• Diagnosis Related Group Clinical Validation…

    Elevance Health (Mason, OH)
    …make an impact:** + Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance of medical ... audit activities. + Draws on advanced ICD-10 coding expertise,...recommendations. **Minimum Requirements:** + Requires current, active, unrestricted Registered Nurse license in applicable state(s). + Requires a minimum… more
    Elevance Health (08/09/25)
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  • Utilization Review Specialist RN - FT Days

    Houston Methodist (Sugar Land, TX)
    At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... due to failure of the progression of care process. + Conducts chart audits and performs peer-to-peer evaluations for continuous quality improvement. **FINANCE… more
    Houston Methodist (07/29/25)
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  • RN, Case Manager (Part time), Forbes

    Highmark Health (Monroeville, PA)
    …relationships across the organization in a community setting. **GENERAL OVERVIEW:** Registered nurse who is proficient in the coordination of care and manages ... evaluate interventions and outcomes. Interviews and collects patient specified data and chart review related to readmission. + Knowledgeable of and complies with… more
    Highmark Health (05/13/25)
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  • Site Medical Director

    YesCare Corp (Tallahassee, FL)
    …care and chart reviews as requested. Sponsors physician assistants or nurse practitioners as required. + Notifies Regional Medical Director and Site Health ... County in Tallahassee, FL** **Administrative** + Serve as Chairman of the Medical Audit Committee. + Consult with medical providers in the community to resolve… more
    YesCare Corp (05/23/25)
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  • Quality Systems Associate

    Grifols Shared Services North America, Inc (Williamsport, PA)
    …Primary responsibilities for role (level-specific responsibilities should be included in the chart below): * Completes weekly review of equipment QC and maintenance ... documentation. * Reviews unexpected plasmapheresis events including electronic donor chart and related documentation pertaining to exceptions occurring during the… more
    Grifols Shared Services North America, Inc (08/08/25)
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  • RN Clinical Review Appeals Specialist

    St. Luke's University Health Network (Allentown, PA)
    …and procedure code assignment and MS-DRG/APR-DRG accuracy based on denials or audit findings from government and commercial payers. Meet or exceed established ... or commercial payors, or their auditor representative. + Facilitate clinical chart reviews to assist with supporting assigned diagnosis and/or procedures codes… more
    St. Luke's University Health Network (07/08/25)
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  • Health Information Management (HIM) Technician…

    Sacramento Behavioral Healthcare Hospital (Santa Rosa, CA)
    …records for completeness and assigning deficiencies to appropriate clinical and nursing staff, monitoring deficiency analysis work queues and resolving related ... standards. + Responsible for managing patient health records. + Identify chart deficiencies for missing details (ie, Protected Health Information, signatures, dates,… more
    Sacramento Behavioral Healthcare Hospital (07/25/25)
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  • OB/GYN

    Grace Health (Battle Creek, MI)
    …Provides medical consults for and collaborates in patient care with advanced nurse practitioners and certified nurse midwives, as indicated. TYPICAL PHYSICAL ... Creek Hospital within the scope of their specialty. 4. Responsible to review audit findings, provide in-service training, review changes in service and implement new… more
    Grace Health (08/07/25)
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  • Quality Risk Management Coordinator - Northwest…

    Surgery Care Affiliates (Wilsonville, OR)
    …Medical Executive Committee/Governing Body a minimum of quarterly: + Medical Record Audit reports; Monthly or quarterly data collection from ongoing systematic ... chart review to assess quality of documentation. + Infection...by Center Administrator. Qualifications Licenses or Certifications: Licensed Registered Nurse Education, vocational training, and experience: + Registered … more
    Surgery Care Affiliates (06/06/25)
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  • Medical Assistant

    MTC (Quincy, FL)
    …back to a healthy, productive life. **Position Summary:** Reports to the nursing supervisor. Will receive instruction and direction from licensed provider staff. ... history of assigned patients. 3. Prepare patients for examinations and assist nurse or provider during examination. 4. Work efficiently to ensure providers have… more
    MTC (07/30/25)
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