• Diagnosis Related Group Clinical Validation…

    Elevance Health (Latham, NY)
    …state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement , and a minimum of ... **Diagnosis Related Group Clinical Validation Auditor -RN** **Virtual:** This role...and Hospital-Acquired Conditions (HACs). + Suggests and develops high quality , high value, concept and or process improvement more
    Elevance Health (08/09/25)
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  • Risk Adjustment Auditor Educator - St.…

    Trinity Health (Albany, NY)
    …years' experience as a risk adjustment auditor and educator and/or clinical documentation improvement specialist with a solid background in value-based plans ... efforts toward the improvement and integrity of clinical documentation through the role of auditor ...providers and members of the healthcare team. + Performing quality audits and evaluating clinical documentation of… more
    Trinity Health (08/16/25)
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  • Clinical Coding Auditor & Trainer

    Centene Corporation (New York, NY)
    …Diagnosis Related Group (DRG) and Medical Record Audit Programs for Fidelis Care. The Clinical Coding Auditor & Trainer position is primarily remote with a small ... work performed by staff and present findings and recommendation for areas of improvement to management + Under minimal supervision responsible for all aspects of… more
    Centene Corporation (06/28/25)
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  • HCC Risk Adjustment Auditor - Full Time…

    Datavant (Albany, NY)
    …for healthcare. **What We're Looking For:** As an HCC (Hierarchical Condition Category) Auditor you will review medical records that have been coded in a ... purposes. You will play a critical role in translating clinical documentation into precise codes that reflect the complexity...You Will Do:** + Audit coded charts assigned by quality supervisor per the client guidelines + Ability to… more
    Datavant (08/01/25)
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  • Senior Coding Data Quality Auditor

    CVS Health (Albany, NY)
    …for continuous improvement . This position will sit within our Coding Quality Operations team and offers the flexibility of working from home. **Position ... each and every day. Aetna's Revenue Integrity team is hiring Senior Coding Data Quality Auditors to support our growing risk adjustment efforts. This role plays a… more
    CVS Health (08/24/25)
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  • Professional Coding Auditor

    Albany Medical Center (Albany, NY)
    …assess compliance with related rules and regulatory requirements, and to identify clinical documentation improvement opportunities. + Identify trends based on ... Day (United States of America) Salary Range: $60,367.47 - $90,551.20 Professional Coding Auditor will apply an advanced professional coding skill set to act as a… more
    Albany Medical Center (07/30/25)
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  • Auditor , HCC Risk Adjustment Coding - Full…

    Datavant (Albany, NY)
    …educational and life experiences to realize our bold vision for healthcare. As an Auditor , HCC Risk Adjustment Coder, you will review medical records to identify and ... and reimbursement purposes. You will play a critical role in translating clinical documentation into precise codes that reflect the complexity and severity of… more
    Datavant (08/08/25)
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  • Program Director, Quality

    Molina Healthcare (Rochester, NY)
    **JOB DESCRIPTION** **Job Summary** Molina's Quality Improvement function oversees, plans, and implements new and existing healthcare quality improvement ... QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Program Director is a key Quality Improvement (QI) leader within the organization, empowered to… more
    Molina Healthcare (08/02/25)
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  • Director, Clinical Data Acquisition (HEDIS…

    Molina Healthcare (Yonkers, NY)
    …and are aligned with effective practices as identified in the healthcare quality improvement literature and within Molina plans. + Develops and ... clinical data acquisition related to performance reporting and improvement , including member and provider outreach. + Serves as...operations subject matter expert and lead for Molina Plan quality improvement HEDIS operations using a defined… more
    Molina Healthcare (08/21/25)
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  • Asst Dir, Qual & Reg Assr, Clinical Trials

    University of Rochester (Rochester, NY)
    …for Quality (ASQ), Certified Regulatory Affairs Certification (RAC), or Certified Quality Auditor (CQA) upon hire preferred. The University of Rochester is ... individual, and internal equity considerations._ **Responsibilities:** General Purpose Leads the Quality Assurance team for clinical research conducted at CHeT.… more
    University of Rochester (08/07/25)
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