Nurse Medical Management Specialist
3 weeks ago
At Absolute Staffing & Consulting Solutions, we are seeking a highly skilled Nurse Medical Management professional to join our team. As a Nurse Medical Management, you will play a critical role in collaborating with healthcare providers and members to promote quality member outcomes, optimize member benefits, and promote effective use of resources for more complex medical issues.
Key Responsibilities:- Conducts precertification, continued stay review, care coordination, or discharge planning for appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
- Consults with clinical reviewers and/or medical directors to ensure medically appropriate, high quality, cost effective care throughout the medical management process.
- Collaborates with providers to assess member's needs for early identification of and proactive planning for discharge planning.
- Facilitates member care transition through the healthcare continuum and refers treatment plans/plan of care to clinical reviewers as required and does not issue non-certifications.
- Facilitates accreditation by knowing, understanding, correctly interpreting, and accurately applying accrediting and regulatory requirements and standards.
- Current active unrestricted RN license to practice as a health professional in applicable state(s) or territory of the United States.
- Requires minimum of 3 years acute care clinical experience or case management, utilization management or managed care experience; or any combination of education and experience, which would provide an equivalent background.
- Participation in the American Association of Managed Care Nurses preferred.
- Knowledge of medical management process and ability to interpret and apply member contracts, member benefits, and managed care products strongly preferred.
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Medical Management Specialist
3 days ago
Providence, Rhode Island, United States Absolute Staffing & Consulting Solutions Full timeJob Title: Medical Management SpecialistAt Absolute Staffing & Consulting Solutions, we are seeking a highly skilled Medical Management Specialist to join our team. As a Medical Management Specialist, you will play a crucial role in providing non-clinical support to our client's Medical Management and Operations areas.Key Responsibilities:Gather clinical...
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Medical Management Specialist
3 weeks ago
Providence, Rhode Island, United States Absolute Staffing & Consulting Solutions Full timeJob Title: Medical Management SpecialistAt Absolute Staffing & Consulting Solutions, we are seeking a highly skilled Medical Management Specialist to join our team.Job Summary:The Medical Management Specialist will provide non-clinical support to the Medical Management and/or Operations areas. This role will be responsible for gathering clinical information,...
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Medical Management Specialist
1 day ago
Providence, Rhode Island, United States Absolute Staffing & Consulting Solutions Full timeJob Title: Medical Management SpecialistAt Absolute Staffing & Consulting Solutions, we are seeking a highly skilled Medical Management Specialist to join our team.Job Summary:We are looking for a detail-oriented and organized individual to provide non-clinical support to our Medical Management and Operations areas.Key Responsibilities:Gather and analyze...
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Medical Management Specialist
1 week ago
Providence, Rhode Island, United States Absolute Staffing & Consulting Solutions Full timeJob Title: Medical Management SpecialistAbsolute Staffing & Consulting Solutions is seeking a Medical Management Specialist to join our team.Job Summary:We are looking for a highly skilled and detail-oriented individual to provide non-clinical support to our Medical Management and Operations areas.Key Responsibilities:Gather and analyze clinical information...
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Medical Management Specialist
3 weeks ago
Providence, Rhode Island, United States Absolute Staffing & Consulting Solutions Full timeJob Title: Medical Management SpecialistAt Absolute Staffing & Consulting Solutions, we are seeking a highly skilled Medical Management Specialist to join our team.Job Summary:We are looking for a detail-oriented and organized individual to provide non-clinical support to our Medical Management and Operations areas.Key Responsibilities:Gather and analyze...
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Nurse Medical Management Specialist
4 weeks ago
Providence, Rhode Island, United States Absolute Staffing & Consulting Solutions Full timeJob Title: Nurse Medical ManagementAt Absolute Staffing & Consulting Solutions, we are seeking a highly skilled Nurse Medical Management professional to join our team.Job Summary:The Nurse Medical Management role is responsible for collaborating with healthcare providers and members to promote quality member outcomes, optimize member benefits, and promote...
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Nurse Medical Management Specialist
3 weeks ago
Providence, Rhode Island, United States Absolute Staffing & Consulting Solutions Full timeJob Title: Nurse Medical ManagementAt Absolute Staffing & Consulting Solutions, we are seeking a highly skilled Nurse Medical Management professional to join our team.Job Summary:The Nurse Medical Management role is responsible for collaborating with healthcare providers and members to promote quality member outcomes, optimize member benefits, and promote...
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Nurse Medical Management Specialist
1 month ago
Providence, Rhode Island, United States Absolute Staffing & Consulting Solutions Full timeJob Title: Nurse Medical ManagementAt Absolute Staffing & Consulting Solutions, we are seeking a highly skilled Nurse Medical Management professional to join our team.Job Summary:The Nurse Medical Management role is responsible for collaborating with healthcare providers and members to promote quality member outcomes, optimize member benefits, and promote...
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Travel Nurse RN Specialist
1 day ago
Providence, Rhode Island, United States OneStaff Medical Full timeJob Title: Travel Nurse RN Specialist Job Summary: We are seeking a skilled Travel Nurse RN Specialist to join our team at OneStaff Medical. As a Post-Anesthesia Recovery Nurse, you will provide care for post-operative patients recovering from anesthesia, including general, regional, and local. Responsibilities: * Provide care for post-operative patients...
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Medical Specialist
4 weeks ago
Providence, Rhode Island, United States Phoenix Technologies Full timeJoin Our Team as a Specialist in Internal MedicineAt Phoenix Technologies, we are committed to providing exceptional medical care to our patients. We are seeking a highly skilled Specialist in Internal Medicine to join our team.About the Role:As a Specialist in Internal Medicine, you will be responsible for providing high-quality medical care to our...
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Medical Imaging Specialist
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Providence, Rhode Island, United States Summit Medical Staffing Allied Full timeJob Title: Medical Imaging SpecialistSummit Medical Staffing Allied is seeking a Medical Imaging Specialist for a travel job in North Providence, Rhode Island.Job Description & RequirementsSpecialty: Medical ImagingDiscipline: Allied Health ProfessionalStart Date: ASAPDuration: 13 weeksShift: 8 hours, eveningsEmployment Type: TravelRequirements:1 year of...
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Medical Laboratory Specialist
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Providence, Rhode Island, United States Access Healthcare Full timeAccess Healthcare is seeking a Medical Laboratory Specialist for a travel job in North Providence, Rhode Island.Job DetailsSpecialty: Medical Laboratory SpecialistDiscipline: Allied Health ProfessionalDuration: 13 weeks40 hours per weekShift: 8 hours, eveningsEmployment Type: TravelAccess Healthcare offers a competitive pay package based on 8 hour shifts and...
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Medical Coding Specialist
2 days ago
Providence, Rhode Island, United States Complete Staffing Solutions Full timeJob Title: Medical Coding SpecialistWe are seeking a highly skilled Medical Coding Specialist to join our team at Complete Staffing Solutions.Job Summary:The Medical Coding Specialist will be responsible for researching and resolving variance analysis between third party payer contracts and actual payments, as well as comprehending and interpreting all third...
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Medication Technician
2 weeks ago
Providence, Rhode Island, United States Davenport Management Inc. Full timeJob Title: Medication TechnicianAt Davenport Management Inc., we are seeking a highly skilled Medication Technician to join our team. As a Medication Technician, you will play a vital role in ensuring the safe and effective administration of medications to our residents.Job SummaryThe Medication Technician will be responsible for accurately preparing,...
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Travel Nurse Position
4 weeks ago
Providence, Rhode Island, United States Travel Nurse Source Full timeER/Trauma RN Job OpportunityWe're working with QS Nurses to find a qualified ER/Trauma RN in Warwick, Rhode Island.About the PositionQS Nurses is looking for a skilled and experienced ER/Trauma RN to join their team.Key ResponsibilitiesProvide high-quality patient care in the ER/Trauma departmentCollaborate with the healthcare team to ensure effective...
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Clinical Practice Manager/Clinical Nurse Specialist
54 minutes ago
Providence, Rhode Island, United States Women & Infants Hospital Full timeJob Summary:The Clinical Practice Manager/Clinical Nurse Specialist (CPM/CNS) is a key professional in our organization, responsible for demonstrating excellence in clinical nursing and serving as a role model, expert consultant, educator, and resource in managing and developing clinical nursing practice.In collaboration with the nursing director/manager and...
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Medication History Specialist
1 month ago
Providence, Rhode Island, United States Lifespan Full timeJob SummaryWe are seeking a highly skilled Medication History Specialist to join our team at Lifespan. As a key member of our pharmacy-managed medication reconciliation practice model, you will play a critical role in ensuring the accuracy and completeness of patient medication lists.Key ResponsibilitiesObtain and compile current detailed and complete home...
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Providence, Rhode Island, United States Women & Infants Hospital Full timeJob Summary:The Clinical Practice Manager/Clinical Nurse Specialist (CPM/CNS) serves as a professional role model, expert consultant, educator, and resource in managing and developing clinical nursing practice. This individual demonstrates excellence in clinical nursing by assessing, planning, designing, organizing, implementing, and evaluating professional...
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Providence, Rhode Island, United States Women & Infants Hospital Full timeJob Summary:The Clinical Practice Manager/Clinical Nurse Specialist plays a pivotal role in advancing clinical nursing practice, serving as a professional role model, expert consultant, educator, and resource. In collaboration with nursing leadership and staff, this individual assesses, plans, designs, organizes, implements, and evaluates professional...
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Providence, Rhode Island, United States Women & Infants Hospital Full timeJob SummaryThe Clinical Practice Manager/Clinical Nurse Specialist (CPM/CNS) is a key professional role model, expert consultant, educator, and resource in managing and developing clinical nursing practice. In collaboration with the nursing director/manager and nursing staff, this individual assesses, plans, designs, organizes, implements, and evaluates the...