RN Readmission & Payment Integrity Leader (Remote)
Centene Corporation
- Remote job
Centene Corporation is seeking an experienced RN with coding credentials to lead Payment Integrity initiatives focused on preventable readmissions, cost recovery, and payment accuracy across the enterprise. You will supervise auditors and clinical staff and ensure alignment with internal policies and regulatory requirements. Qualified candidates bring 5+ years in Payment Integrity with DRG validation, 3+ years of people leadership, and hands-on experience with DRG encoders such as 3M or TruCode. #J-18808-Ljbffr Centene Corporation
$87.7k - $157.8k
...Requirements A Licensed RN paired with a Coding Credential... ...potentially preventable readmissions, cost recovery, cost avoidance, and payment accuracy. You will lead... ...experience in Payment Integrity, including readmission... ...approach to work with remote, hybrid, field or office...Remote workFull timePart timeWork at officeFlexible hours- Cambia Health Solutions in the United States is hiring a Payment Integrity Nurse I to review post-service claims and ensure accurate coding within defined medical policies. The role supports patient care while maintaining compliance and high-quality review standards. You...Remote jobWork from home
- ...leading healthcare solutions firm seeks a Payment Integrity Supervisor to oversee daily operations... ...focus on improving service delivery. This remote position requires strong experience in... ...hold an Associate Degree in Nursing and RN licensure. #J-18808-Ljbffr CorVel CorporationRemote jobDaily paid
- Zact Inc. is seeking an experienced payments professional to own the delivery of issuer processor integrations and major implementation projects. This role goes beyond traditional project management and requires coordinating technical teams, processor personnel, banks,...Remote job
- CorVel Corporation seeks a Payment Integrity Analyst (Team Lead) to supervise the Policy and Payment Integrity (PPI) team while overseeing audits... ..., staff training, and timely completion of audits, with a remote work arrangement. Strong knowledge of CMS policies, ICD-10...Remote job
- Cambia Health Solutions is seeking a Payment Integrity Nurse I to perform post-service claims reviews, ensuring accurate coding, proper payment... ...care and claims integrity while working within a flexible remote model across certain western states. The position emphasizes...Remote jobFlexible hours
- Abacus Insights is seeking a Complex Clinical Audit (CCA) Business Solutions Lead with 5+ years in payment integrity to translate payer needs into scalable product logic. You’ll work with AI Engineering on backend build, demo capabilities to major payers, and shape how...Remote job
- Cambia Health Solutions is seeking a Payment Integrity Nurse I to review claims and medical records for accurate payments. The role supports post... ...Claim Review team. The position requires clinical experience, RN licensure in a supported state, and familiarity with coding...Remote jobFlexible hours
- Cambia Health Solutions is seeking a Payment Integrity Nurse I to perform post service reviews of claims, ensuring accurate coding and... ...least 3 years of direct care experience and an unrestricted RN license. Remote work is available within Oregon and neighboring states,...Remote job
$132.4k - $251.6k
...seeking a highly motivated and experienced Integrated Product Team Lead (IPTL) to lead and... ...role is designated as on-site, hybrid or remote.The salary range for this role is 132,40... ...covered by a collective-bargaining agreement. Payments under these annual programs are not...Remote workTemporary workWork experience placementWork at officeLocal areaRelocationFlexible hours- ...operational processes and client interactions in Atlanta, GA or remotely. The ideal candidate will have 5-7 years of experience in... ...reporting, and exceptional support strategies. Rialtic values integrity, collaboration, and continuous improvement. #J-18808-Ljbffr Rialtic...Remote job
- ...platform in the United States is seeking a Product Manager-Payments to lead the global payments ecosystem expansion. In this remote position, you will own the roadmap for global payment coverage, driving integration strategy with processors. The ideal candidate possesses...Remote jobWorldwide
- The Payment Integrity Supervisor is responsible for the daily activities of payment integrity team related to quality assurance and provider... ...improving how we deliver service to our customers. This is a remote position. ESSENTIAL FUNCTIONSAND RESPONSIBILITIES:...Remote workDaily paidMinimum wageFull timeWork experience placementWork at officeLocal areaFlexible hours
- Elevance Health is seeking a Carelon Payment Integrity Manager in Kansas to oversee claims payment accuracy and fraud, waste, and abuse prevention. The role collaborates with health plan leaders and cross-functional teams to enforce compliance with state and federal rules...Work at office
$166k - $220k
...JOBWe are seeking an experienced EW Mission Integration Lead with prior training and experience... ...Anduril’s engineers.Conduct onsite and remote troubleshooting support with customers... ...These scammers often attempt to extract payment or sensitive personal information.To ensure...Remote workFull timeContract workWork experience placementImmediate start$107.5k - $204.5k
...a Principal Systems Engineer - Mission Integration Lead, supporting one of our premier programs... ...is designated as on-site, hybrid or remote.The salary range for this role is 107,50... ...covered by a collective-bargaining agreement. Payments under these annual programs are not...Remote workContract workTemporary workWork experience placementWork at officeRelocationFlexible hours$285.7k
...to build a better working world.The opportunityThe Global Integrated Planning Leader is responsible for designing, orchestrating, and governing... ...CPA or other professional certification beneficial.Location: Remote, with flexibility across global time zones; travel as required...Remote workSummer holidayLocal areaFlexible hours$142.4k - $213.6k
...data-driven services are deployed across industries.As an AI Integration Leader, you play a central role across the full solution lifecycle —... ...professional experience considered.LocationBoston, MA Preferred / Remote PossibleLanguagesFull professional proficiency in English is...Remote workFull timeTemporary workFlexible hours$84 per hour
...Role Overview Lead clinical documentation integrity programs and evaluate AI-generated... ...compliance, and revenue capture. In this remote, hourly role you will manage CDI workflows... ...Clinical or coding credentials such as RN, RHIA, or CCS. Familiarity with AI-assisted...Remote workHourly pay- ...observation versus inpatient conversion rates, and readmission rates. Ensure compliance with CMS... ...role. Active clinical licensure, RN required. Physician advisor roles, MD or... ...organisation UM program. Work Terms Location: Remote Employment Type: Hourly...Remote workHourly payNight shift
- ...re a fast-growing fintech in the B2B cross-border payments space, and we need a Payment Operations and Integrations Engineer to ensure our customers have a seamless... ...at a well-funded early-stage startup Fully remote first, with in-person international team offsites...Remote workFull timeWork from homeFlexible hours
- ...quality, timely delivery, and unwavering integrity. We take pride in our role as a trusted government... ...Summary The Integrity Assurance Leader is responsible for overseeing program... ...highly desired Flexible work location, Remote-friendly Key Responsibilities Plan...Remote workContract workTemporary workFor contractorsFlexible hours
$165k - $185k
...Medical, dental, vision, 401(k) Location + Travel: Position is remote with 30-50% US travel required, with the preference for this... ...capabilities, and performance management systems. Reliability & Integrity Programs Provide technical leadership for equipment...Remote workFull time- Vytwo is seeking a senior leader with a former CTO profile in the payments domain. This role involves thought partnership with the team and senior clients, focusing on large-scale platform consolidation efforts. The ideal candidate will have a strong background in payments...Remote jobFull timePart timeWork from homeFlexible hours
$96.21k - $134.11k
...Clinical Documentation Integrity Specialist Location: Partially Remote- Will support sites within Austin, TX & Waco... ...Improvement Specialists (ACDIS) RN license in Texas Expert understanding... ...: Ascension will never ask for payment or to provide banking or financial...Remote workFull timeLocal areaMonday to Friday- ...Experience Manager at Rialtic, Inc. Atlanta or Remote About Rialtic Rialtic is an enterprise... ...Partners, Rialtic’s best‑in‑class payment accuracy product brings programs in-... ...than relationship‑focused. Values High Integrity - Do the right thing, provide candid feedback...Remote workWork from homeHome office
- A healthcare integrity solutions provider is looking for an Outpatient Payment Integrity Coder Auditor in New York City. In this role, you will audit outpatient medical claims for coding accuracy and compliance with CMS guidelines. The ideal candidate must have advanced...Remote work
- ...We are currently seeking a RR Integration lead to join our team in... ...sheets, invoices, invoice status, payment remittance, supplier... ...business and technology services leader, serving 75% of the Fortune Global... .... While many positions offer remote or hybrid work options, these...Remote workWork at officeFlexible hours
- Feeld is looking for a MarTech Manager to join our remote team. You will own and evolve the marketing technology ecosystem, ensuring systems are scalable and integrated. Your role includes collaboration with various teams to improve marketing infrastructure, implementing...Remote job
- ...startup is seeking a Founding Business Development Leader to shape its go-to-market strategy in the embedded payments space. This role involves owning all aspects of... ...particularly within healthcare SaaS. This fully remote position offers flexibility and numerous opportunities...Remote work
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