- LA Care Health Plan (Los Angeles, CA)
- Manager, Delegation Oversight Clinical Audit Job Category: Clinical Department: Executive Services Location: Los Angeles, CA, US, 90017 Position Type: Full ... achieve that purpose. Job Summary The Manager, Delegation Oversight Clinical Audit is directly responsible for the...collaboratively with other LA Care departments to improve Service Quality and Clinical Quality provided… more
- BrightSpring Health Services (Louisville, KY)
- Our Company BrightSpring Health Services Overview Clinical Denials Management and Audit monitors, responds to, and performs the clinical denial and appeal ... processes across Home Health branches for all payor types striving to improve clinical documentation and minimize lost revenue. They conduct analysis on denials and… more
- BrightSpring Health Services (Louisville, KY)
- Our Company BrightSpring Health Services Overview The Clinical Coding and Audit Specialist monitors, responds and performs the clinical coding and audit ... across the Home Health enterprise for all payor types striving to improve clinical documentation and minimize lost revenue. Conducts analysis on timely submission of… more
- Immigration and Customs Enforcement (Pearsall, TX)
- … clinical advisory tasks related to such functions as developing and assessing clinical health outcomes quality measures; evaluating clinical case reviews ... practices of professional nursing to improve the efficiency and quality of work performed or to protect the ...for adequacy of care, compliance with clinical and regulatory guidelines, overpayment, and audit … more
- Immigration and Customs Enforcement (Pearsall, TX)
- … clinical advisory tasks related to such functions as developing and assessing clinical health outcomes quality measures; evaluating clinical case reviews ... for adequacy of care, compliance with clinical and regulatory guidelines, overpayment, and audit ...Service Corps (IHSC), Office of Deputy Assistant Director of Clinical Services (DAD-CSU). The Nurse Manager (NM)… more
- WelbeHealth (San Jose, CA)
- …+ In collaboration with CSD and Quality Improvement Director, serve as the audit lead for clinical and nursing elements during CMS/DHCS audit review ... communities by providing comprehensive medical care and community-based services. The WelbeHealth Clinical Nurse Manager is accountable for the delivery of high-… more
- Molina Healthcare (Columbia, SC)
- … who must be licensed in the state you reside. We are looking for a Clinical Nurse Appeals RN to support our SC Health plan (Medicaid and Marketplace). Strong ... decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical /medical… more
- Ascension Health (Birmingham, AL)
- …additional specifics._ **Responsibilities** Develop, implement, and has oversight over the Clinical Documentation Integrity (CDI) audit plan, utilizing audit ... and ancillary staff. Responsibilities: + Oversee and develop the audit plan and schedule for CDI department, including performing...clinical and ancillary staff to improve the overall quality and completeness of clinical documentation. +… more
- ICON Clinical Research (Knoxville, TN)
- …sponsor or FDA audit and assisting the auditor for the duration of the audit . + Ordering clinical supplies, as well as ordering, storing and monitoring of ... Collaboration, Partnership and Integrity. We want to be the Clinical Research Organisation that delivers excellence to our clients...of Working in ICON: Our success depends on the quality of our people. That's why we've made it… more
- Sharp HealthCare (Bonita, CA)
- … quality outcomes in complex, new/unusual, or other high-risk clinical situations, collaborating or seeking additional resources as needed.Complete quality ... Healthcare) - American Heart Association; HPCC Certified Hospice and Palliative Nurse (CHPN) - Hospice and Palliative Credentialing Center; California Registered … more
- CommuniCare Health Services Corporate (Wellsburg, WV)
- RN - Regional Director of Clinical Operations CommuniCare Health Services is currently recruiting an experienced and dynamic Registered Nurse , BSN preferred, for ... the position of Regional Director of Clinical Operations. This position covers Wellsburg, Kingwood, Keyser, and...procedure, and care. + Visit facilities weekly for intervention, audit and training. + Train new nursing management. +… more
- CDPHP (Albany, NY)
- …share these values and invites you to be a part of that experience. The Clinical Review and Coding Nurse is responsible to attain procedure and diagnosis coding ... and consistency on referred cases. The RN will perform and coordinate the clinical component of the provider appeal function including communication of the decision… more
- Corewell Health (Grand Rapids, MI)
- …Legal or regulatory field; healthcare focus desirable Preferred + Compliance auditor, nurse auditor, or other audit function Required + Project ... and results having an impact on people, costs, and quality of service. Assists with the development, implementation and...coding and billing standards. + Creates clear and accurate audit findings and recommendations in written audit … more
- UNC Health Care (Rocky Mount, NC)
- …Integrity/Regulatory Services, Document Management, Chart Correction, Forms Management and RAC/ Audit . Provides direction and leadership to assure support and ... organizational goals and customer expectations. Makes decisions that produce high- quality results by applying knowledge, analyzing problems, and calculating risks.… more
- InnovaCare (Ponce, PR)
- …committed to bringing passion and customer focus to the business. POSITION DESCRIPTION The Quality Specialist Nurse is responsible for monitoring quality of ... activities geared at improving quality measures. Coordinates quality assessment activities related to clinical areas...in physician's offices of selected HEDIS sample. Performs follow audit to those providers with a score below 80%… more
- Athena Health Care Systems (CT)
- …talents are nurtured to allow you to grow within the company. As a Regional Nurse , you will be responsible for varied clinical or clinically related duties that ... their dedication. We are not only committed to delivering high- quality care and customer service to our patients and...out specific duties as assigned by the Director of Clinical Services. The Regional Nurse may be… more
- Johns Hopkins University (Baltimore, MD)
- …for the CAR T-cell position cover the areas of project development/coordination, quality and performance improvement activities with clinical staff and ancillary ... audits and site visits. Responds with assistance from the Quality Coordinator to any audit or site...Nurse (OCN) and/or Blood and Marrow Transplant Certified Nurse (BMTCN) + Certification from Association of Clinical… more
- STG International (Washoe County, NV)
- …in accordance with established charting and documentation policies and procedures. + Audit clinical record for appropriate consents and assessments including ... (inspections) made by authorized government agencies as requested. + Audit nursing documentation in the clinical record...member. + Assist the Director of Nursing in planning clinical supervision for nurse aide trainees, nursing… more
- Veterans Affairs, Veterans Health Administration (Seattle, WA)
- …professional growth, development and practice. Performs as a mentor, preceptor, or nurse educator providing didactic and clinical instruction for graduate-level ... Participates in the development of the anesthesia patient care audit processes which involves the in depth review and...mission as a mentor or preceptor providing didactic and clinical instruction in anesthesia to student nurse … more
- Centene Corporation (El Centro, CA)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** The Quality Compliance Nurse -CA Only conducts on-site visits, follow-up in-services ... the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified,… more