• Auditor , Clinical Services

    Molina Healthcare (Dallas, TX)
    …+ Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), Member ... Team (MAT), Health Management (HM), and/or Disease Management (DM). + Monitors key clinical staff for compliance with NCQA, CMS, State and Federal requirements. May… more
    Molina Healthcare (09/06/24)
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  • LTSS Service Coordinator- Auditor

    Elevance Health (Grand Prairie, TX)
    **LTSS Service Coordinator - Auditor (Remote in...law and contract. The audit process does not involve clinical judgment. **How you will make an impact:** + ... of one of our Elevance Health PulsePoints in Indiana or Texas. The **LTSS Service Coordinator- Auditor ** is responsible for auditing member individual service more
    Elevance Health (09/17/24)
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  • Pharmacy Internal Auditor

    Elevance Health (Grand Prairie, TX)
    …-first lens, to deliver member-centered, lasting pharmacy care. The **Pharmacy Internal Auditor ** is responsible for driving service quality excellence by ... **Pharmacy Internal Auditor ** **Location:** This position will work a hybrid...and billing and claims processing, as well as customer service written and verbal inquiries. **How you will make… more
    Elevance Health (09/11/24)
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  • Coding Quality Auditor - 100% Remote…

    Houston Methodist (Fort Worth, TX)
    At Houston Methodist, the Coding Quality Auditor position is responsible for ensuring accuracy in code assignment of diagnosis and procedure to outpatient and/or ... and provides good feedback during coding section meetings, coding education in- services , and coder/CDMP meetings. Takes initiative to assist others and shares… more
    Houston Methodist (09/14/24)
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