- Molina Healthcare (Dallas, TX)
- …+ Performs monthly auditing of registered nurse and other clinical functions in Utilization Management (UM), Case Management (CM), Member ... Team (MAT), Health Management (HM), and/or Disease Management (DM). + Monitors key clinical staff for compliance with NCQA, CMS, State and Federal requirements. May… more
- Actalent (Philadelphia, PA)
- Must have BSN, Prior Clinical Research...go in office 2x a week in Philadelphia. The Clinical Research Nurse Auditor is responsible for ... to research compliance, quality control and quality assurance. The monitor/ auditor will follow all DOCM policies and procedures and...GCP federal policies and guidance for the conduct of clinical research. Qualifications: Must have a Nursing… more
- Providence (Beaverton, OR)
- …best people, we must empower them._** **Providence Health Plan is calling a Clinical Nurse Auditor , HEDIS who will:** + Be responsible for conducting ... clinical quality audits for the Quality Department + Identify...Learn more at providence.jobs/benefits. **About the Team** Providence Shared Services is a service line within Providence… more
- The County of Los Angeles (Los Angeles, CA)
- … services programs to ensure, proper utilization of funds and provision of services . + Consults with clinical , administrative, and program planning staff in ... through the allocation of various categorical funds available to specific contract service agreements. + Evaluates proposals for contract services ; supervises… more
- Eurofins (Des Moines, IA)
- …international life sciences company, providing a unique range of analytical testing services to clients across multiple industries, to make life and our environment ... cosmetic product testing and in agroscience Contract Research Organisation services . It is one of the market leaders in...forensics, advanced material sciences and in the support of clinical studies, as well as having an emerging global… more
- Humana (Salt Lake City, UT)
- …our caring community and help us put health first** The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and ... Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the… more
- Johns Hopkins University (Baltimore, MD)
- …in the development of medical record documentation standards and requirements related to clinical services billing. + Keeps current with third party regulations ... across all clinical specialties. Works in close collaboration with the clinical departments, Physicians Billing Service , and the Johns Hopkins Health System… more
- Elevance Health (Walnut Creek, CA)
- **LTSS Service Coordinator - Auditor (Remote)** **Location:** While remote, candidates will ideally be located within 50 miles of one of our Elevance Health ... PulsePoints. The **LTSS Service Coordinator- Auditor ** is responsible for auditing member...law and contract. The audit process does not involve clinical judgment. **How you will make an impact:** +… more
- Veterans Affairs, Veterans Health Administration (Roanoke, VA)
- …Defense, providing internal, independent, and objective assurance for management operations and clinical services . This announcement has been extended and is ... The grade may have been in any occupation, but must have been held in the Federal service...and abilities necessary to perform the work of an Auditor . Degree/coursework must be directly related to… more
- Fallon Health (Worcester, MA)
- …is continually rated among the nation's top health plans for member experience, service , and clinical quality. We believe our individual differences, life ... auditing risks identified in the organization. The Senior Internal Auditor plays a key role in implementing the annual...Plan, including areas such as Compliance, IT and Care Services . + Develop audit programs to identify areas of… more