• Nurse Auditor

    Humana (Providence, RI)
    …a part of our caring community and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record ... is complete, compliant and accurate to support optimal reimbursement. The Nurse Auditor 2 work assignments are varied and frequently require interpretation and… more
    Humana (02/04/25)
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  • RN Compliance Auditor

    Humana (Providence, RI)
    …of our caring community and help us put health first** The Compliance Nurse Auditor reviews utilization management activities and documentation to ensure ... and detect fraud, waste, and abuse. The RN Compliance Nurse 2, Quality Assurance Audit ensures mandatory reporting is...past 3 years + Experience as a Utilization Management Auditor + Health Plan experience working with large carriers… more
    Humana (01/31/25)
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  • Special Investigation Unit Manager Clinical…

    CVS Health (Providence, RI)
    …Ability to travel for business needs. **Preferred Qualifications:** Registered Nurse (RN) Previous leadership experience. AAPC Coding Certification - Certified ... Professional Biller (CPB), Certified Professional Medical Auditor (CPMA), Certified Outpatient Coder (COC), Certified Risk Adjustment Coder (CRC) Licensed Clinical… more
    CVS Health (12/25/24)
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