Talent.com
Clinical Compliance Manager - RN
Clinical Compliance Manager - RNVirtualVocations • Pensacola, Florida, United States
serp_jobs.error_messages.no_longer_accepting
Clinical Compliance Manager - RN

Clinical Compliance Manager - RN

VirtualVocations • Pensacola, Florida, United States
job_description.job_card.variable_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.job_description

A company is looking for a Clinical Compliance Program Manager who will ensure compliance with Utilization Management and Quality Improvement Program regulations.

Key Responsibilities :

Facilitate performance measurement activities and ensure compliance with CMS, NCQA, and regulatory standards

Assist in developing and enforcing policies aligned with Utilization Management and Quality Improvement Program requirements

Conduct compliance audits and prepare for regulatory and accreditation audits

Required Qualifications :

4-6 years of relevant work experience

Advanced knowledge of CMS UM audits with 2-3 years of compliance experience

1-2 years of experience implementing CMS final rule changes

Bachelor's Degree or equivalent work experience

serp_jobs.job_alerts.create_a_job

Rn Clinical Manager • Pensacola, Florida, United States

Job_description.internal_linking.related_jobs
Clinical Trial Project Manager

Clinical Trial Project Manager

VirtualVocations • Pensacola, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Trial Project Manager to oversee contracted clinical trials from initiation through completion. Key Responsibilities Coordinate execution of sponsored trials, i...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
North Carolina Licensed Case Manager, RN

North Carolina Licensed Case Manager, RN

VirtualVocations • Pensacola, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Remote Case Manager.Key Responsibilities : Collaborate with a multidisciplinary healthcare team to monitor utilization patterns and facilitate appropriate care delivery ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Licensed Utilization Review Clinician

Licensed Utilization Review Clinician

VirtualVocations • Pensacola, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Utilization Review Clinician - ABA.Key Responsibilities Evaluates member's care and health status related to Applied Behavioral Analysis (ABA) services Performs prior ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
RCM Manager

RCM Manager

VirtualVocations • Pensacola, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a RCM Manager, Remote.Key Responsibilities Manage day-to-day production of multiple operational groups focusing on technology-driven processes and financial operations P...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
State Licensed Clinical Content Reviewer

State Licensed Clinical Content Reviewer

VirtualVocations • Pensacola, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Content Editor - PGY-1 / Medical Students.Key Responsibilities Collaborate with a multidisciplinary team to create and curate content on emerging medical technol...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Affordable Housing Compliance Manager

Affordable Housing Compliance Manager

VirtualVocations • Pensacola, Florida, United States
serp_jobs.job_card.full_time
A company is looking for an Affordable Housing Compliance Manager.Key Responsibilities Act as the in-house expert on affordable housing compliance and inform product development Translate regula...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
RN Clinical Appeals Specialist

RN Clinical Appeals Specialist

VirtualVocations • Pensacola, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Appeals RN - Remote.Key Responsibilities Perform initial assessments of appeals, medical records, and compliance with coverage criteria Identify additional in...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Healthcare Compliance Director

Healthcare Compliance Director

VirtualVocations • Pensacola, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Director of Compliance - Remote.Key Responsibilities Identify and mitigate organizational risks across various domains including clinical and operational Oversee compl...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Manager of Virtual Health

Manager of Virtual Health

VirtualVocations • Pensacola, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Manager of Virtual Health : Primary Care Support.Key Responsibilities Oversees daily operations of the practice, including patient scheduling, registration, and clinical...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
CPCS Certified Credentialing Manager

CPCS Certified Credentialing Manager

VirtualVocations • Pensacola, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Manager of the Central Credentials Resource Department.Key Responsibilities Oversee the operations of the Central Credentials Resource Department Develop, manage, and ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
Florida Licensed UR Manager

Florida Licensed UR Manager

VirtualVocations • Pensacola, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Regional Utilization Review (UR) Manager to oversee and support utilization review operations across multiple facilities. Key Responsibilities Manage and support facilit...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
RN Licensed Senior Bill Reviewer

RN Licensed Senior Bill Reviewer

VirtualVocations • Pensacola, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Senior Complex Bill Reviewer.Key Responsibilities Conduct medical reviews of provider and hospital bills for accuracy and compliance Audit complex medical bills and va...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
RN Case Management Manager

RN Case Management Manager

VirtualVocations • Pensacola, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Manager, Case Management.Key Responsibilities Oversee the execution and implementation of Clinical Programs' strategy and operations Lead and develop a team of clinica...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
Tennessee Licensed Clinical Review Manager

Tennessee Licensed Clinical Review Manager

VirtualVocations • Pensacola, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Review Manager to oversee medical reviews for utilization management.Key Responsibilities Initiate referrals for appropriate coordination of care Assist in co...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Clinical Review Coordinator

Clinical Review Coordinator

VirtualVocations • Pensacola, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Review Coordinator to support their Specialty Infusion Pharmacy remotely.Key Responsibilities Conducts prior authorization reviews to evaluate patient clinical...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
Clinical Study Operations Manager

Clinical Study Operations Manager

VirtualVocations • Pensacola, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Study Operations Manager.Key Responsibilities Oversee study startup planning, site onboarding, and operational oversight to ensure timely execution of clinical...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
RN Clinical Documentation Consultant

RN Clinical Documentation Consultant

VirtualVocations • Pensacola, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a CDI Consultant to support clinical documentation improvement in a remote capacity.Key Responsibilities Review and evaluate medical record documentation for completeness...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Utilization Review Clinical Liaison

Utilization Review Clinical Liaison

VirtualVocations • Pensacola, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Utilization Review Clinical Liaison.Key Responsibilities Serve as the primary point of contact for 1st level utilization review (UR) cases Coordinate 2nd level escalat...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
Remote Inpatient Care Management RN

Remote Inpatient Care Management RN

VirtualVocations • Pensacola, Florida, United States
serp_jobs.filters.remote
serp_jobs.job_card.full_time
A company is looking for an Inpatient Care Management RN - Remote.Key Responsibilities Perform initial and concurrent review of inpatient cases using evidence-based criteria Collaborate with hea...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
New York Licensed Clinical Review Nurse

New York Licensed Clinical Review Nurse

VirtualVocations • Pensacola, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Review Nurse.Key Responsibilities Perform Utilization Review activities in accordance with jurisdictional guidelines Assess medical necessity and appropriaten...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted