14 home health jobs found

Quality Management Nurse / RN Compensation and Benefits Salary: $110,000 annually Bonus/Benefits: •             $40,000/total tuition reimbursement, $10,000/yearly •             4 weeks vacation, 8 sick days, and additional holidays Location: On-site in Brooklyn, NY Organization: Large, Respected Certified Home Care Agency (CHHA) Position Summary We are seeking an experienced and detail-oriented Quality Management Registered Nurse to join our Quality Management Department. This role is responsible for supporting regulatory compliance, promoting clinical excellence, and driving quality and performance improvement initiatives across home health programs.   The ideal candidate will possess strong analytical skills, sound clinical judgment, and the ability to identify opportunities for process improvement while ensuring high standards of patient care and compliance. Responsibilities Schedule/Shift: Monday – Friday,...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions.Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications.Participates in strategic planning for and evaluation of the Care ManagementThe successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Cardiology, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the past 18 months).Must...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions.Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications.Participates in strategic planning for and evaluation of the Care ManagementThe successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Neurology, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the past 18 months).Must...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions.Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications.Participates in strategic planning for and evaluation of the Care ManagementThe successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Surgery - Orthopedics, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the past 18...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions.Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications.Participates in strategic planning for and evaluation of the Care ManagementThe successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Gastroenterology, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the past 18...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions.Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications.Participates in strategic planning for and evaluation of the Care ManagementThe successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Oncology, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the past 18 months).Must have...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions.Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications.Participates in strategic planning for and evaluation of the Care ManagementThe successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Oncology Radiation, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the past 18...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions.Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications.Participates in strategic planning for and evaluation of the Care ManagementThe successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Maternal - Fetal Medicine, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the past 18...

Job title Licensed Health Insurance Agents About Sagility Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries. Job title: Licensed Health Insurance Agents Job Description: Your experience has a place here. BroadPath, a Sagility Company, is seeking experienced Licensed Health Insurance Agents to join our growing remote team, with opportunities available selling Medicare or Under 65 health plans. We are hiring both English-speaking and English/Spanish bilingual agents for...

About Core Clinical Partners At Core Clinical Partners, we re redefining healthcare partnerships by doing things better. As a physician-founded, owned, and led physician services company, we offer the personalized care of a local group with the support and resources of a national company while staying debt-free, allowing us to stay true to our mission. We actively engage and empower our clinicians, and our localized approach ensures the needs of each clinician, hospital, and community are met. Your expertise is valued, your voice is heard, and your impact is real. Together, we re not just providing care; we re redefining it. The Opportunity Core Clinical Partners is seeking a Hospital Medicine Medical Director to lead our established program at St. Mary's Healthcare in Amsterdam, New York. This is an opportunity for a physician leader who wants to remain clinically active while helping shape the future of a growing hospital medicine program. The Medical Director will...

Overview Company Overview: At Essen Health Care, we care for that! As the largest privately held multispecialty medical group in the Bronx, we provide high-quality, compassionate, and accessible medical care to some of the most vulnerable and under-served residents of New York State. Guided by a Population Health model of care, Essen has five integrated clinical divisions offering urgent care, primary care, and specialty services, as well as nursing home staffing and care management. Founded in 1999, our over 20-year commitment has fueled an unwavering dedication toward innovating a better healthcare delivery system. Essen has expanded from a single primary care office to an umbrella organization offering specialties from women s health to endocrinology, from psychiatry to a vast array of other specialties. All clinical services are offered via telehealth or in-person at over 35 medical offices and at home through the Essen House Calls program. Essen Health Care is...

Company Overview : At Essen Health Care, we care for that! As the largest privately held multispecialty medical group in the Bronx, we provide high-quality, compassionate, and accessible medical care to some of the most vulnerable and under-served residents of New York State. Guided by a Population Health model of care, Essen has five integrated clinical divisions offering urgent care, primary care, and specialty services, as well as nursing home staffing and care management. Founded in 1999, our over 20-year commitment has fueled an unwavering dedication toward innovating a better healthcare delivery system. Essen has expanded from a single primary care office to an umbrella organization offering specialties from women s health to endocrinology, from psychiatry to a vast array of other specialties. All clinical services are offered via telehealth or in-person at over 35 medical offices and at home through the Essen House Calls program. Essen Health Care is the place...

Essen Health Care is seeking at Essen is seeking a full-time Medical Director to oversee various Nursing Home within Essen The Nursing Home Medical Director will oversee the daily operations of various Nursing Homes and collaborate with multidisciplinary teams at Essen. In this role, your responsibilities will include staffing, financial management, supervising resident care, marketing, and community outreach. A thorough knowledge of federal, state, and local standards for long-term care is a necessity. The selected candidate serves in this leadership role which offers opportunity for teaching and mentoring. Ensure the facility's compliance with the rules and regulations of government and accrediting bodies with potential innovative pilot projects, but not limited to: Collaborates with the facility leadership, staff, and other practitioners and consultants to help develop, implement and evaluate resident care policies and procedures that reflect current standards of...

Essen Health Care is a growing community healthcare network provides high quality, compassionate, and accessible medical care to some of the most vulnerable and under-served residents of New York State. Guided by a population health model of care, Essen has five integrated clinical divisions offering services in primary & specialty offices, urgent care centers, and nursing homes, as well as house calls for home bound patients; all clinical services are also offered via telehealth. Our Care Management division supports patient-centered care through care coordination, complex care management and helping address health-related social needs. COME JOIN US Essen is currently seeking a Pain Management Physician. Our dedicated and compassionate team of professionals come from culturally diverse backgrounds and they share the common vision of providing our outpatient population with the best primary and preventative health care available. The Pain Management Physician has...