- Humana (Albany, NY)
- **Become a part of our caring community and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that ... rendered is complete, compliant and accurate to support optimal reimbursement. The Nurse Auditor 2 work assignments are varied and frequently require… more
- Northwell Health (Garden City, NY)
- …experience. 2 .Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed. *Additional ... 1.Leverages clinical expertise to identify and validate DRG code assignment. 2 .Full review of CDI suggested code changes 3.Demonstrates comprehensive knowledge of… more
- Northwell Health (Westbury, NY)
- …Degree in Nursing, preferred. Must be enrolled in an accredited BSN program within two ( 2 ) years and obtain a BSN Degree within five (5) years of job entry date. ... + Current License to practice as a Registered Professional Nurse in New York State required, plus specialized certifications as needed. *Additional Salary Detail The… more
- Molina Healthcare (Bronx, NY)
- …and works collaboratively to subsequently resolve/correct. Required Qualifications * At least 2 years health care experience, with at least 1 year experience in ... managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in state of practice.… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, Geriatrics, etc.) to ensure continuity and ... NYS DOH, CMS, NCQA, and HEDIS, serving as internal auditor within the group. + Responsible for all aspects...addition to Level I Qualifications) + A minimum of 2 years in case management position. + Case Management… more
- Molina Healthcare (Buffalo, NY)
- …or equivalent experience, OR completion of any of the following programs: + Registered Nurse (RN) or State Licensed Vocational Nurse (LVN), or + Registered ... Min. 4 years experience in healthcare Quality/HEDIS projects/audits * 2 + years of experience in HEDIS medical records collection...completion of any of the following programs: + Registered Nurse (RN) or State Licensed Vocational Nurse … more