Top 8 Quality improvement nurse Jobs in Douglas, Wy

Case Manager
Memorial Hospital of Converse County —Douglas, WY
- Full-time
- Master of Social Work
- Nursing
- RN License
Med/Surg RN
Memorial Hospital of Converse County —Douglas, WY
- Full-time
- Nursing
- RN License
- PALS Certification
Pre-op/PACU RN
Memorial Hospital of Converse County —Douglas, WY
- $37.75 - $47.37 an hour
- Full-time
- RN License
- PALS Certification
- Customer service
ER Registered Nurse
Memorial Hospital of Converse County —Douglas, WY
- Full-time
- Nursing
- RN License
- Mid-level
2d
NP / PA
ROCKY MOUNTAIN CARE GROUP —Douglas, WY
- $40 - $60 an hour
- Part-time
- Skilled nursing facility
- Mid-level
- Travel
- Paid training
- Flexible schedule
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Sr Quality Improvement/HEDIS Spec, Health Plan Interventions (Remote In Ohio)
Molina Healthcare —Columbus, OH
If licensed, license must be active and unrestricted in state of practice. Implements evidence-based and data-informed key member intervention strategies…
$54,922 - $107,099 a year
Quality Improvement Specialist
PrimaryOne Health —Columbus, OH
Successful candidates must have an active Registered Nurse (RN) or Licensed Practical Nurse (LPN) license in the State of Ohio.
1d

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quality improvement nurse jobs near douglas, wy

Case Manager

Memorial Hospital of Converse County -
Douglas, WY

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Job Details

Full-time

Qualifications

Vendor relationship building
BLS Certification

Full Job Description

The Case Manager coordinates all authorizations and reauthorizations for patient services, identifies care needs for safe and appropriate discharge planning, ensures compliance with third-party payers, and acts as Utilization Review liaison with Health Information Management (HIM).

Registered Nurse or a Social Worker

Master of Social Work or current WY RN license or a in social work

Two to three years' experience in hospital setting preferred

Experience with hospital, SNF, and health plan-based case management systems preferred

BLS required

Assist with the development, implementation, and ongoing evaluation of the Case Management System, including collaboration with clinical departments and community resources.

Direct, coordinate, and deliver case management for patients, including assessment of needs, planning interventions, monitoring effectiveness, and maintaining required documentation.

Participate in case finding, pre-admission evaluation, and screening for optimal reimbursement and proactive discharge planning.

Perform comprehensive case management assessments and prepare transition plans that optimize clinical and psychosocial outcomes, involving family and outside agencies as needed.

Supply clinical information to third-party payers to ensure continued reimbursement and timely authorizations.

Communicate and collaborate with the healthcare team to optimize resource utilization, anticipate barriers, and facilitate timely and appropriate discharge planning.

Identify, refer, and facilitate admissions to Transitional Care Center (TCC) and other appropriate referral organizations, monitoring criteria and readiness.

Prepare, update, and maintain records, reports, and written transfer/discharge plans, following all regulatory and institutional requirements.

Establish and maintain external relationships with referral sources, insurers, vendors, and external case managers, ensuring effective communication and care continuity.

Maintain a professional commitment, flexibility, and current knowledge of relevant guidelines, CEU credits, and resources for case management and discharge planning.

Assure department delivers high-quality services meeting regulatory standards and participating in quality improvement program reporting.

Achieve agreed-upon goals and objectives within prescribed timelines, supporting the hospitals overall mission.

Follows all exposure control plans for bloodborne/airborne pathogens and maintains compliance with protective barrier policies and annual education.

Promote effective working relationships, foster a supportive team environment, participate in meetings, and support the hospital’s mission and policies.

Behave and dress in a professional and courteous manner consistent with the facilities Standards of Behavior.

Perform other duties as assigned

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quality improvement nurse jobs in douglas, wy

Case Manager

Med/Surg RN

Pre-op/PACU RN

ER Registered Nurse

NP / PA

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