- Humana (Jefferson City, MO)
- …where your clinical expertise and passion for accuracy will make a meaningful impact. As the Nurse Audit Manager , you will spearhead audit and validation ... relevant coding. + Identifies the root cause analysis of audit findings and submits recommendations for appropriate change management....skills to make an impact** **Required Qualifications** + Registered nurse (RN). + 5 or more years of clinical… more
- Saint Luke's (Kansas City, MO)
- …**Saint Luke's is hiring an Experienced RN to join their team as a Charge Audit Nurse Specialist!** + Remote position but must live in the Kansas City ... metro facilities. + Manage Epic work queues assigned to nurse auditors for edit/issue resolution and complete accounts in...issues to Charge Management service line analyst and Charge Audit Manager . + Participate in ad hoc… more
- Elevance Health (St. Louis, MO)
- **Telephonic Nurse Case Manager Senior** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person ... in different states; therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager Senior** is responsible for care management within… more
- Elevance Health (MO)
- The ** Nurse Case Manager ** **Lead** is responsible for care management within the scope of licensure for members with complex and chronic care needs by ... and functions as preceptor for new care management staff. + Participates in audit activities and assists supervisor with management of day-to-day activities, such as… more
- CVS Health (Jefferson City, MO)
- …travel if a plan sponsor requests pharmacist attendance for an onsite visit/assessment/ audit . The Pharmacy Program Manager role includes: -Collaborate with an ... with heart, each and every day. The Pharmacy Program Manager is an individual contributor (non-people manager )...interdisciplinary care management team ( nurse case managers, medical directors, dietitians, social workers) to… more
- ChenMed (St. Louis, MO)
- …expanding and we need great people to join our team. The Center Clinical Manager (CCM) is an active leadership role responsible for the day-to-day management of back ... that help the center meet/exceed organizational goals. The Center Clinical Manager demonstrates thorough knowledge and proficiency in healthcare data analytics,… more
- Blue KC (Kansas City, MO)
- …relative to peers and clinical standards, etc. In conjunction with the Manager and/or Senior Investigator, evaluate FWA risks and prioritize for further review, ... and abuse in accordance with SIU policies and procedures. May work with Manager and/or Senior Investigator on larger, more complex, investigations. + Create and… more