Elevance Health jobs
Diagnosis Related Group Clinical Validation Auditor-RN
Diagnosis Related Group Clinical Validation Auditor-RN
Location: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations.
The Diagnosis Related Group Clinical Validation Auditor is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Re...
Diagnosis Related Group Clinical Validation Auditor-RN
Diagnosis Related Group Clinical Validation Auditor-RN
Location: This position will work a hybrid model (remote and office). Ideal candidates will live within 50 miles of one of our PulsePoint locations.
The Diagnosis Related Group Clinical Validation Auditor is responsible for auditing inpatient medical records to ensure clinical documentation supports the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Re...
Reviewer Therapy Svcs-1
Location: This is a virtual position , must be located within 50 miles of the nearest pulse point.
Schedule : Monday-Friday 9:30am-6:00pm PST
Responsible for the review of medical records to determine if requests for therapy services (physical therapy, occupational therapy, and/or speech-language pathology) were medically necessary and filed appropriately.
Primary duties may include...
Reviewer Therapy Svcs-2
Location: This is a virtual position , must be located within 50 miles of the nearest pulse point.
Schedule : Monday-Friday 9:30am-6:00pm PST
Responsible for the review of medical records to determine if requests for therapy services (physical therapy, occupational therapy, and/or speech-language pathology) were medically necessary and filed appropriately.
Primary duties may include...
Associate Medical Director, Clinical Operations (Surgery)
Carelon Medical Benefits Management is currently seeking a Board-Certified Surgeon (or other surgical subspecialties beyond general surgery) to participate in pre-authorization and quality improvement solutions for a wide range of surgical procedures. Medical Directors determine the medical necessity of requests using clinical appropriateness guidelines.
The Associate Medical Director, Clinical Operations (Surgery) is responsible for supporting the medical manageme...