• Diagnosis Related Group Clinical Validation…

    Elevance Health (Nashville, TN)
    **Diagnosis Related Group Clinical Validation Auditor -** **Registered Nurse ** **Location:** This position will work a hybrid model (remote and office). Ideal ... one of our PulsePoint locations. The **Diagnosis Related Group Clinical Validation Auditor ** is responsible for auditing inpatient medical records to ensure clinical… more
    Elevance Health (01/01/25)
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  • RN Compliance Auditor

    Humana (Nashville, TN)
    …of our caring community and help us put health first** The Compliance Nurse Auditor reviews utilization management activities and documentation to ensure ... and detect fraud, waste, and abuse. The RN Compliance Nurse 2, Quality Assurance Audit ensures mandatory reporting is...past 3 years + Experience as a Utilization Management Auditor + Health Plan experience working with large carriers… more
    Humana (01/23/25)
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  • Special Investigation Unit Manager Clinical…

    CVS Health (Nashville, TN)
    …Ability to travel for business needs. **Preferred Qualifications:** Registered Nurse (RN) Previous leadership experience. AAPC Coding Certification - Certified ... Professional Biller (CPB), Certified Professional Medical Auditor (CPMA), Certified Outpatient Coder (COC), Certified Risk Adjustment Coder (CRC) Licensed Clinical… more
    CVS Health (12/25/24)
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