• Lead , Auditor ( RN

    Molina Healthcare (Mesa, AZ)
    …to resolve/correct them.. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ) Program and an Associate's or ... be discussed during our interview process. This is a remote position. Work hours: Monday- Friday: 8:00am -5:00pm. Michigan...+ Required License, Certification, Association + Active, unrestricted State Registered Nurse ( RN ) License in… more
    Molina Healthcare (01/04/25)
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  • Diagnosis Related Group Clinical Validation…

    Elevance Health (FL)
    **Diagnosis Related Group Clinical Validation Auditor -** ** Registered Nurse ** **Location:** This position will work a hybrid model ( remote and office). ... and efficiency recommendations. **Minimum Requirements:** + Requires current, active, unrestricted Registered Nurse license in applicable state(s). + Requires a… more
    Elevance Health (01/01/25)
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  • Claims Auditor Lead

    Elevance Health (Mason, OH)
    **Claims Auditor Lead ** _This position will work a hybrid model ( remote and office), 1-2 times per week. The Ideal candidate will live within 50 miles of one ... is determined to recover, eliminate and prevent unnecessary medical-expense spending. The Claims Auditor Lead is responsible for leading the high dollar audit… more
    Elevance Health (01/03/25)
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  • Provider Auditor Senior

    Elevance Health (Winston Salem, NC)
    **Provider Auditor Senior** _This position will work a hybrid model ( remote and office), 1-2 times per week. The Ideal candidate will live within 50 miles of one ... to recover, eliminate and prevent unnecessary medical-expense spending. The Provider Auditor Senior conducts on-site reviews of medical charts, medical notes,… more
    Elevance Health (01/07/25)
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  • Quality Review & Audit Lead Analyst - DRG…

    The Cigna Group (Bloomfield, CT)
    …Specialist (CCS) or Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) required.** ** RN License preferred ... **The DRG Auditor performs an in-depth review of the medical record to evaluate the diagnostic and procedural information in the record and validates accurate coding… more
    The Cigna Group (12/13/24)
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  • Sr Specialist, Quality Interventions/QI Compliance…

    Molina Healthcare (Hattiesburg, MS)
    …functions: Quality Interventions and Quality Improvement Compliance. + Acts as a lead specialist to provide project-, program-, and / or initiative-related direction ... in Health Quality (CPHQ) + Active, unrestricted Nursing License ( RN may be preferred for specific roles) + Active,...for specific roles) + Active, unrestricted Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you… more
    Molina Healthcare (12/05/24)
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