- Humana (Columbus, OH)
- …a part of our caring community and help us put health first** The Compliance Nurse Auditor reviews utilization management activities and documentation to ... to prevent and detect fraud, waste, and abuse. The RN Compliance Nurse 2, Quality...past 3 years + Experience as a Utilization Management Auditor + Health Plan experience working with large carriers… more
- Molina Healthcare (Columbus, OH)
- For this position we are seeking a ( RN ) Registered Nurse who lives in OHIO or KENTUCY and must be licensed for the state they reside Clinical Auditor ... Disease Management (DM). + Monitors key clinical staff for compliance with NCQA, CMS, State and Federal requirements. May...them. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ) Program and… more
- CVS Health (Columbus, OH)
- …and external partners. Ability to travel for business needs. **Preferred Qualifications:** Registered Nurse ( RN ) Previous leadership experience. AAPC Coding ... CPC's, working closely with internal and external stakeholders and ensuring compliance with regulatory requirements. The Manager develops strategies to manage… more