- Centene Corporation (New York, NY)
- …and requires an clinical license. 3+ years of nursing or quality improvement experience. **Licenses/Certifications:** Current state's clinical license ... processes to measure member outcomes. Assess provider performance and quality of care through clinical case reviews....and delivered timely + Perform other performance and process improvement activities + Performs other duties as assigned +… more
- Elevance Health (Jersey City, NJ)
- …state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement , and a minimum of ... **Diagnosis Related Group Clinical Validation Auditor -RN** **Virtual:** This role...and Hospital-Acquired Conditions (HACs). + Suggests and develops high quality , high value, concept and or process improvement… more
- Molina Healthcare (Yonkers, NY)
- **JOB DESCRIPTION** **Job Summary** Molina's Quality Improvement function oversees, plans, and implements new and existing healthcare quality improvement ... is responsible for developing, implementing, and monitoring the success of quality improvement interventions. The Manager works to coordinate resources… more
- RWJBarnabas Health (Oceanport, NJ)
- … quality issues and errors in the revenue cycle. Develop and implement quality improvement plans. + Training and Development Develop and deliver training ... Place, Oceanport, NJ 07757 Job Overview: The Revenue Cycle Quality Review Representative acts as both an auditor...analyze revenue cycle performance metrics to identify areas for improvement . Conduct audits and quality checks to… more
- RWJBarnabas Health (Oceanport, NJ)
- …or a related field. + Certified Public Accountant (CPA), Certified Internal Auditor (CIA), or equivalent professional certification preferred. + Minimum of 6-8 years ... risk assessments, testing, and reporting findings, ensuring timely delivery and high- quality outcomes. + Evaluate the effectiveness of internal controls, policies,… more