- 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
- Sedgwick (Columbus, OH)
- …a Great Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Quality Review Nurse **PRIMARY PURPOSE** : To monitor team and colleague ... technical and quality activities with a focus on trends and ...**ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Responsible for auditing, tracking/trending audit results, and development and delivery of training to… 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
- CVS Health (Columbus, OH)
- …new audit concepts, technology improvements, etc. that enhance production, quality , and client satisfaction. + Must be able to work independently without ... to meet quality and metric expectations. **Required Qualifications** + Registered Nurse (RN) - active license. + 3+ Years of clinical experience. + 1+… 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 ... Utilization Management and Long-Term Services & Supports issues. + Identifies and reports quality of care issues. + Prepares and presents cases in conjunction with… more
- Fresenius Medical Center (Hinckley, OH)
- …objectives ensuring alignment with those of the region, division, and company. Implements quality goals and action plans to achieve quality standards. + ... with operations leaders, market development, in-center leadership and patient education and quality teams to promote home therapies growth in assigned programs. +… more
- United Therapeutics (Columbus, OH)
- …you're passionate about pharmacovigilance! You are a team player who loves quality , compliance, finding solutions and ensuring training standards are implemented and ... role in Global Patient Safety (GPS) will focus on enhancing and maintaining quality , training, and compliance (QTC) of GPS operations and practices. They will serve… more
- Elevance Health (Mason, OH)
- …and reference information to generate audit determinations and formulate detailed audit findings letters. + Maintains accuracy and quality standards as ... coding principles, clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding expertise, mastery of… more
- Medical Mutual of Ohio (OH)
- …provide peace of mind to more than 1.2 million members through our high- quality health, life, disability, dental, vision and indemnity plans. We offer fully insured ... business (Commercial, Marketplace, Medicare Advantage, and Medicaid), including HEDIS audit submission, Consumer Assessment of Healthcare Providers and Systems… more
- Sunrise Senior Living (Dublin, OH)
- …LPN Medication Care Manager is responsible for providing the highest degree of quality care and services by administering medication and treatments in a safe ... the Mission for Sunrise Senior Living, "to champion the quality of life for all seniors" in accordance with...medication updates from Resident Care Director (RCD) or Wellness Nurse . + Administer, assist with, and observe medications and… more