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Health is our business...It takes more than expert care to keep our members healthy. At Kaiser Permanente, our business teams support our systems, strengthen our facilities, and shape our future.

From HR and sales to construction and IT, we offer rewarding careers and the chance to add your vision to the future of care in Portland, Oregon.Medical Staff CoordinatorIn this important role, you will ensure that Kaiser Permanente hospitals maintain Joint Commission accreditation by meeting requirements of all regulatory, certifying, licensing, and accrediting bodies, including audit preparation, planning, and management. You will also verify that the credentialing and privileging program aligns with regional goals, contributes to patient safety, and protects the organization from unnecessary risk of medical malpractice or loss of accreditation.Requirements include:Bachelors degree or equivalent experience in credentialing and/or medical staff servicesMinimum three years experience in credentialing and/or medical staff servicesExperience in preparing for, and participating in, TJC, NCQA, and/or other external surveys.NAMSS CPCS and/or CPMSM certification or willingness to obtain within two years Working knowledge/understanding/interpretation and application of external regulatory requirements including TJC, NCQA, and CMS related to medical staff and/or credentialing standards.Thorough knowledge of business writing, editing, and compositionDemonstrated ability to work collaboratively with medical staff leaders and credentialing support staffProficiency in credentialing software, and software associated with paperless credentialing, e.g., Adobe, scanning modules, etc., is preferredProven ability to work independently with attention to detailExcellent problem-solving, time management, and decision making skillsIf you would like to hear the Kaiser Permanente story as told by our employees, watch the videos on our Careers Home Page at kp.org/jobs/video

The Military HIV Research Program (MHRP) is dedicated to HIV vaccine development, prevention, disease surveillance and care and treatment for HIV.HIV-1 continues to pose a significant and persistent threat to the military and allied forces both in terms of readiness and force protection. The brisk pace of deployments to locations throughout the world requires the MHRP to develop products and capabilities with an international scope.This program builds on the strength of the U.S. military medical research community, and addresses specific HIV research requirements to meet its mission: prevention of HIV-1 disease in the active force and, by extension, the global community at risk of infection.Responsibilities:1. Reviews and approves documents. Develops and maintains a centralized documentation system for all records.2. Ensure internal audits are performed each month and report findings at the monthly QA meeting after passing to the Lab Manager for review. Identifies critical episodes, events deficiencies, recommends remedial actions, confirms implementation of actions and reports findings to laboratory management.3. Track the receiving of Proficiency test panels and submitting of results to vendor (generate a calendar of all PTP´s to be received each year, documenting date received, date results submitted, and score received). The program includes serology/immunology, Western Blot, HTV-1 RNA Viral Load, HIV Genotype, Hematology and Flow Cytometry.4. Coordinates all equipment/building validation issues and ensures regulatory compliance.5. Reviews and tracks all Standard Operating Procedures (SOPs), medical device reports and Occurance Reports. Manages monitoring, evaluation, and corrective actions and reports the results to the appropriate department level committee.6. Oversees the duties of 3 staff members: Document Control; QA Specialist and Technical Writer7. Serves as the advisor and senior consultant to laboratory management and other officials on various aspects of laboratory performance improvement. Performs duties related to medical technology such as instructing and credentialing supervisors in the theoretical and practical aspects or the performance improvement program.8. Manages external proficiency program to ensure that all analyses and procedures surveyed are in accordance with current accrediting and regulatory agency guidelines. Coordinates the ordering of surveys through the College of American Pathology (CAP), Accutest, and VQA. Manages the evaluations of surveys, requesting the investigation of all failed challenges and directing documentation of corrective action.9. Represents HDRL on department level performance improvement and infectious control committees.10. Manages the risk management program maintaining all incident report documentations and coordinating response to the appropriate committee.11. Write SOPs as related to the Quality Management Plan12. Completes other projects as needed.Required Knowledge, Skills, and Abilities:- Mastery of medical technology principles, theories, practices, and methodologies to perform the full range of duties connected with the design and implementation of a clinical QC program. - Comprehensive and detailed knowledge of accrediting and regulatory agency requirements, including federal and state laws. - Knowledge of document control, validation/calibration of system and equipment and audit of records- Excellent organization, computer and communication skills; ability to handle multiple priorities.Minimum Education/Training Requirements: Bachelor´s degree in ScienceMinimum Experience: 4 to 6 years experience in quality assuranceSupervisory Responsibilities/Controls:Supervises Quality Assurance TechniciansWork Environment: Office and laboratory environment

You´ve always wanted to work in a dynamic place. At Bakersfield Memorial Hospital, you have all the challenge and growth you need in order to drive your career.

FACILITY INFORMATIONAs our city grows, the New West Tower affords Bakersfield Memorial Hospital the ability to treat more patients, allowing families to stay close to home rather than traveling elsewhere for services and quality care they need and deserve. Patient rooms that offer privacy for patients and family, which enhance healing. The new 114 bed West Tower includes 24 state-of-the art ICU beds, helping Memorial meet the growing demand for beds from patients coming through the Emergency department. There are two additional 30-bed telemetry/med surgery floors and a new 30 bed Family Care floor (post-partum, GYN). Our tiniest patients receive the highest level of care from Kern County´s most experienced and trusted doctors and nurses in Memorial´s expanded Neonatal Intensive Care unit. This unit is equipped with the most advanced technology and soon our Pediatric Intensive Care Unit will be open to treat local children with critical healthcare needs. The New West Tower has given Memorial Hospital over 400-licensed acute care beds, making Memorial hospital the largest full service Hospital in Kern County. POSITION REQUIREMENTSUnder the direction of the Director of Quality Management oversees the Continuous Accreditation Readiness and regulatory compliance program for Bakersfield Memorial Hospital. Provides leadership for the program on an ongoing basis to ensure compliance with applicable standards. Required: 5 years experience in a healthcare setting. 3 years experience in Joint Commission/Regulatory Compliance. Bachelor´s degree in healthcare completed or in process. Good working knowledge of computers and software programs including Microsoft Office. Excellent written and verbal communication skills. Team Management, team building, and performance improvement experience required. Current CA RN license. Keywords: Nurse Manager, Accreditation and Regulatory Compliance, Quality Management, RN, Registered Nurse, Bakersfield, CA, California *MH* CB~ *HJ

You have many choices in todays nursing market. Whatever stage you are in your nursing career, Johns Hopkins Nursing has a place for you. The spirit of collaboration, teamwork and empowerment youll know as a Johns Hopkins nurse is a unique experience. At Johns Hopkins, you can enjoy the support of a team while maintaining your individuality.We are currently hiring Utilization Management Specialists, reqs 27839, 27844, 27836 and Utilization Management Appeals Specialists, reqs 27760 and 27847.The Utilization Management Specialist, reqs 27839, 27844, 27836, is an integral part of a sophisticated healthcare team and reports to the Department of Utilization/Clinical Resource Management. This professional nursing role performs UM activities which include:- Concurrent and retrospective clinical reviews for medical necessity and level of care appropriateness. - Identifies utilization issues that impact reimbursement for the patients hospital stay- Facilitates peer to peer reviews with third party payers.- Collaborates with the healthcare team to expedite the patient plan of care.- Requirements:o 3 to 5 years of clinical RN experience; UM experience preferredo Understanding reimbursement, admitting, case management and care management, Medicare and Medicaid utilization requirementso Excellent interpersonal and communication written and verbal skills necessary to gather and exchange data with key professionalso Ability to assess medical records and make determinations on length of stay and proper procedures in accordance with policies and procedures with experience in assigned specialtyThe Utilization Management Appeals Specialist, reqs 27760 and 27847, fulfills the responsibilities of the UM Specialist, is an integral part of a sophisticated heathcare team and reports to the Department of Utilization/Clinical Resource Management. This professional nursing role performs UM activities which include:- Processes third party appeals for Inpatient, Outpatient and Emergency Department commercial denials as well as the upcoming RAC denials pertaining to Medicare patients. - Requirements:o Excellent written communication and verbal skills necessary to gather and exchange data with key professionals and third party payerso 5 years of clinical RN experience; UM experience preferred. Previous Appeals experience preferred but not required.o Understanding reimbursement, admitting, case management and care managemento Ability to assess medical records and make determinations on length of stay and proper procedures in accordance with policies and procedures with experience in assigned specialtyo Familiar with Interqual and/or Milliman criteria

VANTHCS is an integrated health care system serving veterans in 38 counties. In addition to a wide variety of acute care services, VANTHCS provides over one million outpatient visits a year at our Dallas, Bonham, Tyler and Fort Worth locations.

Chief of Clinical Quality Management. This position involves: 1) providing oversight and direction for risk management, accreditation, performance improvement and data management; 2) actively participating at the senior leadership management level on overall planning and development of goals, objectives and policy and 3) developing effective and timely responses to emerging priorities. The position includes an assignment to specific areas as liaison in performance improvement including VA performance measures and related quality management activities, in addition to the overall Quality Management program throughout the Health Care System. The Chief, Clinical Quality Management is responsible for fulfillment of the Health Care Systems mission, vision and values. She/he must be knowledgeable of the organization and administration of a multi-faceted health care delivery system. She/he provides direction on matters of governance and policy management. The position serves as a leader in applying managed healthcare applications in measuring and improving health services delivery, communication and training. Qualifications would typically include clinical knowledge base with management experience or advanced management degree.

Chief of Clinical Quality Management. This position involves: 1) providing oversight and direction for risk management, accreditation, performance improvement and data management; 2) actively participating at the senior leadership management level on overall planning and development of goals, objectives and policy and 3) developing effective and timely responses to emerging priorities. The position includes an assignment to specific areas as liaison in performance improvement including VA performance measures and related quality management activities, in addition to the overall Quality Management program throughout the Health Care System. The Chief, Clinical Quality Management is responsible for fulfillment of the Health Care Systems mission, vision and values. She/he must be knowledgeable of the organization and administration of a multi-faceted health care delivery system. She/he provides direction on matters of governance and policy management. The position serves as a leader in applying managed healthcare applications in measuring and improving health services delivery, communication and training. Qualifications would typically include clinical knowledge base with management experience or advanced management degree.

Advocate Health Care is currently seeking candidates for a Quality Improvement- QI position.

This position is responsible for enhancing patient care and satisfaction through quality activity, monitoring and to coordinate and execute the specific tasks required for efficient and effective operation of the quality improvement program in accordance with department, contractual and regulatory agency standards.Qualifications: Good organizational and interpersonal skills.Computer skills, basic keyboard knowledge. Willingness to be flexible with work scheduleKnowledge of managed care or utilization review or hospital quality. BSN or 2-4 equivalent years experience in managed care.1-2 years experience in utilization management/QI activity. 3-5 years of clinical experienceCurrent RN license issued by the state of IllinoisCurrent CPR certificationAdvocate Health Care, based in Oak Brook, Illinois, is the largest fully integrated health care delivery system in metropolitan Chicago and the state of Illinois, and is recognized as one of the top health care systems in the country. Advocate is the second largest private sector employer in metropolitan Chicago with more than 25,000 associates and has the largest trauma network in the state of Illinois.

Coordinator will be responsible for (but not limited to):*Coordinate and participate in Root Cause Analysis Prepare Root Cause Analysis write-ups.*Enter and maintain key quality data for the NYPORT Database and hospital based access database*Acts as liaison with NYSDOH and other state and federal health department authorities in investigative matters and matter related to submission.*Follow up on corrective action measures established during the root cause and quality review processes.*Act as a subject matter expert related to outcome reporting standards and clinical standards to the hospital clinical areas.*Maintain and organize quality review files. Prepares a quarterly report for the involved departments*Review trends and variances with involved departments.*Analyze unanticipated and adverse events to determine next steps.*Coordinate quality reviews for unanticipated and adverse events.*Participate in all PI projects as requested by the Vice Present of Quality*Assists in the planning of in-service programs through teaching and attending.*Responsible for quarterly review of information submitted through the NYPORT system and Root Cause Analysis.*Collaborates with physicians and other disciplines in the development of critical pathways.*Review hospital written occurrence reports and investigate occurrences for potential quality issues.*Assists in implementing and maintaining departmental systems and programs, including activities to meet the requirements of various regulatory agencies.*Assists in the evaluation of the Quality Care *Management Departments goals, and the impact on improving patient care and safety.*Maintains current knowledge of federal, state and JCAHO guideline, NYPORT (outcome) reporting requirements and applies them to the activities of the department.Requirements:A degree in Nursing is required. A Masters degree is highly preferred with concentration in related healthcare science. Minimum of 5-7 years experience as a RN with clinical experience, plus at least two years of managerial experience is required. In addition the candidate must:Demonstrate a proficiency in working collaboratively. Have a working knowledge of outcome reporting and data abstraction and process oversight. Have knowledge of clinical standards of care, Federal, State and JCAHO. Have a working knowledge of the New York Patient Outcome Reporting system, reporting requirements, standards and exceptions. Be proficient in MS Word, Excel and Power Point and strong verbal and writing skills. Have a working knowledge of Microsoft Access or willingness to learn Access.We offer a competitive salary and a comprehensive benefits package.

Yuma Regional Medical Center (YRMC) in Yuma, Arizona offers a welcome alternative for health specialists who wish to develop their skills and career.

Title: Ambulatory Claims Analyst (EPIC / EMR) Department: 8236-Clinical Informatics Employment Category: Full Time Job Type: Regular Shift: First Shift Weekends: Occasional On Call: No Salary: 29.04 - 43.57 The Information Technology Division at Yuma Regional Medical Center provides the vision for planning and the platform for implementing and maintaining all technology for the organization. Recently we have begun the implementation of an integrated Epic Electronic Medical Record (EMR). We will be addressing Ambulatory, Business and Clinical aspects of the EMR in a patient-centric manner. In addition, the healthcare providers and ancillary departments will continue to be supported by telecommunications, data systems and switchboard operations.POSITION SUMMARY: The Ambulatory Claims Analyst will be responsible for building all the claims adjudication features in the ambulatory office setting. Should be knowledgeable about policies, procedures, and business operations in an ambulatory office setting. Participates in regular day-to-day communication with other project teams and works with Epic and community based Subject Matter Experts (SMEs) to ensure the claims build will fit the organizations and community integration needs. Participates in the development of workflows, data collection and analysis, reporting, and other technical issues associated with the use of the ambulatory software. Participates in developing and documenting the standard build procedures that will be used in conjunction with other Epic applications.Education Required: Associates Degree in related field Education Preferred: Bachelors Degree in related field Experience Required: 2+ years healthcare setting experience; Demonstrate expertise in Claims Adjudication; Demonstrate proficiency in related technical knowledge Experience Preferred: EpicCare Ambulatory Claims experience; 5+ years healthcare setting experience; 3+ years working in physician office setting Certification/Travel Requirement: Must become certified in appropriate module which includes travel to the training facility for three separate week periods and successfully pass tests and project assignments within designated time periods. Must maintain certification yearly per Epic Standards. Note: YRMC will accept equivalent combination of education and experience.YRMC will accept equivalent combination of education and experience.

Regulatory and Quality Improvement SpecialistAs the only academic medical center in the Rocky Mountain region, University of Colorado Hospital leads the way with the most advanced care and research. U.S. News and World Report ranked us for the 14th time as one of America´s Best Hospitals and our Magnet designation is testimony to nursing excellence. We pride ourselves on delivering high-quality services with compassion and professionalism.We are currently seeking a Regulatory and Quality Improvement Specialist for Ambulatory Services. -Responsible for leading the initiatives to keep a consistent state of readiness for JCAHO, Magnet and other regulatory inspections throughout the Ambulatory Services Division. -Interprets regulatory standards and assists Division Managers and Charge Nurses in applying them in their clinical practices. -Responsible for pulling together clinical, financial, statistical, and analytical data support to determine current levels of safe practice and quality outcomes throughout ambulatory services. -Assists Department Managers and Charge Nurses in interpreting data, developing process improvement and action plans, and implementing them. -Represents Ambulatory Services in institution wide and departmental committees. -Reports to the Director of Nursing and Professional Standards for Ambulatory ServicesPrefer clinical (patient care) training, highly skilled in statistics, with knowledge of computer applications, databases, spreadsheets: Bachelors Degree in health related field required. A BSN strongly preferred. Registered Health Information Administrator (RHIA) or Certified Professional in Healthcare Quality CPHQ a plus.University of Colorado Hospital has been ranked one of the best in the country in six of 16 medical specialties in U.S. News & World Report. Join our fast-paced and challenging environment. For immediate consideration, apply online at www.uch.edu/employment. Excellent compensation and benefits available. EOE/AA.