• Senior Overreader, HEDIS/Quality Improvement…

    Molina Healthcare (NE)
    …conducts oversight and audits of the data collected and abstracted from medical records for HEDIS projects, HEDIS like projects and supplemental data collection. ... and 2nd overread standards to ensure accuracy of their audit skills. Sr. Overread team members will mentor new...**Job Duties** + Performs the role of the HEDIS medical record review overreader/auditor which includes ongoing review of… more
    Molina Healthcare (08/21/25)
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  • Application Analyst (Senior, Mid, Associate)

    Penn Medicine (Philadelphia, PA)
    …leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across ... IS and UPHS to ensure necessary controls, documentation and audit trails Associate Application Analyst: + Responsible for enhancing,...Health Care Professional Certificate and/or License such as MT, RN , PA, or DPM, a Bachelors degree, and at… more
    Penn Medicine (08/07/25)
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  • Associate/Mid/Senior Clinical or Application…

    Penn Medicine (Philadelphia, PA)
    …leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across ... of IS and UPHS to ensure necessary controls, documentation and audit trails Associate Application Analyst: Responsible for enhancing, supporting, and maintaining… more
    Penn Medicine (08/07/25)
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  • Corporate Responsibility Auditor Senior

    SSM Health (MO)
    …for an Corporate Responsibility Auditor Senior role SSM Health! Preferred RN background is a plus. **Job Summary:** Enhances overall financial performance ... by reviewing all assigned government audit denials and determining appropriate follow-up actions. Appeals denials...are found to be unsubstantiated through review of the medical record and/or billing information. Tracks assigned cases and… more
    SSM Health (08/23/25)
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  • Operations Associate, Full Time, Nights

    Baystate Health (Springfield, MA)
    …weekend and rotating holidays required **LOCATION** : + Baystate Main Campus, Medical /Neuro ICU Unit + Springfield, MA **THE ADVANTAGES OF WORKING WITH BAYSTATE!** ... + Excellent Compensation High-quality, low-cost medical , dental and vision insurance + Generous PTO -...be applicable to this role.** **Summary:** Reports to the Nurse Manager but daily activities are coordinated by the… more
    Baystate Health (09/12/25)
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  • Health Compliance Inspector, Home Care Services…

    State of Colorado (Denver, CO)
    …Department of Public Health & Environment Division Health Facilities & Emergency Medical Services Opening Date 09/17/2025 Closing Date 9/28/2025 11:59 PM Mountain ... are available, your HRBP will work with you to audit your step pay/time-in-series upon an offer. If you...for this position is $66,024/annually. Health Facilities and Emergency Medical Services Division Now hiring for our Home and… more
    State of Colorado (09/18/25)
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  • Nurse Investigator

    State of Georgia (Fulton County, GA)
    Nurse Investigator Georgia - Fulton - Atlanta (https://ga.referrals.selectminds.com/jobs/64040/other-jobs-matching/location-only) Hot ... Job Alerts The Office of the Attorney General Georgia Department of Law Nurse Investigator- Medicaid Fraud Division *To move forward in the recruiting process ALL… more
    State of Georgia (09/18/25)
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  • Clinical Research Nurse 2

    University of Miami (Plantation, FL)
    …of Miami/UHealth Department of SCCC has an exciting opportunity for a Full Time Clinical Research Nurse 2 to work at the UHealth Medical campus in Miami, Fl Core ... Responsibilities:The Clinical Research Nurse 2 ensures the integrity and quality of clinical research studies are maintained and conducted in accordance with… more
    University of Miami (08/13/25)
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  • Application Analyst (Senior, Mid, Associate)

    Penn Medicine (Philadelphia, PA)
    …leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across ... IS and UPHS to ensure necessary controls, documentation and audit trails. + Performs duties in accordance with Penn...Health Care Professional Certificate and/or License such as MT, RN , PA, or DPM, a Bachelor's degree, and at… more
    Penn Medicine (08/26/25)
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  • Director, Clinical Data Acquisition (HEDIS / Risk…

    Molina Healthcare (St. Petersburg, FL)
    …projects, Risk Adjustment, Risk Adjustment Data Validation, and other state specific audit projects and deliverables. This role also works with the Health Plan ... supplemental data source (SDS) acquisition from providers as well as Electronic Medical Record (EMR) access. This position would oversee management of training for… more
    Molina Healthcare (08/21/25)
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