Top 21 Nurse coach Jobs in Utah

RN Readmission Manager, Payment Integrity
Centene Corporation —Utah
- $87,700 - $157,800 a year
- Full-time
- Remote
- Nursing
- RN License
- 3 years
- Paid holidays
- Health insurance
8d
Nurse Practitioner
Lindora Bountiful —Woods Cross, UT
- $60 - $70 an hour
- Part-time
- CPR Certification
- Nursing
- Blood sampling
- Flexible schedule
Quick Apply
SUBSTITUTE NURSE
Park City School District —Park City, UT
- $35 an hour
- RN License
- Bachelor's degree
- Children
14d
Patient Health Advocate- VBC
Somatus, Inc. —Salt Lake City, UT
- Full-time
- Spanish
- Microsoft Outlook
- Computer literacy
- Continuing education credits
- Health insurance
Sr Clinical Admin Nurse RN
Optum —Draper, UT
- $60,200 - $107,400 a year
- Full-time
- Hybrid work
- Nursing
- RN License
- Pass drug screening
Quick Apply
6d
Manager, Medical Case Management
AmTrust Financial Services, Inc. —South Jordan, UT
- $90,000 - $140,000 a year
- Full-time
- Spanish
- Nursing
- RN License
- Health insurance
- Dental insurance
Wellness Director (Registered Nurse)
Legacy Village of Sugar House —Salt Lake City, UT
- From $85,000 a year
- Full-time
- Nursing
- RN License
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Wellness Nurse (LPN/RN)
Legacy House of South Jordan —South Jordan, UT
- $30 - $34 an hour
- Part-time
- RN License
- Mid-level
- Organizational skills
- Health savings account
- Health insurance
Quick Apply
Nursing Professional Development Practitioner ED ICU
Intermountain Healthcare —Logan, UT
- $45.31 - $67.01 an hour
- Full-time
- Hybrid work
- Acute care
- Nursing
- RN License
7d
Senior Living RN - Health Director
Legacy Village of Sugar House —Salt Lake City, UT
- From $85,000 a year
- Full-time
- RN License
- Mid-level
- Residential
- Health insurance
- Dental insurance
Quick Apply
2d
RN - Registered Nurse
Staffers LLC —Utah
- Nursing
- RN License
- Computer literacy
Quick Apply
Remote Nurse Practitioner Contractor- Multi-State
Perry Health Inc —Salt Lake City, UT
- $30 an hour
- Choose your own hours
- Remote
- Spanish
- Nursing
- Mid-level
- Opportunities for advancement
Quick Apply
CUCF Medical PA/NP - Sanpete County
State of Utah —Gunnison, UT
- $58.14 an hour
- Full-time
- Background check
- Nursing
- Writing skills
Psychiatric Nurse Practitioner- Utah
SonderMind —Salt Lake City, UT
- Up to $200 an hour
- Contract
- Remote
- Private practice
- Psychiatry
- Mid-level
Quick Apply
LPN - Licensed Practical Nurse
Staffers LLC —Utah
- Nursing
- Computer literacy
- Pass drug screening
Quick Apply
Manager NICU RN
St. Mark's Hospital —Salt Lake City, UT
- Full-time
- Mid-level
- Leadership
- 2 years
- Employee stock purchase plan
- Disability insurance
Quick Apply
9d
Functional Medicine Licensed Nurse Practitioner
bVital Park City —Park City, UT
- $90,000 - $115,000 a year
- Full-time
- Outpatient experience
- Clinic
- Neurology
- Health insurance
- 401(k)
Quick Apply

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RN Readmission Manager, Payment Integrity

Centene Corporation -
Utah

Apply Now

Job Details

Full-time
$87,700 - $157,800 a year
8 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

nurse coach jobs in utah

RN Readmission Manager, Payment Integrity

Nurse Practitioner

SUBSTITUTE NURSE

Patient Health Advocate- VBC

Sr Clinical Admin Nurse RN

Manager, Medical Case Management

Wellness Director (Registered Nurse)

Wellness Nurse (LPN/RN)

Nursing Professional Development Practitioner ED ICU

Senior Living RN - Health Director

RN - Registered Nurse

Remote Nurse Practitioner Contractor- Multi-State

CUCF Medical PA/NP - Sanpete County

Psychiatric Nurse Practitioner- Utah

LPN - Licensed Practical Nurse

Manager NICU RN

Functional Medicine Licensed Nurse Practitioner

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