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A company is looking for an RN Educator, Clinical Documentation Integrity who must reside in Colorado.Key ResponsibilitiesFacilitate improvement in the quality and accuracy of medical record documentation through education and trainingDevelop and...

A company is looking for a Complex Discharge Planner (RN).Key ResponsibilitiesDevelops and coordinates complex discharge plans for high-risk members based on needs assessmentsInteracts with providers and community agencies to ensure safe and...

A company is looking for a Registered Nurse Coding Auditor - HCS-D, COS-C - Full Time.Key ResponsibilitiesValidates Acute Inpatient coded charts for accurate diagnostic information and complianceConducts coding audits and reviews...

A company is looking for a RN Call Center Obstetrics - Remote from a Compact State.Key ResponsibilitiesConduct telephonic assessments with obstetric patients and provide care coordinationEducate patients and families about treatment and services,...

A company is looking for a Clinical Faculty, Graduate Nursing Practicum.Key ResponsibilitiesTeach and manage up to ten course sections annually in graduate nursing, focusing on practicum and leadership/education coursesMentor and support adjunct...

A company is looking for a Clinical Audit Specialist - Utilization Management.Key ResponsibilitiesConduct retrospective and targeted audits of medical necessity determinationsAnalyze audit findings to identify trends and systemic issues in...

A company is looking for a Nurse Auditor.Key ResponsibilitiesPerform charge audits and assessments to resolve incorrect or missing chargesMonitor revenue loss reports and identify documentation needs to support charge captureEducate stakeholders...

A company is looking for a Utilization Review Clinician - Behavioral Health.Key ResponsibilitiesEvaluate member's treatment for mental health and substance abuse to ensure medical appropriatenessPerform prior authorization reviews and concurrent...

A company is looking for a Nurse Case Manager (WC and PIP).Key ResponsibilitiesNegotiate fees and coordinate referrals with rehabilitation and medical case management vendorsGather, analyze, and report service data significant to clients and...

A company is looking for a Utilization Management Director - RN Required - Remote.Key ResponsibilitiesOversee day-to-day operations of the Utilization Management Department to ensure compliance with payer requirements and regulatory...

A company is looking for a Utilization Management Nurse.Key ResponsibilitiesCoordinate and facilitate correct identification of patient statusConduct concurrent and retrospective reviews and support the medical necessity denial and appeal...

A company is looking for a RN Pediatric Operating Room -Acute SME for a 3-day remote workshop.Key ResponsibilitiesParticipate in discussions and research related to pediatric operating room practicesTake exams and review content focused on the...