- Houston Methodist (Cypress, TX)
- At Houston Methodist, the Nurse Auditor position is responsible auditing and reconciling patient charts (ie medical record) on a daily basis or upon request from ... to accurately support reasons for treatment, billing, payment or operations. The Nurse Auditor position ensures clinical documentation supports all patient… more
- LA Care Health Plan (Los Angeles, CA)
- …perform Utilization Management (UM) functions on behalf of LA Care (LAC) is in compliance with all UM regulatory requirements and new legislation through the ... Policies/Procedures, Letter Templates, Workflows, Processes, and Audit Tools in compliance with all regulatory requirements/new legislation. Works… 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
- SSM Health (MO)
- …Status Review, and Case Management departments. Performs operational audits and compliance audits adhering to regulatory requirements. Standardizes policies, ... and Status Review; Case Management Standard Work. + Performs operational and compliance audits adhering to regulatory requirements. + Creates and standardizes… more
- Molina Healthcare (Dallas, TX)
- **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), ... Disease Management (DM). + Monitors key clinical staff for compliance with NCQA, CMS, State and Federal requirements. May...approach and tool use. + Assists in preparation for regulatory audits by performing file review and preparation. +… more
- Highmark Health (Pittsburgh, PA)
- …Information Systems Auditor (CISA + Juris Doctorate (JD) + Registered Nurse (RN) + PharmD **SKILLS** + Demonstrate expert knowledge of business and technology ... team of specialists. Identify, develop, coordinate, and implement legislative, regulatory , sub- regulatory , and licensing / accreditation requirements.Perform… 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
- MD Anderson Cancer Center (Houston, TX)
- …and /or government sponsors). * Provides direct support to research nurse /data coordinator for research protocols. * Coordinates regulatory correspondence ... grants in order to prepare for Progress Reports * Continuous monitoring of compliance status of your manuscripts in My NCBI **Protocol Regulatory Coordination:**… more
- GE Vernova (Wilmington, NC)
- …for New Nuclear Projects. Evaluate New Plants Projects (NPP) activities for compliance to regulatory , customer, and GEH internal requirements, and provide ... Certified or able to be certified as a Lead Auditor to ASME NQA-1 or ANSI N45.2.23 requirements. +...drug coverage; access to a Health Coach, a 24/7 nurse -based resource; and access to the Employee Assistance Program,… more