- 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 (Morristown, 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
- 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