- Centene Corporation (Atlanta, GA)
- …and requires an clinical license. 3+ years of nursing or quality improvement experience. **Licenses/Certifications:** Current state's clinical license ... processes to measure member outcomes. Assess provider performance and quality of care through clinical case reviews....and delivered timely + Perform other performance and process improvement activities + Performs other duties as assigned +… more
- UPMC (Pittsburgh, PA)
- UPMC Health Plan has an exciting opportunity for a Clinical Auditor /Analyst Intermediate! The Clinical Auditor /Analyst Intermediate is an integral part ... establishes and revises better best practice within the department. The Clinical Auditor /Analyst Intermediate creates, maintains and analyzes auditing reports… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Clinical Revenue Auditor -CDM Patient Financial Services-Corporate-Full-Time-Days- Hybrid.** The Clinical Revenue Auditor for the ... financial health and compliance of the organization and bridges the gap between clinical care and medical billing and reimbursement. This position will report to the… more
- Elevance Health (Chicago, IL)
- …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 (CDI, MS-DRG, AP-DRG...and Hospital-Acquired Conditions (HACs). + Suggests and develops high quality , high value, concept and or process improvement… more
- Elevance Health (Boston, MA)
- …reporting and trending analysis. + Provides feedback on processing errors; identifies quality improvement opportunities and initiates basic requests related to ... all the above, plus: Independently interprets Medical Policy and Clinical Guidelines. + **Claims Auditor Senior** -...a minimum of 1 year related experience in a quality audit capacity (preferably in healthcare or insurance sector);… more
- Integra LifeSciences (Princeton, NJ)
- …the audited sites such as follow-up or re-audits and participate in any continuous improvement or quality initiatives as a representative of Global quality ... engineering and design, statistical analysis, process validation, regulatory compliance, clinical trials, computer systems validation, quality systems and/or… more
- Kelly Services (Lancaster, SC)
- …CFR Parts 210, 211, 507, and 111 (or equivalent standards). + Certification as a Quality Auditor (eg, ASQ CQA) is preferred. + Strong computer skills, including ... ** Quality Assurance Auditor ** **Location: Lancaster, South...potential areas of internal non-compliance, and contribute to process improvement or policy development. + Assist in preparation for… more
- Catalent Pharma Solutions (Greenville, NC)
- ** Quality Assurance Auditor ** The Quality Assurance Auditor will provide key quality support and leadership to development, operations, and ... projects. **Position Summary** This position is 100% on-site at the Greenville site. The Quality Assurance Auditor will lead in promotion of a culture of… more
- Bristol Myers Squibb (Indianapolis, IN)
- …application should be directed to Chat with Ripley. R1594472 : Senior Quality Auditor **Company:** Bristol-Myers Squibb **Req Number:** R1594472 **Updated:** ... GCP), internal procedures, and industry standards. This role supports the continuous improvement of RayzeBio's Quality Management System and ensures readiness… more
- Humana (Columbus, OH)
- …entry regarding claim/encounter information + Support and participate in process and quality improvement initiatives **What Humana Offers** We are fortunate to ... our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct… more