• Senior Internal Auditor - Hybrid

    Houston Methodist (Houston, TX)
    …variety of business functions that operate at the system level to help enable clinical departments to provide high quality patient care. Houston Methodist is an ... At Houston Methodist, the Sr. Internal Auditor is responsible for independently planning, coordinating, and...- State Licensure **OR** + CIA - Certified Internal Auditor (IIA) **OR** + CFE - Certified Fraud Examiner… more
    Houston Methodist (08/08/25)
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  • Senior Coding Data Quality Auditor

    CVS Health (Austin, TX)
    …all with heart, each and every day. Aetna's Revenue Integrity team is hiring Senior Coding Data Quality Auditors to support our growing risk adjustment efforts. This ... risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal...and vendor coding resources. + Acts as mentor to provide education to internal staff based on audit findings;… more
    CVS Health (08/24/25)
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  • Senior Inpatient Medical Coding…

    Humana (Austin, TX)
    …a part of our caring community and help us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a variety of ... requires an in-depth evaluation of variable factors. **Responsibilities** The Senior Inpatient Medical Coding Professional confirms appropriate diagnosis related… more
    Humana (08/02/25)
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  • Sr Compliance RCM & Coding Auditor

    Humana (Austin, TX)
    …with business partners to uphold ethical standards and mitigate risks. The Senior Clinical Compliance Professional will support the Director of Compliance, ... caring community and help us put health first** CenterWell Senior Primary Care (PCO) is a growing provider...requires an in-depth evaluation of variable factors. As the Senior Clinical Compliance Professional, you will develop… more
    Humana (08/23/25)
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  • Director, Clinical Data Acquisition (HEDIS…

    Molina Healthcare (Fort Worth, TX)
    **Job Description** **Job Summary** The Director, Clinical Data Acquisition is responsible for the implementation, monitoring, and oversight of all chart collection ... within Molina plans. + Develops and implements targeted collection of clinical data acquisition related to performance reporting and improvement, including member… more
    Molina Healthcare (08/21/25)
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  • Senior Specialist, Member & Community…

    Molina Healthcare (TX)
    …Member & Community Interventions oversees and implements new and existing clinical quality member intervention initiatives including all lines of business (Medicare, ... pacific time zone. **Job Duties** + Acts as a lead specialist to provide project, program, and/or initiative related direction and guidance for other specialists… more
    Molina Healthcare (07/31/25)
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  • Compliance Manager

    Houston Methodist (Houston, TX)
    …variety of business functions that operate at the system level to help enable clinical departments to provide high quality patient care. Houston Methodist is an ... modalities. Provides detailed analysis and reporting as necessary to senior management. Develops materials & presentations for various stakeholders. **QUALITY/SAFETY… more
    Houston Methodist (08/14/25)
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  • Compliance Coding And Billing Analyst

    University of Texas Rio Grande Valley (Mcallen, TX)
    …Collaborates with the medical billing team to improve the quality of clinical documentation for compliance, billing, coding, and reimbursement processes. + Reviews, ... a solution as well as preventative measures. + Communicates findings to senior management and makes recommendations for preventive measures. + Coordinates, evaluates… more
    University of Texas Rio Grande Valley (08/20/25)
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