- A-Line Staffing Solutions (Harrisburg, PA)
- …provider documentation to determine compliance with Medical Assistance regulations. Nurse Auditor Hybrid / Remote Requirements Registered Nurse issued by ... A-Line Staffing is now hiring a Nurse Auditor Hybrid / Remote in...behavioral health setting drug and alcohol setting managed care quality management/utilization review or other related clinical … more
- Novo Nordisk Inc. (Plainsboro, NJ)
- About the Department The Clinical , Medical and Regulatory (CMR) department at Novo Nordisk is one of the most diverse and collaborative groups within the ... find better and more innovative ways to improve their quality of life. We're changing lives for a living....NNI Finance, Global Business Services (GBS), PV & GDP Auditor (s) as well as with counterparts in Global Safety… more
- Elevance Health (Metairie, LA)
- …business hours, Monday through Friday.** **TRAVEL: Travel is required to provider locations.** The Clinical Quality Auditor Sr. is responsible for ensuring ... clinical quality through an audit process. Primary duties may include,...problems and propose solutions. **Required Qualifications** + Current unrestricted RN or LCSW license issued by the state of… more
- Healthfirst (NY)
- The Clinical Auditor performs audit functions for Healthfirst clinical teams (eg Care Management, Reassessment/ Clinical Eligibility, Utilization ... clinical and critical thinking skills to evaluate the quality and effectiveness of case management and/or utilization review...duties as assigned Minimum Qualifications: + NYS LPN or RN license. + In order to access the Uniform… more
- UNC Health Care (Chapel Hill, NC)
- …Association) certification - AAPC (American Academy of Professional Coders) certification - RN ( Registered Nurse ) license - LPN (Licensed Practical ... position reports to the HCS Supervisor Coding and CDI Quality and Training. This position may travel from entity...across the state to train and shadow round with Clinical Documentation Specialists. The CDS auditor provides… more
- LA Care Health Plan (Los Angeles, CA)
- Delegation Oversight Clinical Auditor RN II Job Category: Clinical Department: Executive Services Location: Los Angeles, CA, US, 90017 Position Type: ... to achieve that purpose. Job Summary The Delegation Oversight Clinical Auditor RN II is...& literacy with Word, Excel, PowerPoint Skills. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- HCA Healthcare (Nashville, TN)
- …Coding Auditor , you will be responsible for performing internal quality assessment reviews on Health Information Management Service Center (HSC) coders to ... inclusion thrive? Submit your application for our Inpatient Coding Auditor opening with Parallon today and find out what...that we continue to provide all patients with high quality , efficient care. Did you get into our industry… more
- HCA Healthcare (Nashville, TN)
- …Coding Auditor , you will be responsible for performing internal quality assessment reviews on Health Information Management Service Center (HSC) coders to ... inclusion thrive? Submit your application for our Inpatient Coding Auditor opening with Parallon today and find out what...that we continue to provide all patients with high quality , efficient care. Did you get into our industry… more
- Emory Healthcare/Emory University (Atlanta, GA)
- **Description** **JOB DESCRIPTION:** The Lead Clinical Documentation Integrity (CDI) DRG Auditor works under the direction of the Associate Director of CDI ... Quality and Education. He/she performs all the requirements of the Lead CDI DRG Auditor . In addition, this position is responsible for identifying areas of… more
- RWJBarnabas Health (Oceanport, NJ)
- Physician Billing Auditor - Oceanport, NJReq #:0000137296 Category:Professional / Management Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate ... 2 Crescent Place, Oceanport, NJ 07757 Job Overview: The Physician Billing Auditor prepares and conducts employed provider billing audits according to the current… more
- Centene Corporation (Madison, WI)
- …Licensed Clinical Social Worker (LCSW), Licensed Mental Health Counselor (LMHC), Registered Nurse ( RN ), or Licensed Psychologist (Ph.D. or Psy.D.) ... the auditing of corporate, health plan, and specialty company staff related to clinical systems entry and/or processes + Develop and maintain the audit process and… more
- Centene Corporation (Trenton, NJ)
- …Clinical Mental Health Counselor, Licensed Clinical Social Worker (LCSW), Registered Nurse ( RN ), Licensed Psychologist (Psy.D.), Licensed Marriage and ... and maintain the audit process and tools related to: authorizations, appeals, quality events, and case management in CCMS; interrater reliability related to… more
- InnovaCare (San Juan, PR)
- …MMM Holdings, Inc.Job Description Inpatient Unit POSITION: Concurrent Review Nurse (CRN) POSITION DESCRIPTION Manages the inpatient utilization of healthcare ... any processes not in compliance with the Plan's SNP policies and MOC requirements. Clinical staff who do not complete the required annual training may not perform… more
- Centene Corporation (Austin, TX)
- …States. **Position Purpose:** Responsible for developing and conducting training and quality auditing programs for the Diagnosis Related Group (DRG) and Medical ... + Conducts training needed analyses to determine specific training needs for clinical and coding staff + Identifies, selects, or develops appropriate training… more
- Intrepid USA (Henderson, KY)
- …Capable of making challenging decisions and willing to take responsibility for them. + Current Registered Nurse license in the state of practice + One (1) year ... Intrepid University + Clinician centric WellSky EHR to improve clinical documentation quality and patient care +...the Administrator should the Administrator be unavailable for the surveyor/ auditor . + Manages the patient care team to assure… more
- University of Pennsylvania (Philadelphia, PA)
- …or related field preferred. Minimum of seven years of experience as a clinical research monitor/ auditor , research nurse or research coordinator with ... of Operations, Compliance and Monitoring (DOCM) is seeking a clinical research monitor/ auditor to support our ...related to research compliance, quality control and quality assurance. The monitor/ auditor will follow all… 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 ... accuracy and consistency on referred cases. The RN will perform and coordinate the clinical ...experience required. + A minimum of two (2) years quality /utilization review experience in an HMO, managed care organization,… more
- Baystate Health (Springfield, MA)
- …Team Operations Associate Cardiac Monitor Tech will function in a supportive role to a registered nurse and work collaboratively with the health care team in the ... communication with NEOPO and related paperwork in conjunction with RN . Screen calls for clinical team and...forms, etc. **8)** Unit Resource: Post/file MD schedules for clinical team inquiry. In coordination with charge nurse… more
- CGI Technologies and Solutions, Inc. (Dallas, TX)
- …to be successful in this role:** The Payment Integrity Edits Manager is a Registered Nurse ( RN ) with active, unrestricted licensure through the Board ... and post-payment medical claims auditing in conjunction with maintaining a robust quality assurance program. Edits are developed through a well-defined process which… more
- Molina Healthcare (AZ)
- … Quality Improvement (QI) Interventions/Compliance contributes to either or both critical Quality functions: Clinical Quality Interventions and Quality ... business objectives. **Preferred License, Certification, Association** + Certified Professional in Health Quality (CPHQ) + Nursing License ( RN may be preferred… more
