- Elevance Health (Denver, CO)
- …and efficiency recommendations. **Minimum Requirements:** + Requires current, active, unrestricted Registered Nurse license in applicable state(s). + Requires a ... **Diagnosis Related Group Clinical Validation Auditor ** **Location:** This position...are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical … more
- Molina Healthcare (Jackson, MS)
- **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management ... Management (HM), and/or Disease Management (DM). + Monitors key clinical staff for compliance with NCQA, CMS, State and...them. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ) Program and… more
- Catholic Health Initiatives (Chattanooga, TN)
- …with us today! **Responsibilities** **Job Summary / Purpose** The Sr Coding Compliance Auditor is responsible for reviewing chart notes for proper coding with an ... met at the highest level. The Sr Coding Compliance Auditor 's primary focus will be to facilitate and ensure...assist with educating providers on quality opportunities as well. Clinical background preferred but not required. **Essential Key Job… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …and visitors. **Education and experience requirements:** + Bachelors degree required. + Clinical background preferred (ie, LPN, RN , etc.). + Current Certified ... mentorship and leadership programs + And more! **Description** Reporting to the Manager , Compliance Audit and Analysis, develops and executes audit, monitoring, and… 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 ... compliance with the Plan's SNP policies and MOC requirements. Clinical staff who do not complete the required annual...to the Health Services Department / UM Medical Care Manager a monthly report of activities performed.15. Attends all… more
- Molina Healthcare (Ypsilanti, MI)
- **JOB DESCRIPTION** _For this position we are seeking a ( RN ) Registered Nurse who must live and have a current active unrestricted RN license in the ... QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist, Quality Improvement ( Registered Nurse ) contributes to one or more of… more
- Baystate Health (Westfield, MA)
- …to: **Cole Courtemanche, Healthcare Recruiter** **###@baystatehealth.org** **Summary:** Reports to the Nurse Manager but daily activities are coordinated by the ... **10)** Observes cardiac monitors. Identifies and reports irregular rhythms to registered nurse for interpretation and intervention. Records and processes… more
- Baystate Health (Springfield, MA)
- …incentive payments that may be applicable to this role.** **Summary:** **Reports to the Nurse Manager but daily activities are coordinated by the charge nurse ... communication with NEOPO and related paperwork in conjunction with RN . Screen calls for clinical team and...by Zoned Hospitalist. Make available the unit based assignment ( RN /Case Manager /Social Worker as well as covering… more
- Baystate Health (Springfield, MA)
- …any incentive payments that may be applicable to this role. Summary: Reports to the Nurse Manager but daily activities are coordinated by the charge nurse . ... communication with NEOPO and related paperwork in conjunction with RN . Screen calls for clinical team and...by Zoned Hospitalist. Make available the unit based assignment ( RN /Case Manager /Social Worker as well as covering… more
- Molina Healthcare (Columbus, OH)
- …activities and results to identify opportunities for improvement. + Surfaces to Manager and Director any gaps in processes that may require remediation. + ... Excel and Visio (flow chart equivalent). **Preferred Education** Preferred field: Clinical Quality, Public Health or Healthcare. **Preferred Experience** + 1 year… more
- Molina Healthcare (New Bedford, MA)
- …activities and results to identify opportunities for improvement. + Surfaces to Manager and Director any gaps in processes that may require remediation. + ... Excel and Visio (flow chart equivalent). **Preferred Education** Preferred field: Clinical Quality, Public Health or Healthcare. **Preferred Experience** 1 year of… more
- Molina Healthcare (Flint, MI)
- …activities and results to identify opportunities for improvement. + Surfaces to Manager and Director any gaps in processes that may require remediation. + ... Excel and Visio (flow chart equivalent). **Preferred Education** Preferred field: Clinical Quality, Public Health or Healthcare. **Preferred Experience** 1 year of… more
- Molina Healthcare (Seattle, WA)
- …activities and results to identify opportunities for improvement. + Surfaces to Manager and Director any gaps in processes that may require remediation. + ... and Visio (flow chart equivalent). **Preferred Education** Preferred field: Clinical Quality, Public Health or Healthcare. **Preferred Experience** + Understanding… more