Top 1639 Neurodiagnostic technologist, registered Jobs in South Dakota

RN Readmission Manager, Payment Integrity
Centene Corporation —South Dakota
- $87,700 - $157,800 a year
- Full-time
- Remote
- Nursing
- RN License
- 3 years
- Paid holidays
- Health insurance
6d
Registered Dental Hygienist
Tri State Dental Care —Dakota Dunes, SD
- From $40 an hour
- Full-time
- Dental office
- HIPAA
- Mid-level
- 401(k)
- Paid time off
Quick Apply
Registered Dietitian: San Diego
Treatment Center Management LLC —Sioux Falls, SD
- $80,000 - $85,000 a year
- Full-time
- Adults
- Bachelor's degree
- Adolescents
- Health savings account
- AD&D insurance
Quick Apply
6d
RN - Registered Nurse - Outpatient Dialysis
Sanford Health —Chamberlain, SD
- $32 - $48 an hour
- 12 hour shift
- Background check
- Nursing
- RN License
- Health insurance
- Dental insurance
Quick Apply
RN - Registered Nurse - Chamberlain Medical Center - Full Time
Sanford Health —Chamberlain, SD
- $33.50 - $44.50 an hour
- 12 hour shift
- Background check
- Nursing
- RN License
- Health insurance
- Dental insurance
Quick Apply
RN - Chamberlain Medical Center - Surgery - Full Time
Sanford Health —Chamberlain, SD
- $35.50 - $48.00 an hour
- 8 hour shift
- Background check
- Nursing
- Surgery
- Health insurance
- Dental insurance
Quick Apply
RN - Registered Nurse - OR
Sanford Health —Rapid City, SD
- $34 - $48 an hour
- 8 hour shift
- Background check
- Nursing
- RN License
- Health insurance
- Dental insurance
Quick Apply
CT Technologist
Exceptional Healthcare Inc. —Rapid City, SD
- 12 hour shift
- Hospital
- Customer service
- BLS Certification
- Health insurance
- Dental insurance
Quick Apply
RN Traveler - Solutions by Sanford - Chamberlain OB/MS
Solutions by Sanford —Chamberlain, SD
- $3,010 a week
- Online Application
- Background check
- Nursing
- RN License
- Health insurance
- Dental insurance
Quick Apply
4d
Respiratory Therapist, Registered
Sanford Health —Sioux Falls, SD
- Online Application
- Background check
- Hospital
- BLS Certification
- Health insurance
- Dental insurance
Quick Apply
Travel RN ICU - Intensive Care Unit Registered Nurse
Focus Staff —Rapid City, SD
- $2,816.76 - $2,874.24 a week
- Travel nursing
- RN License
- BLS Certification
- Mid-level
- Travel reimbursement
- Health insurance
Quick Apply
8d
Inpatient Registered Nurse (RN)
Exceptional Healthcare Inc. —Rapid City, SD
- 12 hour shift
- CPR Certification
- Nursing
- RN License
- Health insurance
- Dental insurance
Quick Apply
Registered Nurse - Weekend Bonus
Correctional Medical Management, LLC —Sioux Falls, SD
- $32.00 - $37.50 an hour
- 12 hour shift
- Background check
- CPR Certification
- Nursing
- Paid holidays
- Disability insurance
Quick Apply
Registered Dental Hygienist
Knutson Family Dentistry —Vermillion, SD
- Full-time
- Dental office
- US work authorization
- In-person
- 401(k)
- Paid time off
Quick Apply
12d
Travel PCU RN - Progressive Care Unit Registered Nurse
Focus Staff —Rapid City, SD
- $2,201.82 - $2,246.75 a week
- Urgently hiring
- RN License
- BLS Certification
- Mid-level
- Travel reimbursement
- Relocation assistance
Quick Apply
Home Health Registered Nurse/Licensed Practical Nurse
Independent Health Solutions —Huron, SD
- $29 - $33 an hour
- Part-time
- Nursing
- Vital signs
- RN License
- Health insurance
- Paid time off
Quick Apply
Travel PCU RN - Progressive Care Unit Registered Nurse
Focus Staff —Rapid City, SD
- $2,718.77 - $2,774.25 a week
- Urgently hiring
- RN License
- BLS Certification
- Mid-level
- Travel reimbursement
- Relocation assistance
Quick Apply
8d
LPN or RN - Full Time Varies
Good Samaritan —Canton, SD
- $26 - $48 an hour
- Online Application
- Background check
- Nursing
- RN License
- Health insurance
- Dental insurance
Quick Apply
RN - Registered Nurse - OR
Sanford Health —Rapid City, SD
- $34 - $48 an hour
- 12 hour shift
- Background check
- Nursing
- RN License
- Health insurance
- Dental insurance
Quick Apply
RN or LPN - Full Time Nights
Good Samaritan —Canton, SD
- $26 - $48 an hour
- Online Application
- Background check
- Nursing
- RN License
- Health insurance
- Dental insurance
Quick Apply

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RN Readmission Manager, Payment Integrity

Centene Corporation -
South Dakota

Apply Now

Job Details

Full-time
$87,700 - $157,800 a year
6 days ago

Benefits

Paid holidays
Health insurance
401(k)
Tuition reimbursement
Paid time off

Qualifications

Medical claims processing software
Healthcare team management
Healthcare reimbursement methods
Healthcare coding investigations
Documentation reviews
DRG

Full Job Description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

A Licensed RN paired with a Coding Credential is the candidate this team is seeking for this position that will lead and oversee PI initiatives focused on potentially preventable readmissions, cost recovery, cost avoidance, and payment accuracy. You will lead a team focused on expanded readmission reviews allowing CNC to ensure payment accuracy as well as alignment with internal policies and regulatory requirements. Experience Required for all RN's with Coding Credentials applying:

5 + years of progressive experience in Payment Integrity, including readmission review and DRG validation activities, required.
3+ years of people leadership experience, including direct management of teams, required.
2+ or more years of experience using Diagnosis Related Group encoder and grouper tools (for example, 3M, Optum Encoder, TruCode, TruBridge, WebSTRAT, Payment Systems Incorporated, or similar tools), required.

Position Purpose:
Manages a team of auditors and clinical professionals and is accountable for audit quality, consistency, and overall program performance for potentially preventable readmissions. Oversees payer readmission review programs to ensure accurate, compliant determinations and achievement of payment integrity objectives. This role directs the identification and validation of potentially preventable readmissions while supporting appropriate reimbursement under MS-DRG and APR-DRG methodologies. Responsible for driving program results through audit oversight, trend analysis, and the development of standardized review criteria and best practices.

Lead and oversee Payment Integrity initiatives focused on potentially preventable readmissions, cost recovery, cost avoidance, and payment accuracy, ensuring alignment with established objectives, internal policies, and regulatory requirements.
Collaborate with Health Plans, Medical Economics, Finance, Compliance, Legal, Provider Relations, and Technology teams to support the design, execution, and ongoing monitoring of readmission and DRG-related Payment Integrity strategies.
Monitor program performance against defined metrics, financial targets, and operational benchmarks, using trend analysis to identify risks, variances, and opportunities for improvement.
Provide leadership and operational oversight to teams performing readmission, MS-DRG, and APR-DRG reviews, ensuring accuracy, consistency, timeliness, and adherence to established review standards.
Ensure compliance with federal and state regulations, managed care organization requirements, contractual obligations, and internal policies governing Payment Integrity and audit activities.
Prepare and present reports, analyses, and performance summaries to leadership and key stakeholders, highlighting audit outcomes, trends, and actionable recommendations.
Identify process gaps, operational risks, and control weaknesses, and implement or recommend corrective actions to improve quality, efficiency, and program effectiveness.
Lead, coach, and develop team members by setting clear expectations, promoting accountability, and fostering a culture of collaboration, quality, and continuous improvement.
Serve as a subject matter expert for Payment Integrity practices within assigned scope, providing guidance on readmission review methodology, audit standards, and reimbursement considerations.
Performs other duties as assigned.
Complies with all policies and standards.

Education/Experience:

Bachelor’s degree in Healthcare Administration, Business, Public Health, Health Information Management, Nursing, or a related field required; an additional four (4) years of directly related experience may be considered in lieu of a degree.

5 + years of progressive experience in Payment Integrity, including readmission review and DRG validation activities, required.
3+ years of people leadership experience, including direct management of teams, required.
2+ or more years of experience using Diagnosis Related Group encoder and grouper tools (for example, 3M, Optum Encoder, TruCode, TruBridge, WebSTRAT, Payment Systems Incorporated, or similar tools), required.
Experience working with payer claims systems preferred.
Demonstrated experience supporting government programs, regulatory compliance, or audit activities preferred.
Project management experience preferred.
Experience partnering with external vendors supporting Payment Integrity audit, recovery, or edit programs preferred.
Inpatient hospital documentation improvement experience preferred.

Master’s degree preferred.

License/Certification: Active Health Information Management or coding credentials required, such as RHIT, RHIA, CCS, CIC, or CCDS or Registered Nurse licensure or higher clinical qualification, in combination with a coding credential, required.

Pay Range: $87,700.00 - $157,800.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Apply Now

Refine Your Search

neurodiagnostic technologist, registered jobs in south dakota

RN Readmission Manager, Payment Integrity

Registered Dental Hygienist

Registered Dietitian: San Diego

RN - Registered Nurse - Outpatient Dialysis

RN - Registered Nurse - Chamberlain Medical Center - Full Time

RN - Chamberlain Medical Center - Surgery - Full Time

RN - Registered Nurse - OR

CT Technologist

RN Traveler - Solutions by Sanford - Chamberlain OB/MS

Respiratory Therapist, Registered

Travel RN ICU - Intensive Care Unit Registered Nurse

Inpatient Registered Nurse (RN)

Registered Nurse - Weekend Bonus

Registered Dental Hygienist

Travel PCU RN - Progressive Care Unit Registered Nurse

Home Health Registered Nurse/Licensed Practical Nurse

Travel PCU RN - Progressive Care Unit Registered Nurse

LPN or RN - Full Time Varies

RN - Registered Nurse - OR

RN or LPN - Full Time Nights

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