- Humana (Frankfort, KY)
- …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
- BrightSpring Health Services (Louisville, KY)
- …to the governing board + Additional responsibilities as assigned Qualifications + Registered Nurse with current licensure to practice in assigned state(s) ... Our Company BrightSpring Health Services Overview Our Hospice Compliance Auditors are responsible for supporting the Regional Compliance Directors with chart… more
- Molina Healthcare (Florence, KY)
- 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 (Frankfort, KY)
- …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