulmonary Resuscitation (CPR) certification or Basic Life Support (BLS) certification from approved vendor per AH policy: Required Facility Specific License/Certifications: Basic Life Support (BLS) certification from approved vendor per AH policy: Required Department Specific License/Certifications: Advanced Cardiovascular? Life Support (ACLS)?certification from approved vendor per AH policy: Required Pediatric Advanced Life Support (PALS)?certification from approved vendor per AH policy: Required National Institutes of Health Stroke Scale: Required Essential Functions: Collects relevant data pertinent to the patient?s health or situation.
NewTravel Nurse RN - Med Surg - $2,479 per week Fusion Medical Staffing-NursingTravel Nurse RN - Med Surg - $2,479 per weekAntioch, CAThis role involves assessing patient health conditions, monitoring cardiac telemetry data, and collaborating with multidisciplinary teams to manage diverse patient needs. As a member of our team, you'll have the opportunity to make a positive impact on the lives of patients while enjoying competitive pay, comprehensive benefits, and the support of a dedicated clinical team.
Travel Nurse RN - Labor and Delivery - $2,400 per week Cross Country NursesTravel Nurse RN - Labor and Delivery - $2,400 per weekModesto, CAAdditional Information: The role is responsible for providing compassionate and efficient care for patients in the Labor and Delivery department, adhering to hospital protocols and policies. Pay package is based on 12 hour shifts and 36.0 hours per week (subject to confirmation) with tax-free stipend amount to be determined.
NewTravel Nurse RN - Labor and Delivery - $3,185 per week Fusion Medical Staffing-NursingTravel Nurse RN - Labor and Delivery - $3,185 per weekModesto, CAThis role encompasses assessing maternal and fetal health, administering treatments, and collaborating with healthcare teams to ensure high-quality, patient-centered care during labor, delivery, and the immediate postpartum period. As a member of our team, you'll have the opportunity to make a positive impact on the lives of patients while enjoying competitive pay, comprehensive benefits, and the support of a dedicated clinical team.
NewRN/Registered Nurse-Cath Lab Macpower Digital Assets Edge Private LimitedRN/Registered Nurse-Cath LabModesto, CA$107,000–$141,000 / yearPrinciple duties consists of assisting physicians in monitoring, collecting, and processing radiological and physiological data during diagnostic and interventional examinations and studies such as both coronary and peripheral diagnostic angiograms, PCI's (Percutaneous Coronary Interventions), PTA's (Percutaneous Transluminal Angioplasty). 2 years recent (within 6 months) Critical Care or Cath lab experience (Please Note: ER experience NOT considered critical care experience).