- Elevance Health (Woburn, MA)
- **Anticipated End Date:** 2024-09-16 **Position Title:** RN Hospital Bill Audit /Appeal Lead **Job Description:** **RN Hospital Bill Audit /Appeal Lead ** ... eliminate and prevent unnecessary medical-expense spending. The **RN Hospital Audit /Appeal Lead ** is responsible for leading a...line policy edits. + Trains and provides guidance to nurse auditors and manages workflow and priorities for the… more
- Humana (Boston, MA)
- …and help us put health first for our members, providers and ourselves. Desired Lead Associate to lead and manage the enterprise framework to facilitate and ... decision making. + Interfacing with established controls provided by quality audit , clinical policy, process policy/documentation and reporting teams. + Established… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …The RN Clinical Provider Post Service Review Manager , led by a Registered Nurse , is responsible for a team of provider correspondence associates who research and ... and NCQA requirements which is required to identify opportunities to mitigate audit risk and/or implement innovative solutions for processing efficiencies. The role… more
- Veterans Affairs, Veterans Health Administration (West Roxbury, MA)
- …recruitment will result in the hiring of one of the following disciplines: Nurse Practitioner or Physician Assistant. All interested Nurse Practitioners must ... PAs at the PA-III grade are at the full performance level and lead and organize patient care independently, practice within multi-disciplinary teams, and coordinate… more
- Beth Israel Lahey Health (Cambridge, MA)
- …Therapeutics Committee and at applicable enterprise committees. This individual will lead the tracking, trending, and analysis of antimicrobial use and resistance ... including but not limited to: a. Overseeing daily prospective audit of antimicrobials b. Working with the infectious disease...drugs with the same therapeutic action). Contact physician or nurse when necessary to prevent any problems or potential… more