Clinical Nurse Educator, Consultant

Your Role The Medical Care Solutions education team is responsible for all clinical education for all departments within Medical Care Solutions as well as some Health Solutions teams. This includes Utilization Management, Care Management, Post Service, and Appeals. This clinical educator role will be responsible for Utilization Management for all lines of...

Your Role The Clinical Quality Review (CQR) team is responsible for reviewing potential quality of care issues (PQIs) reported by a member, a member representative, or an internal partner. The Clinical Quality Review (CQR) Nurse Trainer/Auditor will report to the Senior Manager, Clinical Quality Review. In this role you will be responsible for understanding...

Summit Medical Staffing Nursing is a Veteran and Employee-owned company that provides staffing resources to Healthcare providers, hospitals and clinics, nationwide.About the OpportunityWe are seeking a Traveling RN to primarily fill new employee orientation needs for RN and ED RN onboarding, clinical skills and education. The ideal candidate will have...

Your Role The Prior Authorization (PA) team utilizes clinical knowledge to review authorization requests for coverage under the outpatient pharmacy benefit. The Pharmacist, Consultant will work as part of the pharmacy benefit Prior Authorization (PA) team to support the Blue Shield of California (BSC) Pharmacy and Therapeutics Committee (P&T) by ensuring...

Your Role The Pharmacy Services Drug Utilization Management team provides efficient and accurate responses to external customer (physicians, office staff, pharmacy providers, members and brokers) and internal team members for all outpatient medical benefit inquires . The Pharmacist, Consultant will report to the Manager of Medical Benefit Drug Utilization....

Your Role The Pharmacy Services Drug Utilization Management team provides efficient and accurate responses to external customer (physicians, office staff, pharmacy providers, members and brokers) and internal team members for all outpatient medical benefit inquires. The Pharmacist, Consultant will report to the Manager of Medical Benefit Drug Utilization. In...

Your Role Remember to check your CV before applying Also, ensure you read through all the requirements related to this role. The Pharmacy Services Drug Utilization Management team provides efficient and accurate responses to external customer (physicians, office staff, pharmacy providers, members and brokers) and internal team members for all outpatient...

Your Role The Prior Authorization (PA) team utilizes clinical knowledge to review authorization requests for coverage under the outpatient pharmacy benefit. The Pharmacist, Consultant will work as part of the pharmacy benefit Prior Authorization (PA) team to support the Blue Shield of California (BSC) Pharmacy and Therapeutics Committee (P&T) by ensuring...

Your Role The Prior Authorization (PA) team utilizes clinical knowledge to review authorization requests for coverage under the outpatient pharmacy benefit. The Pharmacist, Consultant will work as part of the pharmacy benefit Prior Authorization (PA) team to support the Blue Shield of California (BSC) Pharmacy and Therapeutics Committee (P&T) by ensuring...

Your Role The Prior Authorization (PA) team utilizes clinical knowledge to review authorization requests for coverage under the outpatient pharmacy benefit. The Pharmacist, Consultant will work as part of the pharmacy benefit Prior Authorization (PA) team to support the Blue Shield of California (BSC) Pharmacy and Therapeutics Committee (P&T) by ensuring...

Your Role The Pharmacy Services Drug Utilization Management team provides efficient and accurate responses to external customer (physicians, office staff, pharmacy providers, members and brokers) and internal team members for all outpatient medical benefit inquires . The Pharmacist, Consultant will report to the Manager of Medical Benefit Drug Utilization....

Your Role The Pharmacy Services Drug Utilization Management team provides efficient and accurate responses to external customer (physicians, office staff, pharmacy providers, members and brokers) and internal team members for all outpatient medical benefit inquires . The Pharmacist, Consultant will report to the Manager of Medical Benefit Drug Utilization....

Your Role The Pharmacy Services Drug Utilization Management team provides efficient and accurate responses to external customer (physicians, office staff, pharmacy providers, members and brokers) and internal team members for all outpatient medical benefit inquires . The Pharmacist, Consultant will report to the Manager of Medical Benefit Drug Utilization....

Career OpportunityAureus Medical Group invites experienced Registered Nurses (RNs) to apply for the ER Nurse Educator position in California. This is an excellent chance to combine your passion for nursing education with your clinical expertise and travel the country while doing it!Estimated Salary Package: $145,000 - $160,000 per year, based on bill rate at...

Are you a dedicated Registered Nurse looking for a challenging and rewarding opportunity?We are seeking a skilled RN Educator to join our team at Host Healthcare, a leading travel healthcare company.This role offers a unique blend of clinical expertise and educational experience, making it an ideal fit for nurses who enjoy teaching and mentoring others.As an...

Your Role The Clinical Compliance Principal, Medical Care Solutions is responsible for developing and maintaining the team’s audit playbook for all lines of business for all regulatory and mock audits.  Clinical Compliance Principal is also responsible for managing changing UM requirements driven by contractual changes or All Plan Letter requirements. The...

Job OverviewHost Healthcare is seeking a skilled travel nurse RN educator for a challenging opportunity in Rancho Cordova, CA.Salary InformationThe estimated annual salary for this position is approximately $123,000 based on 40 hours per week and an 8-hour shift schedule.Job ResponsibilitiesEducate and train healthcare professionals in various...

Your Role The Clinical Compliance Principal, Medical Care Solutions is responsible for developing and maintaining the team’s audit playbook for all lines of business for all regulatory and mock audits.  Clinical Compliance Principal is also responsible for managing changing UM requirements driven by contractual changes or All Plan Letter requirements. The...

Program Manager Clinical, Principal (Clinical Compliance) at Blue Shield of California summary: The Clinical Compliance Principal oversees the development and maintenance of audit playbooks for regulatory compliance across multiple lines of business. This role requires strategic engagement with internal and external stakeholders to adapt to changing...

Job Title: Travel Nurse Clinical SpecialistOverview of the RoleWe are seeking a dedicated and skilled travel nurse to join our team as a clinical specialist in a clinic setting. This exciting opportunity allows for professional growth and development while making a meaningful impact on patient care.The successful candidate will possess excellent clinical...