- Elevance Health (FL)
- …and efficiency recommendations. **Minimum Requirements:** + Requires current, active, unrestricted Registered Nurse license in applicable state(s). + Requires a ... **Diagnosis Related Group Clinical Validation Auditor- RN (CDI, MS-DRG, AP-DRG and APR-DRG)** **Virtual:** This...clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding expertise,… more
- BayCare Health System (Tampa, FL)
- …Nursing or Bachelors Healthcare Related + Preferred Bachelors Nursing **Credentials:** + Required RN ( Registered Nurse ) + CPPS (Patient Safety) certification ... foster a safety culture across the health system + Oversee and audit safety process adherence and maintains documentation of performance improvement efforts… more
- Molina Healthcare (Miami, FL)
- …and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... **PREFERRED QUALIFICATIONS:** + Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional… more
- Fresenius Medical Center (Homestead, FL)
- …PCT II HT are to be performed under the direct supervision of the Home Therapies registered nurse (HT RN ), in compliance with, and as permissible per state ... for patients under the direct supervision of a licensed nurse under organization policies, procedures, and training and in...processes and rapport with patients, care partners, the HT RN , direct and non-direct patient care staff, providers, and… more
- Immigration and Customs Enforcement (Miami, FL)
- …preferred. Qualifications-Licenses and Certifications Required: Nursing License- Must be a Registered Nurse ( RN ). Maintains current/documented professional ... Summary The Clinical Assistant Nurse Manager supervises nursing services at ICE facilities,...include staff supervision, quality assurance, and patient care. Requires RN licensure, 5+ years of clinical experience. Reports to… more
- Immigration and Customs Enforcement (Miami, FL)
- …preferred. Qualifications-Licenses and Certifications Required: Nursing License- Must be a Registered Nurse ( RN ). Maintains current/documented professional ... Summary The Clinical Nurse Manager oversees nursing services at ICE facilities,...care, compliance with clinical and regulatory guidelines, overpayment, and audit recovery; and developing policy guidance for nursing care… more
- AssistRx (Orlando, FL)
- …and/or financial access programs preferred. + Bilingual - Spanish preferred. + Bachelor's Degree or Registered Nurse (BSN or RN ) a plus. + COMPETENCIES: + ... Previous call center experience participating in quality call and system audit performance reviews preferred. + Previous experience in patient support/patient… more
- Zelis (FL)
- …adherence to Zelis standards regarding privacy What you'll bring to Zelis: + Registered Nurse licensure preferred + Inpatient Coding Certification required (ie, ... CM, MS-DRG and APR-DRG claims preferred + Solid understanding of audit techniques, identification of revenue opportunities and financial negotiation with providers… more
- Zelis (St. Petersburg, FL)
- …( ie . CCS, CIC,RHIA , RHIT, CPC or equivalent credentialing). + Registered Nurse licensure preferred + Bachelor's Degree Preferred in business, healthcare, ... or technology preferred. + Solid understanding of audit techniques, identification of revenue opportunities and financial negotiation with providers + Experience and… more
- CenterWell (Tallahassee, FL)
- …questions related to authorization determinations. * Collaborate with Quality, Compliance, and Audit teams to support medical reviews and audits. * Translate payer ... Medicaid, and commercial payer authorization and revalidation requirements. * Maintain audit -ready documentation and processes. * Support external audits (MAC, SMRC,… more