• Quality Improvement Auditor

    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
    Centene Corporation (05/10/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Woodbridge, 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** **Location:** This position...and Hospital-Acquired Conditions (HACs). + Suggests and develops high quality , high value, concept and or process improvement more
    Elevance Health (04/29/25)
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  • Lead Overreader, HEDIS Abstraction…

    Molina Healthcare (New York, NY)
    **Job Description** **Job Summary** Molina's Quality Improvement Lead Overreader conducts oversight and audits of the data collected and abstracted from medical ... the lead role of the HEDIS medical record review overreader/ auditor which includes ongoing review of records reviewed and...abstracted records as required by specifications. + Assists the quality improvement staff with physician and member… more
    Molina Healthcare (04/11/25)
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  • Manager - Contract Review and Compliance Reporting

    Novo Nordisk (Plainsboro, NJ)
    …tasks at all times + Provides strategic input and contributes to process / quality improvement initiatives + Guides the successful completion of major programs ... About the Department The Clinical , Medical and Regulatory (CMR) department at Novo...find better and more innovative ways to improve their quality of life. We're changing lives for a living.… more
    Novo Nordisk (05/10/25)
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