Bachelor's Degree in Nursing (BSN), Health Administration, Nutrition or business related field. 3 years of management experience in a managed health care setting. Other current experience in utilization management. Required Licensed Registered Nurse (RN)
A healthcare company has a current position open for a Remote Revenue Integrity Analyst Registered Nurse in the Tampa. Candidates will be responsible for the following: Performing charge audits reviews by verifying billing data. Identifying charging, coding, or clinical documentation issues.
Position Requirements Include: May be required to travel at least 10% of time based on business need. 3+ years clinical experience required. Associate's degree or diploma (Nursing program) required. Must have SNF experience.
In-depth knowledge of current standard of medical practices and insurance benefit structures. Strong knowledge of case-management processes, standards, and an understanding of managed care in all lines of business. Proficiency in Microsoft Word.
Support corporate, customer, product, and business initiatives. Skills and Requirements Include: Current RN licensure unrestricted. 3 years experience in case management or utilization review. Bachelors/CCM preferred.
Bachelor's degree or equivalent work experience Nursing, Healthcare, Business. RN - Registered Nurse - State Licensure And/Or Compact State Licensure. Experience or working knowledge of HEDIS, Stars and the Qualified Health Plan/Quality Rating System.
A provider of business, compliance, and technology services needs applicants for an opening for a Remote RN Case Manager. Must be able to: Coordinate care and services for health plan members. Review a member's Health Information Form / Health Risk Assessment.
2-5 years acute care clinical experience. Current unrestricted RN license from the State of California. Ability to facilitate member care transition. Requires a minimum of 8 hours per day during business hours of 8:00am - 5:30pm. Ability to facilitate accreditation.