• Diagnosis Related Group Clinical Validation…

    Elevance Health (Grand Prairie, TX)
    …state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement , and a minimum of ... **Diagnosis Related Group Clinical Validation Auditor -RN** **Virtual:** This role...and Hospital-Acquired Conditions (HACs). + Suggests and develops high quality , high value, concept and or process improvement more
    Elevance Health (08/09/25)
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  • Coding Quality Auditor

    Houston Methodist (Houston, TX)
    …live in TX, LA, FL, TN, WA or GA** At Houston Methodist, the Coding Quality Auditor position is responsible for ensuring accuracy in code assignment of diagnosis ... coding accuracy, and revenue preservation. Additional duties include participating in quality review and performance improvement projects throughout the… more
    Houston Methodist (07/12/25)
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  • DRG Coding Auditor

    Elevance Health (Houston, TX)
    …as re-admissions, Inpatient to Outpatient, and HACs. + Suggests and develops high quality , high value concept and or process improvement and efficiency ... **DRG CODING AUDITOR ** **_Virtual_** **_: _** _ _ _​_ This...Clinical Validation Audit setting or hospital coding or quality assurance environment preferred. + Broad knowledge of medical… more
    Elevance Health (08/13/25)
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  • HCC Risk Adjustment Auditor - Full Time…

    Datavant (Austin, TX)
    …for healthcare. **What We're Looking For:** As an HCC (Hierarchical Condition Category) Auditor you will review medical records that have been coded in a ... purposes. You will play a critical role in translating clinical documentation into precise codes that reflect the complexity...You Will Do:** + Audit coded charts assigned by quality supervisor per the client guidelines + Ability to… more
    Datavant (08/01/25)
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  • Auditor , HCC Risk Adjustment Coding - Full…

    Datavant (Austin, TX)
    …educational and life experiences to realize our bold vision for healthcare. As an Auditor , HCC Risk Adjustment Coder, you will review medical records to identify and ... and reimbursement purposes. You will play a critical role in translating clinical documentation into precise codes that reflect the complexity and severity of… more
    Datavant (08/08/25)
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  • Director, Clinical Data Acquisition (HEDIS…

    Molina Healthcare (Fort Worth, TX)
    …and are aligned with effective practices as identified in the healthcare quality improvement literature and within Molina plans. + Develops and ... clinical data acquisition related to performance reporting and improvement , including member and provider outreach. + Serves as...operations subject matter expert and lead for Molina Plan quality improvement HEDIS operations using a defined… more
    Molina Healthcare (08/21/25)
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  • Clinical Documentation Specialist

    University of Texas Rio Grande Valley (Harlingen, TX)
    …with coding conventions. * Works closely with Revenue Cycle coding staff on Clinical Documentation Improvement ( CDI ) activities, processes, and procedures. * ... and other times as necessary. * Presents recommendations for quality management and processes improvement opportunities regarding workflow… more
    University of Texas Rio Grande Valley (06/25/25)
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  • Quality Systems Manager for Plasma Center

    Biomat USA, Inc. (Odessa, TX)
    …Works toward certification from American Society for Quality to be a Certified Quality Auditor . + Works toward certification as a Designated Trainer for ... calibration of equipment and documentation of procedures. + Ensures that Clinical Laboratory Improvement Amendments (CLIA) proficiency test surveys, complaint… more
    Biomat USA, Inc. (08/26/25)
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  • System Accreditation Specialist

    Houston Methodist (Houston, TX)
    quality , accreditation or health care certifications **OR** + CQA - Certified Quality Auditor (ASQ) -- Related quality , accreditation or health care ... improvement in compliance with standards, including ISO 9001 Quality Management System. + Conducts internal surveys across the...that operate at the system level to help enable clinical departments to provide high quality patient… more
    Houston Methodist (07/25/25)
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  • Sr. Specialist, Member & Community Intervention…

    Molina Healthcare (El Paso, TX)
    …Specialist, Member & Community Interventions oversees and implements new and existing clinical quality member intervention initiatives including all lines of ... maintain critical program milestones, deadlines, and/or deliverables + Participates in quality improvement activities, meetings, and discussions with and between… more
    Molina Healthcare (08/24/25)
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