- Bowman (Paonia, CO)
- …application of sound professional judgement. Review work produced by junior staff for quality assurance . **At the Operational and Company Level** + Assist with ... and written communication skills. + Strong work ethic and commitment to quality . + Self-reliance and ability to operate independently with limited direction. +… more
- CareFirst (Baltimore, MD)
- …performance; identifying and resolving operations problems; supervising process improvement and quality assurance programs; installing upgrades. + Prepares call ... training and development, policies, procedures, and work production quantity and quality . Functional areas may include but not limited to: installation,… more
- Sharp HealthCare (San Diego, CA)
- …plans related to health plan audits and requirements of National Committee on Quality Assurance (NCQA) and other governing regulatory bodies. Collaborates with ... the Quality , Compliance, and Training Department to effectively integrate and...setting. **Other Qualification Requirements** + Utilization, Case Management, or Quality Management certification preferred. **Essential Functions** + Ambulatory Case… more
- Akumin (NV)
- …error-reporting activities, ongoing policy and procedure reviews, and treatment planning system quality assurance activities, as well as other tasks in ... planning note, and department policies. + Participates in ongoing departmental quality improvement activities such as chart rounds, chart audits, weekly checks,… more
- Trinity Health (Columbus, OH)
- …and payer-specific risk adjustment guidelines. + Participate in internal audits and quality assurance processes to ensure coding accuracy. + Provide feedback ... and training to clinical staff on documentation improvement opportunities. + Stay current with updates to coding guidelines, risk adjustment models (eg, CMS-HCC, HHS-HCC), and regulatory changes. + Train and mentor peers and new coders on risk adjustment… more
- NexTec Group (TX)
- …and concerns to project manager and/or architect/lead. + Providing coaching and quality assurance to ensure team members are following NexTec implementation ... methodology and best practices + Negotiating resolutions to business/process/functional issues with business stakeholders. + Establishing and maintaining "trusted advisor" relationship with customers. + Following NexTec implementation methodologies. +… more
- Molina Healthcare (OH)
- …assists with the implementation of changes. * Conducts employee and team productivity/ quality assurance checks and documents results for accuracy and time ... of care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties * Supervises healthcare… more
- Bowman (Boynton Beach, FL)
- …of sound techniques and principles. Review work produced by junior staff for quality assurance . **At the Operational and Company Level** + From time-to-time, ... verbal and written communication skills. + Strong work ethic and commitment to quality . + Commitment to working in partnership with others inside and outside the… more
- Bowman (Manassas, VA)
- …application of sound techniques and principles. Review work produced by staff for quality assurance . **At the Operational and Company Level** + Negotiate the ... and written communication skills. + Strong work ethic and commitment to quality . + Strong marketing/business development skills and mindset. + Commitment to… more
- CareFirst (Baltimore, MD)
- …implement new overpayment/cost avoidance concepts. + Reviews claims edit concept results for quality assurance and proof of concept validation. + Reviews all ... available sources including federal and state statutes, regulations, provider manuals, Provider contracts, and bulletins for changes to and/or new payment rules. + Identifies and documents changes to and/or new payment rules or language in the source document… more