- PruittHealth (Norcross, GA)
- **JOB PURPOSE:** The Compliance Auditor (CA) reports directly to the Vice President of Compliance (VPC) to conduct compliance audits for Health Care ... SOURCE/CCSP service lines. The CA performs routine and focused internal compliance investigations, audits and assessments throughout the organization and develops… more
- Grace Healthcare Services (Edison, NJ)
- …serve patients and families with the highest level of dignity and grace. Purpose: The Compliance Auditor is an experienced nurse to oversees the primary ... Come Join Our Team! Now Hiring Compliance Auditor Company Overview It is our belief that the delivery of hospice care can be taken to a new level of excellence… more
- Northwell Health (Glen Cove, NY)
- …reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. + Applies coding rules and ... the validation review process. + Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. + Instructs professional staff in code… 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 ... ICT and health assessments. Staff will notify supervisors of any processes not in compliance with the Plan's SNP policies and MOC requirements. Clinical staff who do… more
- Rush University Medical Center (Chicago, IL)
- …Schedule:** 8 Hr (8:00:00 AM - 4:30:00 PM) **Summary:** The Revenue Integrity Nurse Auditor position will use an eye for detail, collaboration, assessments, ... patient charges are accurate. In a hybrid/remote setting, the Revenue Integrity Nurse Auditor reviews charges and clinical documentation, performs outside payor… more
- Magellan Health Services (Albuquerque, NM)
- …the appropriate assessments. Provides feedback to the clinical teams on contractual compliance and quality of work within the case management system. Provider ... and demonstrated experience. General Job Information Title CISC Clinical Auditor Grade 25 Work Experience - Required Clinical Work...PSY - Psychologist - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care Mgmt… more
- Molina Healthcare (Mckinney, TX)
- **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), ... (HM), and/or Disease Management (DM). + Monitors key clinical staff for compliance with NCQA, CMS, State and Federal requirements. May also perform non-clinical… more
- Northwell Health (Lake Success, NY)
- …reviews Medicare/non-Medicare charts to ensure that proper standards are maintained in compliance with Federal and State regulations. + Applies coding rules and ... the validation review process. + Reviews codes on Medicare/non-Medicare charts for compliance to rules and conventions. + Communicates DRG changes and rationale to… more
- Fresenius Medical Center (Irwindale, CA)
- …to the Clinical Quality leadership, Education, Clinical Services, Regulatory and Compliance to take the appropriate steps to facilitate achievement of quality ... or an equivalent combination of education and experience + Registered Nurse required + Certification in Nephrology Nursing or quality preferred. **EXPERIENCE… more
- UNC Health Care (Rocky Mount, NC)
- …and well-being of the unique communities we serve. **Summary:** The Recovery Audit Nurse will work closely with other Business Office staff members to assist in ... or prospective review, ie - Medicare and Medicaid RA (Recovery Auditor ) programs. **Responsibilities:** + Ensuring compliant billing guidelines + Assistance with… more
- University of Pennsylvania (Philadelphia, PA)
- …as well as assisting with corrective actions and training related to research compliance , quality control and quality assurance. The monitor/ auditor will follow ... field preferred. Minimum of seven years of experience as a clinical research monitor/ auditor , research nurse or research coordinator with at least three years'… more
- GE Aerospace (Lafayette, IN)
- …quality management issues and is responsible for site Quality System documentation and compliance to the Quality System requirements. This job is expected to be an ... and Responsibilities** + Ensure safe practices are used in compliance with all government and GE Aerospace regulations. +...Improvement methods + Knowledge of AS9100 standards + S-026 Auditor Certified or ASQ Certified Quality Auditor … more
- Immigration and Customs Enforcement (IN)
- …Health Service Corps (IHSC), Office of Deputy Assistant Director for Healthcare Compliance , Health Plan Management Unit (HPMU). This is a supervisory position. This ... for optimum utilization of personnel, facilities and equipment. Incumbent ensures compliance with program regulations (eg, appropriateness of health care and… more
- Medical Mutual of Ohio (OH)
- …. Reviews data sources to ensure accuracy and validity in compliance with HEDIS technical specifications, policies, and operating procedures. Identifies, researches, ... and vendor project planning coordination and facilitation. Works with IT and Clinical Nurse staff to aid in the loading of HEDIS data and collection of… more
- Providence (OR)
- …such as Accredited Healthcare Fraud Investigator (AHFI), Certification as an Internal Auditor (CIA), Healthcare Compliance certification (CHC), or equivalent + ... Special Investigation Unit who will:** + Support timely completion of compliance related audits and investigations of the Special Investigations Unit (SIU)… more
- City of Long Beach (Long Beach, CA)
- …city-wide elected Mayor. Other elected officials include the City Attorney, City Auditor , and City Prosecutor. The elected officials are elected to staggered ... the HIV Care Clinic, and communicable disease patients; + Provides supervision to Nurse Practitioner(s) and or Advanced Practice Registered Nurse (s) ; + Orders,… more
- MD Anderson Cancer Center (Houston, TX)
- The Clinical Coordinator Studies - Regulatory ensures regulatory compliance for the Department of Genitourinary Medical Oncology clinical trials, assists with the ... relevant to regulatory matters to the research staff. Key Functions: **Regulatory Compliance :** * Assembly of regulatory documents required per local and FDA… more
- MD Anderson Cancer Center (Houston, TX)
- Summary The Coordinator, Clinical Studies - Regulatory - ensures regulatory compliance for the Department of Genitourinary Medical Oncology clinical trials, assists ... relevant to regulatory matters to the research staff. Key Functions Regulatory Compliance : Assembly of regulatory documents required per local and FDA regulation,… more
- Intrepid USA (Terre Haute, IN)
- …the role of the Administrator should the Administrator be unavailable for the surveyor/ auditor . + Manages the patient care team to assure safe and effective care ... + Assures current and accurate clinical records are in compliance with documentation requirements and State and Federal Regulations....willing to take responsibility for them. + Current Registered Nurse license in the state of practice + One… more
- HCA Healthcare (San Antonio, TX)
- …true discrepancy and complete incident reports as required. You will review RX Auditor report and generate investigation reports for nurse managers/directors to ... hospital personnel politely and appropriately. You will perform and monitor compliance for quality control and performance improvement functions as assigned. You… more