• Revenue Integrity Nurse Auditor

    Childrens Hospital of The King's Daughters (Chesapeake, VA)
    …duties as assigned. + LICENSES AND/OR CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered Nurse holding a valid Compact ... + GENERAL SUMMARY + The Revenue Integrity Nurse Auditor is responsible for the auditing and...departments regarding compliance with billing regulations and trends in denials of services due to medical necessity or appropriateness… more
    Childrens Hospital of The King's Daughters (10/23/25)
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  • Utilization Review Nurse

    CDPHP (Latham, NY)
    …on nationally recognized criteria and CDPHP policies, and procedures. QUALIFICATIONS: + Registered Nurse with a current New York State license required. ... determinations and appropriate exceptions, coordinating with Medical Directors on denials . In addition, the UR nurse is...years of acute care experience is required as a Registered Nurse . + Minimum of two (2)… more
    CDPHP (09/23/25)
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  • Rehab Admissions Liaison

    Saint Francis Health System (Muskogee, OK)
    …Full Time Days **Full-time Rehab Admissions Liason** M-F 7:30 am - 4:00 pm Registered Nurse preferred 3 years Clinical bedside experience required - Inpatient ... Therapy Assistant; or Valid multi-state or State of Oklahoma Registered Nurse license; or State of Oklahoma...of care need. Acts as a resource to case management for patients requiring post-acute services. Processes all referrals… more
    Saint Francis Health System (11/26/25)
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  • Multi-Site Senior Medical Assistant- Primary Care…

    Houston Methodist (The Woodlands, TX)
    …assigned patient population, under the direct supervision of a Physician, APP and/or Registered Nurse . This position oversees appropriate scope of practice, (ie ... patients visiting the clinic under the direct supervision of a Physician, Registered Nurse , or clinic leadership procedures. Complete pre-visit planning workflow… more
    Houston Methodist (11/18/25)
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  • Regional Manager, Clinical Documentation Integrity…

    Trinity Health (Livonia, MI)
    …Nursing or the equivalent in experience. Must possess one of the below: + Current Registered Nurse ( RN ) License + Registered Health Information ... (CDI) activities for the Health Ministries (HM) in their defined region and day-to-day management of the CDI programs. Works with Director, CDI to ensure the program… more
    Trinity Health (10/08/25)
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  • Quality/Utilization Review Nurse

    George C. Grape Community Hospital (Hamburg, IA)
    …infection control, and payers to resolve care coordination issues. Qualifications: * Education: Registered Nurse ( RN ) license required; BSN preferred. * ... Quality/Utilization Review Nurse Position Summary: The Quality/Utilization Review Nurse...(EHR). o Prepare reports for leadership on utilization patterns, denials , quality metrics, and infection control outcomes. * Education… more
    George C. Grape Community Hospital (11/25/25)
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  • Supervisor, Clinical Documentation Integrity (CDI)…

    Trinity Health (Livonia, MI)
    …or Nursing or equivalent in experience. Must possess one of the below: + Current Registered Nurse ( RN ) License + Registered Health Information ... as it relates to reimbursement and other clinical data quality management for colleague training. Provides quality and productivity monitoring; coordinates and… more
    Trinity Health (11/24/25)
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  • Regional Case Manager

    NHS Management, LLC (Tuscaloosa, AL)
    …in accordance with the assessment and the plan of care. QUALIFICATIONS + Must be a Registered Nurse in good standing in the state(s) in which assigned + Must be ... experience required. RAC certified highly desired! Are you a RN with at least one year of MDS Coordinator...the highest practicable level for each resident. Provides case management services for certain high-risk Medicare Part A residents… more
    NHS Management, LLC (11/26/25)
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  • Prior Authorization Specialist - Inpatient Rehab

    Select Medical (West Orange, NJ)
    …14. Performs other duties as requested. **Qualifications** **Minimum Qualifications** + Licensure as a Registered Nurse or LVN/LPN is required + 2 years of of ... Hospital West Orange, NJ **Prior Authorization Specialist/ Payor Relations Specialist ( RN , LPN )** **Full-Time** **Onsite required** **Salary range of $70,000 -… more
    Select Medical (11/21/25)
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  • Clinical Documentation Integrity Team Lead…

    AdventHealth (Tampa, FL)
    …you'll need to succeed:** Associate's of Nursing Required. 1 years Related Experience Required Registered Nurse ( RN ) current FL Required CCDS - Certified ... as needed, to enhance staff development; leads hiring, training and performance management processes for all site-based CDI employees; coaches, mentors and empowers… more
    AdventHealth (11/13/25)
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