- Humana (Olympia, WA)
- …where your clinical expertise and passion for accuracy will make a meaningful impact. As the Nurse Audit Manager , you will spearhead audit and validation ... relevant coding. + Identifies the root cause analysis of audit findings and submits recommendations for appropriate change management....skills to make an impact** **Required Qualifications** + Registered nurse (RN). + 5 or more years of clinical… more
- Immigration and Customs Enforcement (Tacoma, WA)
- Summary The Clinical Nurse Manager oversees nursing services at ICE facilities, ensuring compliance with laws, regulations, and standards. Responsibilities ... Service Corps (IHSC), Office of Deputy Assistant Director of Clinical Services (DAD-CSU). The Nurse Manager (NM) will report directly to the Regional Nurse … more
- Molina Healthcare (Tacoma, WA)
- …programs. **Preferred Qualifications** * Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified ... JOB DESCRIPTION **Job Summary** The Medical Claim Review Nurse provides support for medical claim review activities....Candidates with knowledge of CPT/HCPCS codes, record review, chart audit , provider disputes, appeals, and 1500 & UB04 claim… more
- Molina Healthcare (Tacoma, WA)
- …**PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Certified Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional ... to clinical experience + Documents clinical review summaries, bill audit findings and audit details in the database + Provides supporting documentation for… more
- CVS Health (Olympia, WA)
- …travel if a plan sponsor requests pharmacist attendance for an onsite visit/assessment/ audit . The Pharmacy Program Manager role includes: -Collaborate with an ... with heart, each and every day. The Pharmacy Program Manager is an individual contributor (non-people manager )...interdisciplinary care management team ( nurse case managers, medical directors, dietitians, social workers) to… more
- Molina Healthcare (Tacoma, WA)
- …licensure required **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case ... in regulatory audits as subject matter expert and fulfilling different audit team roles as required by management. + Maintains member/provider confidentiality… more