- Ochsner Health (New Orleans, LA)
- …of related healthcare experience with a master's degree. **Certifications** Required - Current registered nurse ( RN ) license in state of practice. Preferred ... has never changed - our commitment to serve, heal, lead , educate,** **and innovate. We believe** **that every award...work from the following areas are not eligible for remote work position_ _: Colorado, California, Hawaii, Illinois, Maryland,… more
- Elevance Health (Norfolk, VA)
- …and efficiency recommendations. **Minimum Requirements:** + Requires current, active, unrestricted Registered Nurse license in applicable state(s). + Requires a ... **Diagnosis Related Group Clinical Validation Auditor - RN ** **Location:** This position will work...** **Location:** This position will work a hybrid model ( remote and office). Ideal candidates will live within 50… more
- Ochsner Health (New Orleans, LA)
- …management. Performs and documents audits and presents oral and written conclusions to the Lead Nurse Auditor and department management. Educates and assists ... Required - Certification as CPC, CCS, CHC, RHIA, RHIT, RN , or LPN or other related certification. **Knowledge Skills...through auditing and monitoring or other means to the Lead Nurse Auditor and/or designated… more
- Elevance Health (Independence, OH)
- **Provider Auditor ** _This position will work a hybrid model ( remote and office), 1 time per week. The Ideal candidate will live within 50 miles of one of our ... to recover, eliminate and prevent unnecessary medical-expense spending. The **Provider Auditor ** conducts on-site reviews of medical charts, medical notes, itemized… more
- Centene Corporation (New York, NY)
- …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** Lead medical record audits, monitor and analyze clinical documentation, and ... provider performance and quality of care through clinical case reviews. + Lead clinical audits for provider medical records both remotely via electronic medical… more
- Molina Healthcare (Caldwell, ID)
- …strategic team to present and evaluate intervention strategies. **Only individuals with an RN license are being considered at this time.** + Plans and/or implements ... to improve care and service. + Serves as operations and implementation lead for Molina Plan quality improvement interventions using a defined roadmap, timeline,… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... NYS DOH, CMS, NCQA, and HEDIS, serving as internal auditor within the group. + Responsible for all aspects...Associates degree required. Bachelor's degree preferred. + Active NYS RN or Registered Dietician or Physical Therapist… more
- Molina Healthcare (MI)
- …+ Performs the lead role of the HEDIS medical record review overreader/ auditor which includes ongoing review of records reviewed and data entered by the ... **Job Description** **Job Summary** Molina's Quality Improvement Lead Overreader conducts oversight and audits of the...**O** **C** **I** **A** **TI** **O** **N** **:** Active RN license for the State(s) of employment **PHY** **S**… more
- Molina Healthcare (Everett, WA)
- …+ Performs the lead role of the HEDIS medical record review overreader/ auditor which includes ongoing review of records reviewed and data entered by the ... **Job Description** **Job Summary** Molina's Quality Improvement Lead Overreader conducts oversight and audits of the data collected and abstracted from medical… more