• Provider Auditor (Certified Medical Coder)

    Elevance Health (Norfolk, VA)
    **Provider Auditor ** _This position will work a hybrid model ( remote and office), 1 time per week. The Ideal candidate will live within 50 miles of one of our ... to recover, eliminate and prevent unnecessary medical-expense spending. The **Provider Auditor ** conducts on-site reviews of medical charts, medical notes, itemized… more
    Elevance Health (09/24/25)
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  • Case Manager, RN or Licensed Behavioral…

    Excellus BlueCross BlueShield (Dewitt, NY)
    …varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... NYS DOH, CMS, NCQA, and HEDIS, serving as internal auditor within the group. + Responsible for all aspects...Associates degree required. Bachelor's degree preferred. + Active NYS RN or Registered Dietician or Physical Therapist… more
    Excellus BlueCross BlueShield (09/30/25)
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  • Pre-service Rep ( Remote )

    Ochsner Health (Meridian, MS)
    …Works 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 ... has never changed - our commitment to serve, heal, lead , educate,** **and innovate. We believe** **that every award...determine whether the position you are interested in is remote or on-site._** _Individuals who reside in and will… more
    Ochsner Health (09/25/25)
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  • Director, Clinical Data Acquisition (HEDIS / Risk…

    Molina Healthcare (St. Petersburg, FL)
    …member and provider outreach. + Serves as operations subject matter expert and lead for Molina Plan quality improvement HEDIS operations using a defined roadmap, ... to national, regional and plan meetings. + Demonstrates ability to lead and influence cross-functional teams that oversee implementation of quality projects.… more
    Molina Healthcare (08/21/25)
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