- Humana (Columbus, OH)
- …your clinical expertise and passion for accuracy will make a meaningful impact. As the Nurse Audit Manager, you will spearhead audit and validation processes ... relevant coding. + Identifies the root cause analysis of audit findings and submits recommendations for appropriate change management....skills to make an impact** **Required Qualifications** + Registered nurse (RN). + 5 or more years of clinical… more
- Elevance Health (Mason, OH)
- ** Nurse Audit Senior - Payment Integrity Complex and Clinical Audit ** **Location:** This role enables associates to work virtually full-time, with the ... is determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Nurse Audit Senior** will be responsible for identifying, monitoring,… more
- Bellefaire JCB (Shaker Heights, OH)
- Registered Nurse (MBA & PRTF)-Seeing day shift, second and third shift FT, PT & PRN (3 days/week) Alternating weekends and Holidays SUMMARY: The Registered Nurse ... Residential Treatment Facility (PRTF) & MBA program. The Registered Nurse responds to the clients' health needs as needed,...when indicated. + Count narcotics daily and sign the audit sheets for controlled substances. + Order, receive and… more
- Trinity Health (Columbus, OH)
- …call your own in Columbus. Learn more at www.experiencecolumbus.com The Registered Nurse Clinical Lead will supervise all clinical staff and assist physicians with ... person's physical, emotional, social and spiritual needs within the scope of the Ohio Nurse Practice Act. The Registered Nurse functioning in the spirit of… more
- Sedgwick (Columbus, OH)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Quality Review Nurse **PRIMARY PURPOSE** : To monitor team and colleague technical and quality ... work. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Responsible for auditing, tracking/trending audit results, and development and delivery of training to correct… more
- CVS Health (Columbus, OH)
- …Medical Director referral as needed. + Assists management with training new nurse reviewers/business partners or vendors to include initial and ongoing mentoring, ... client needs. + Recommends, tests, and implements process improvements, new audit concepts, technology improvements, etc. that enhance production, quality, and… more
- Molina Healthcare (Cincinnati, OH)
- …outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases ... + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management… more
- Fresenius Medical Center (Hinckley, OH)
- …any other treatment related data into systems. + Ensures regulatory, compliance, and audit activities are accomplished on time. + Orients and supports all new home ... therapies staff and provides ongoing education, ensuring compliance with all risk management initiatives, including in-center staff. + Responsible for hiring, coaching, and counseling employees, including performance reviews, disciplinary action, and… more
- Elevance Health (Mason, OH)
- …coding principles, clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding expertise, mastery of ... clinical guidelines, and industry knowledge to substantiate conclusions. + Utilizes audit tools, auditing workflow systems and reference information to generate … more
- Premier Health (Dayton, OH)
- …time Nights 7:00pm-7:30am/ 48 Hours Per Pay** The Critical Care Transport Nurse functions in a versatile role that demonstrates professionalism and promotes ... in the practice of Nursing. The Critical Care Transport Nurse utilizes the nursing process in conjunction with evidence-based...days- ITLS or PHTLS 2. 1 year- NRP, ATLS ( audit ) 3. 2 years- CAMTS approved Nursing certification and… more