- NCH (Naples, FL)
- …* Minimum of Associate Degree required; Bachelor's Degree preferred. * Licensed as a Registered Nurse in the state of Florida. * 5+ years CDI auditing/SLR ... + DEPARTMENT: 17117 - Clinical Documentation Integrity + LOCATION: 350 7th Street...Specialist for educational opportunities/outcomes. * Collaborates with CDI liaison/quality auditor when educational needs are identified from second level… more
- Catholic Health Initiatives (Little Rock, AR)
- …up to 25-50% professional travel may be involved. + Supports quality, clinical practice, safety, risk coding, compliance, patient experience and Health Information ... roles. + Serves as market liaison, interfacing with internal clinical leaders and external payer partners for all things...and risk for the value hub. + Through Risk Management/ Auditor Manager, implements a risk adjustment coding department in… more
- CDPHP (Latham, NY)
- … clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... or external referral sources. Applies case management criteria and professional clinical judgment to determine a member's appropriateness for case management… more
- BJC HealthCare (St. Louis, MO)
- …the Licensed Practical Nurse . + Under the direction of the Registered Nurse , provides patient teaching and discharge planning. Participates in professional ... BJC Home Care is looking for an licensed practical nurse Scheduler, auditor and field visits to...field visits to assist our patients and our Hospice clinical team! **Schedule** Monday - Friday 7 am to… more
- Baystate Health (Springfield, MA)
- …appropriate, coordinates communication with NEOPO and related paperwork in conjunction with RN . Screen calls for clinical team and facilitates communication of ... CIS for discharge orders, follows up with MD, CM RN to assure discharge documents are complete. Enters discharges...forms, etc. **8)** Unit Resource: Post/file MD schedules for clinical team inquiry. In coordination with charge nurse… more
- Commonwealth Care Alliance (Boston, MA)
- …Analyst will be responsible for developing prospective claims auditing and clinical coding and reimbursement edits and necessary coding configuration requirements ... Responsibilities:** + Develop enhanced, customized prospective claims auditing and clinical coding and reimbursement policies and necessary coding configuration… more
- Molina Healthcare (Reno, NV)
- …Member & Community Interventions oversees and implements new and existing clinical quality member intervention initiatives including all lines of business (Medicare, ... departments within the organization + Supports provision of high-quality clinical care and services by facilitating/building strategic relationships with… more
- Ochsner Health (New Orleans, LA)
- …with the clinical providers , on- site case management team, as well as LPN/ RN or Nurse Auditor in the Pre-Service department. + Performs Pre-Service ... collection estimation functions and communicates patient liability. + Provides point -of - service information and logistics to ensure an exceptional patient experience.Other related duties as required.The above statements describe the general nature and level… more
- Molina Healthcare (NV)
- …Visio (flow chart equivalent) **PREFERRED QUALIFICATIONS:** + Degree in Preferred field: Clinical Quality, Public Health, or Healthcare + 5 years of experience in ... in Health Quality (CPHQ) + Active, unrestricted Nursing License ( RN may be preferred for specific roles) + Active,...for specific roles) + Active, unrestricted Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you… more
- Molina Healthcare (Rockford, IL)
- …Excel and Visio (flow chart equivalent). **Preferred Education** Preferred field: Clinical Quality, Public Health or Healthcare. **Preferred Experience** + 1 year ... in Health Quality (CPHQ) + Active, unrestricted Nursing License ( RN may be preferred for specific roles) + Active,...for specific roles) + Active, unrestricted Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you… more