• Provider Network Audit

    CVS Health (Nashville, TN)
    …systems and on daily operations and programs + Responsible to support targeted quality audit projects. Report results and make recommendations eg, training ... service to our internal and external customers. **Position Summary** + Performs routine quality audits for network operations and claim testing for PPO … more
    CVS Health (06/01/25)
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  • Quality Assurance, Sr. Coordinator

    Cardinal Health (Nashville, TN)
    …patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to ... and continuous improvement. Accurately score interactions to gauge employee's quality performance based on organizational and departmental policies and requirements.… more
    Cardinal Health (04/22/25)
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  • Rev Integrity Auditor Sr

    Covenant Health Inc. (Knoxville, TN)
    …Overview: Covenant Health is the region's top-performing healthcare network with 10 hospitals (http://www.covenanthealth.com/hospitals/) , outpatient and specialty ... and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million...complex level professional internal auditing work. Work involves compliance audit projects for Covenant Health entities as they relate… more
    Covenant Health Inc. (05/05/25)
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  • Supv Rev Integrity-Ops

    Covenant Health Inc. (Knoxville, TN)
    …conducted by Revenue Integrity Department Auditors and Appeal Coordinators. Oversees audit and denials management workflow including quality and reporting. ... Health Overview: Covenant Health is East Tennessee's top-performing healthcare network with 10 hospitals (http://www.covenanthealth.com/hospitals/) and over 85 outpatient… more
    Covenant Health Inc. (05/03/25)
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  • Principal Risk Manager, Transportation Risk…

    Amazon (Nashville, TN)
    …meeting legal and contractual obligations relating to business practices, driver / provider eligibility, and safety standards. You will be expected to understand ... laws and regulations applicable to the Amazon transportation network , assess effectiveness of existing risk and control concepts, and propose innovative mitigation… more
    Amazon (05/11/25)
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  • Coding Auditor Educator

    Highmark Health (Nashville, TN)
    …retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, ... **Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** Performs all...in the audits compliant with regulatory requirements. Provides written audit guidance. Participates with management in the assessment of… more
    Highmark Health (05/09/25)
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  • Senior Coordinator, Individualized Care (Case…

    Cardinal Health (Nashville, TN)
    …patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to ... point of contact handling inbound calls, with ability to determine needs and provide one call resolution + Process enrollments via inbound fax, phone, and… more
    Cardinal Health (03/15/25)
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  • Sr. Construction Manager, GES Nacf Design…

    Amazon (Nashville, TN)
    …tenant improvement (TI), and engineering deployment for new facilities within the network * Provide technical direction concerning engineering design / AutoCAD, ... (NACF) design parameters * Survey facilities, develop and document procedures to audit the facility, provide evaluations and analysis, and recommend solutions… more
    Amazon (04/08/25)
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  • Sr. Construction Manager, GES Nacf Design…

    Amazon (Nashville, TN)
    …tenant improvement (TI), and engineering deployment for new facilities within the network * Provide technical direction concerning engineering design / AutoCAD, ... Fulfillment (NACF) design parameters *Survey facilities, develop and document procedures to audit the facility, provide evaluations and analysis, and recommend… more
    Amazon (04/04/25)
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  • Clin Supv-HC

    Covenant Health Inc. (Knoxville, TN)
    …HomeCare is East Tennessee's largest locally owned homecare and hospice provider , with one of the largest rehabilitation departmentsin this area ... (https://www.covenanthomecareandhospice.com/locations/) . Since 1978, we have provided quality home healthcare to allow patients to live with comfort, dignity, and… more
    Covenant Health Inc. (05/15/25)
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  • Dir Mgd Care Contracting

    Covenant Health Inc. (Knoxville, TN)
    …Covenant Health Overview: Covenant Health is the region's top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant ... 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we… more
    Covenant Health Inc. (04/12/25)
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  • Director, Grievance and Appeals

    Humana (Nashville, TN)
    …with upstream business partners such as Claims, Clinical Guidance, and the Provider Network to identify opportunities and drives initiatives that will ... midst of a people, process and technology transformation that will improve quality , timeliness and the overall experience for our associates, members and providers.… more
    Humana (05/30/25)
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  • Dir Payment Innovation

    Community Health Systems (Franklin, TN)
    …corrective actions for all participants and reporting teams. + Lead annual ACO GRPO Quality Audit through coordination of data collection and data submission to ... in operational needs, including but not limited to post-acute collaborative network management, case management collaborations, utilization, and quality reviews,… more
    Community Health Systems (05/06/25)
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  • IT Services- Architecture Consultant- Senior…

    PwC IT Services Co. (Nashville, TN)
    …a centralized model to provide security services across the entire member firm network . Mandated at the network level, Network Information Security (NIS) ... strategies. They work to identify vulnerabilities, develop secure systems, and provide proactive solutions to safeguard sensitive data. Those in application security… more
    PwC IT Services Co. (05/31/25)
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  • Senior Site EHS Manager

    Amazon (Memphis, TN)
    …associates are trained and knowledgeable of their responsibilities under each policy * Audit the quality , delivery (including qualifications of the trainer), and ... SME of local/regional regulations and company WHS policy. * Provide guidance and oversight to ensure compliance to all...to support business safety initiatives. * Deliver on-time and quality projects to Operations. * Deep Dive safety metrics… more
    Amazon (03/15/25)
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  • Sr. Claims & Risk Manager, Amazon Shipping

    Amazon (Nashville, TN)
    …Manage the program charter by driving strategic initiatives for growth and quality improvement. * Build and manage relationships with key stakeholders across Amazon ... About the team Amazon Shipping is an industry leading shipping service provider (SSP) that offers better reliability and shipper/recipient experience at the right… more
    Amazon (05/21/25)
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  • Clin Supv-HC

    Covenant Health Inc. (Knoxville, TN)
    …HomeCare is East Tennessee's largest locally owned homecare and hospice provider , with one of the largest rehabilitation departmentsin this area ... (https://www.covenanthomecareandhospice.com/locations/) . Since 1978, we have provided quality home healthcare to allow patients to live with comfort, dignity, and… more
    Covenant Health Inc. (03/26/25)
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  • Construction Manager, North America Construction…

    Amazon (Nashville, TN)
    …(NACF) design parameters * Survey facilities, develop and document procedures to audit the facility, provide evaluations and analysis, and recommend solutions ... Managers will also handle the implementation of the facility network infrastructure; including sortation centers, delivery stations, and auxiliary buildings… more
    Amazon (03/16/25)
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  • Sr. Construction Manager, North America…

    Amazon (Nashville, TN)
    …(NACF) design parameters. * Survey facilities, develop and document procedures to audit the facility, provide evaluations and analysis, and recommend solutions ... Managers will also handle the implementation of the facility network infrastructure; including sortation centers, delivery stations, and auxiliary buildings… more
    Amazon (03/16/25)
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  • Case Manager

    Cardinal Health (Nashville, TN)
    …patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to ... may receive general guidance on new assignments + May provide general guidance or technical assistance to less experienced...inquiry + Make all outbound calls to patient and/or provider to discuss any missing information and/or benefit related… more
    Cardinal Health (05/21/25)
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