- Humana (Trenton, NJ)
- …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 (New York, NY)
- …RN may be preferred for specific roles) + Active, unrestricted Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you are ... direction and implementation of NCQA accreditation surveys and federal/state QI compliance activities. **Experience with health plan quality/HEDIS is important for… more
- Northwell Health (Garden City, NY)
- …five (5) years of job entry date. + Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as ... **Req Number** 125752 Job Description Seeking RN - BSN or MSN candidates with a...charts to ensure that proper standards are maintained in compliance with Federal and State regulations. + Applies coding… more
- CVS Health (Trenton, NJ)
- …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