- 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
- Elevance Health (Grand Prairie, TX)
- **LTSS Service Coordinator - Auditor (Remote)** **Location:** While remote, candidates will ideally be located within 50 miles of one of our Elevance Health ... PulsePoints. The **LTSS Service Coordinator- Auditor ** is responsible for auditing member...law and contract. The audit process does not involve clinical judgment. **How you will make an impact:** +… more
- 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
- Houston Methodist (Dallas, 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
- Elevance Health (Grand Prairie, TX)
- Nurse Auditor Senior - Carelon Payment Integrity **Location:** The ideal candidate will live within 50 miles of one of our pulse point locations and will work on a ... to recover, eliminate, and prevent unnecessary medical-expense spending. The Nurse Auditor Senior is responsible for identifying, monitoring, and analyzing aberrant… more