RN Risk & Quality Auditor, CMS/NCQA Focus
Humana Inc
Humana Inc is seeking a Risk Management Professional 2 to lead quality audits within CenterWell UM, ensuring CMS/NCQA compliance and regulatory readiness. The role emphasizes audit accuracy, data analysis, and identifying risks using Power BI and Power Apps. The ideal candidate is an RN with deep knowledge of clinical criteria and regulatory guidance, capable of translating audit findings into actionable insights for leadership and cross-functional teams. #J-18808-Ljbffr Humana Inc
- ...Typical Day for a Regional Nurse (RN) Consultant - Travel DON... ...standards of practice. Clinical Quality & Documentation Leadership Ensure... ...Center outlining findings, risks, and recommendations. Participate... ...clinical standards of practice, CMS/DIA requirements, quality...CmsRiskInterim roleLocal area
- ...oversee MDS assessments and care plans, ensuring CMS RAI guideline compliance. This role requires a strong... ...collaborate with nursing teams to support high-quality resident care. If you bring race-to-resident outcomes focus and regulatory knowledge, apply today. #J-18808-...Cms
- ...Registered Nurse (RN) | Long-Term Acute Care Location: Des... ...organizations that rely on us for quality candidates. Founded by... ...staffing resources. We found that by focusing on the needs of the... ...of their services. It’s a risk that paid off, making Titan Medical...RiskWeekly payFull timeContract workShift work
- ...Registered Nurse (RN) | Medical-Surgical Location: Des Moines... ...that rely on us for quality candidates. Founded by experienced... ...staffing resources. We found that by focusing on the needs of the... ...of their services. It’s a risk that paid off, making Titan Medical...RiskWeekly payFull timeContract workShift workNight shift
- ...Registered Nurse (RN) | Cardiac Catheterization Lab Location... ...organizations that rely on us for quality candidates. Founded by... ...staffing resources. We found that by focusing on the needs of the... ...of their services. It’s a risk that paid off, making Titan Medical...RiskWeekly payFull timeContract workShift work
- ...Travel Stepdown RN Company: Fusion Medical Staffing Location: Facility in Des... ...with approved nursing techniques, with a focus on cardiac care Prepares equipment and... ...individualized needs, focusing on cardiac health, risk factors, and lifestyle modifications...RiskTemporary work
- ...Registered Nurse (RN) | Dialysis Location: Des Moines, IA... ...organizations that rely on us for quality candidates. Founded by... ...staffing resources. We found that by focusing on the needs of the... ...of their services. It’s a risk that paid off, making Titan Medical...RiskWeekly payFull timeContract workShift work
- ...Registered Nurse (RN) | Operating Room Location: Des Moines... ...organizations that rely on us for quality candidates. Founded by... ...staffing resources. We found that by focusing on the needs of the... ...of their services. It’s a risk that paid off, making Titan Medical...RiskWeekly payFull timeContract workShift workRotating shift
$1,999 per week
...Registered Nurse (RN) | Med/Surg / Telemetry Location: West... ...surgical (MedSurg) unit with a focus on telemetry monitoring. These... ...regularly assessing for fall risks, managing medications safely,... ...infection prevention measures. Quality Improvement and Continuing...RiskFull timeContract workImmediate startShift work- ...Pleasant Hill, IA, is now hiring! Join a quality focused team recognized with a Bronze Quality Award... ...care plans. Ensure compliance with CMS, state, and federal long-term care regulations... ...leadership team. Qualifications Valid RN license in good standing. License must be...CmsImmediate start
$120k - $180k
...learning and development, legal and risk management and recruiting.... ...leaders and caregivers to focus on day-to-day care and operational... ...from other companies is the quality of our most valuable resource... ...Billing regulations as defined by CMS, as well as emerging and...CmsRiskFull timeWork at office- ...SCOPE:**Ensure the provision of quality patient care to all... ...participates in surveys conducted by TJC, CMS, OSHA and other agencies.* Ensure... ...responsibilities may include focus on one or more departments or locations... ...accredited School of Nursing (RN); Advanced degree desirable*...CmsTemporary workNight shiftWeekend work
$2,243 per week
...staffing agency, is seeking a quality Labor & Delivery Registered Nurse... .... Requirements Active RN License Degree from... ...Monitor patients for potential high risk problems. Educate and support... ...healthcare applicant’s journey. Our focus is placing travelers in...RiskHourly payWeekly payContract workShift work- ...healthcare ecosystem to help improve care quality, drive better outcomes, and lower... ...and productivity. Specifically focused on retrieval projects for health plan and CMS campaigns, including but not limited to: HEDIS, DRG, Risk Adjustment, Payment Integrity, RAC, CMS...CmsRiskRemote job
$2,667 per week
...Health is seeking a travel nurse RN Labor and Delivery for a... ...required] current/recent high risk OB experience in level II... ...commitment to excellence, safety, and quality in everything we do. By... .... Join a team that’s focused on your success, your well-being...RiskWeekly payDaily paidLong term contractTemporary workLocal areaShift workNight shift- ...RN - Registered Nurse The role of a Registered Nurse is to work... ...nursing team in providing high quality care and support. Responsible... ...effectively and cost efficiently with focus on resident centered outcomes.... ...are safeguarded against the risk of abuse. This includes but is...RiskLocal areaImmediate startShift work
- Trinity Health is hiring a Neuro ICU RN for night shifts, focusing on providing critical care to high-risk patients. This full-time position involves assessing and planning care while collaborating with interdisciplinary teams to ensure comprehensive patient support. A...RiskFull timeRelocation packageNight shift
$2,284 - $2,752 per month
...Delivery nurse seeking your next adventure? Do you thrive in high-risk OB environments and enjoy making a difference in the lives of... ...Requirements for this role include: ~ Active Iowa or compact/multistate RN license ~1 year experience in Labor & Delivery setting ~ High...RiskContract workShift workNight shift- ...Progressive Care Registered Nurse (RN) to direct nursing education, orientation, competencies and quality improvement initiatives while... ...with elevated instability risk. Position is Temporary/Intermittent... ...delivery, care coordination focused on education and self-management...RiskTemporary workRemote work
- ...professional and appropriate estimating and documentation techniques relative to the owner's needs, team's expectations, acceptable risk, and time constraints throughout the preconstruction period. Document and communicate with the team, the progress during the preconstruction...CmsRiskContract workFor contractorsFor subcontractorWork at officeLocal area
$40 per hour
...Conversion We are seeking a Certified Risk Adjustment Coder (CRC) to... ...and support compliance with CMS guidelines. Key Responsibilities... ...physicians to improve documentation quality Analyze findings and present... ...review Clinical background (RN, CDI certification, or related...CmsRiskContract workWork at officeLocal areaRemote workMonday to Friday- ...suppliers in Des Moines, Iowa. The role involves using Pro QC checklists to ensure compliance with ISO 9001 and identifying potential risks. The ideal candidate will have a strong background in U.S. defense procurement compliance and experience in manufacturing sectors...RiskTemporary workFor contractors
- ...contractor to perform audits at the manufacturing sites of our clients' suppliers in Iowa. You will use Pro QC checklists to identify risks and classify findings against ISO 9001 requirements. Candidates must have a manufacturing background and expertise in U.S. defense...RiskContract workFor contractorsDay shift
- ..., and postpartum stages of pregnancy. Our focus on the maternal-infant dyad means you’ll play... ...of pregnancy and birth, including high-risk situations. Collaborative Environment:... ...Experience: Minimum of twelve months acute RN experience. All newly licensed RNs or...RiskDaily paidFull timeTemporary workRelocation packageShift workNight shiftWeekend work
- ...Perform the audit at the manufacturing sites of our clients' suppliers per Pro QC checklists. Use the process audit to identify relevant risks and point out potential issues. Look at audit findings and classify them against the ISO 9001 requirements. Communicate findings...RiskFor contractorsShift workDay shift
- ...Bilingual RN Case Manager Location : Remote. We are... ...for assigned consumers, ensuring quality outcomes and cost-effective... ...participant's experience in mind. We focus on reducing medical costs,... ...educating the participant with risk-specific targeted communications...RiskFull timeRemote work
$2,243 per week
...Staffing is seeking a travel nurse RN Labor and Delivery for a travel... ...staffing agency, is seeking a quality Labor & Delivery Registered... ...Monitor patients for potential high risk problems. Educate and... ...do. Our mission is simple: you focus on your patients, and we’ll take...RiskHourly payWeekly payContract workTemporary workImmediate startShift work- ...Recovery Center Registered Nurse (RN) Pleasant Hill, IA Shift... ...support work-life balance and focus. PRN positions also available.... ...organization’s commitment to high-quality, person-centered care. Essential... ...nursing assessments, evaluate high-risk indicators, and document...RiskFull timeReliefWork from homeShift workNight shiftDay shift
- ...On Bonus Why Join Us? Organization focused on creating great clinical outcomes for our... ...locations are rated as 4+ stars for quality and satisfaction Directly impact the lives... ...intervention and implements care to prevent risk or reduce risk. Educate clients and...RiskFull timeLocal areaImmediate startRelocation packageMonday to FridayFlexible hours
- ...their families. Demonstrates expertise in handling and managing high-risk calls with professionalism and in accordance with established... ...standards and document all cases in the Case Management System (CMS). Performs call follow-up and reporting as assigned. Demonstrates...CmsRiskContract workWork experience placement
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