Click to search for jobs

Job Description:
* Responsible for the review and evaluation of clinical information and documentation.
* Reviews documentation and interprets data obtained from clinical records or systems to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and/or provider issues.
* Independently coordinates the clinical resolution ...

Become a part of our caring community and help us put health first
The Senior Quality Compliance Nurse Professional is an integral part of the Oklahoma Quality Improvement Department. This role will collaborate with internal and external customers to meet benchmarks, goals and complete time sensitive deliverables for Quality Improvement clinical and non-clinical performance projects. The rol...

Everlywell is a digital health company pioneering the next generation of biomarker intelligence—combining AI-powered technology with human insight to deliver personalized, actionable health answers. We transform complex biomarker data into life-changing insights—seamlessly integrating advanced diagnostics, virtual care, and patient engagement to reshape how and where health happens.
Over the p...

Everlywell is a digital health company pioneering the next generation of biomarker intelligence-combining AI-powered technology with human insight to deliver personalized, actionable health answers. We transform complex biomarker data into life-changing insights-seamlessly integrating advanced diagnostics, virtual care, and patient engagement to reshape how and where health happens.
Over the pa...

Company :
Highmark Inc.
Job Description :
JOB SUMMARY
This job works with appropriate departments in the areas of compliance, process improvement, medical record review and coding, and member and provider satisfaction for all product lines. Recommends and implements process improvements related to the potential of quality medical care and service to members and to improve documentation o...

Company :
Highmark Inc.
Job Description :
JOB SUMMARY
This job works with appropriate departments in the areas of compliance, process improvement, medical record review and coding, and member and provider satisfaction for all product lines. Recommends and implements process improvements related to the potential of quality medical care and service to members and to improve documentation o...