Top 281 Quality improvement nurse Jobs in Fishers In

Patient Safety DRG Clinical Validation Auditor
Elevance Health —Indianapolis, IN
- $86,560 - $129,840 a year
- Full-time
- RN License
- 5 years
- Continuous improvement
- Employee stock purchase plan
- Paid holidays
5d
LPN Licensed Practical Nurse
Wildwood Healthcare Center —Indianapolis, IN
- Up to $37 an hour
- 12 hour shift
- Skilled nursing facility
- Mid-level
- LPN
- Health insurance
- Dental insurance
Quick Apply
QMA Qualified Medication Aide Part Time
Bridgewater Healthcare Center —Carmel, IN
- From $19 an hour
- Part-time
- Basic math
- High school diploma or GED
- Entry level
- Health insurance
- Tuition reimbursement
Quick Apply
QMA Qualified Medication Aide
Bridgewater Healthcare Center —Carmel, IN
- From $19 an hour
- Full-time
- Basic math
- High school diploma or GED
- Entry level
- Health insurance
- Tuition reimbursement
Quick Apply
Patient Safety DRG Clinical Validation Auditor
Elevance Health —Indianapolis, IN
- $86,560 - $129,840 a year
- Full-time
- RN License
- 5 years
- Continuous improvement
- Employee stock purchase plan
- Paid holidays
Quality Assurance Nurse (RN) - Hybrid in Greenfield, IN
ELITE HOME HEALTHCARE LLC —Greenfield, IN
- $80,000 - $90,000 a year
- Full-time
- Hybrid work
- RN License
- Mid-level
- Office
- Flexible schedule
Quick Apply
Clinical Quality Specialist
State of Indiana —Indianapolis, IN
- From $67,314 a year
- Overtime
- Nursing
- RN License
- Research
- Free parking
- Paid parental leave
Nurse
US Veterans Health Administration —Indianapolis, IN
- $75,619 - $126,293 a year
- Online Application
- Hybrid work
- Background check
- Nursing
- Doctoral degree
- Paid holidays
- Loan repayment program
5d
LPN/RN for Corporate Wellness Screenings
Quest Diagnostics —Indianapolis, IN
- $27.41 - $33.34 an hour
- Contract
- RN License
- Customer service
- HIPAA
- Flexible schedule
Quick Apply
Clinical Nurse Specialist
Indiana University Health —Carmel, IN
- Multiple hires
- Nursing
- RN License
- Hospital
- Health insurance
- Dental insurance
RCS-Quality Expert CC
Indiana University Health —Indianapolis, IN
- Full-time
- Nursing
- Microsoft Excel
- Microsoft Access
3d
MA/Phleb for Corporate Wellness Screenings
Quest Diagnostics —Indianapolis, IN
- $20.61 - $26.97 an hour
- Contract
- Customer service
- HIPAA
- Office
- Flexible schedule
Quick Apply
Behavioral Health Therapist - Masters Level
Jane Pauley Community Health Center, Inc. —Indianapolis, IN
- Mid-level
- Master's degree
- Continuous improvement
- Disability insurance
- Health insurance
Inserv Coordinator/IP Nurse
Westminster Village North Inc. —Indianapolis, IN
- Monday to Friday
- Nursing
- RN License
- Mid-level
- Paid holidays
- Disability insurance
10d
Patient Care Coordinator - (RN)
Jane Pauley Community Health Center, Inc. —Anderson, IN
- Hybrid work
- Nursing
- RN License
- BLS Certification
- Disability insurance
- Health insurance
Quick Apply
10d
Clinical Quality Improvement Coordinator
Eskenazi Health —Indianapolis, IN
- Overtime
- RN License
- Hospital
- Research
4d
Trauma Registrar
Indiana University Health —Indianapolis, IN
- Full-time
- Anatomy knowledge
- RN License
- Mid-level
STAFF NURSE II -INFUSION CENTER
Eskenazi Health —Indianapolis, IN
- Full-time
- Nursing
- RN License
- Hospital
Nursing Program Development Specialist
Trilogy Health Services —Greenfield, IN
- Full-time
- Hybrid work
- Nursing
- RN License
- Mid-level
- Health savings account
- Loan repayment program
10d
Ambulatory Care Pharmacist
Indiana University Health —Fishers, IN
- Full-time
- Hybrid work
- Hospital
- Clinic experience
- Mid-level
- Tuition reimbursement
- Employee assistance program
12d

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Patient Safety DRG Clinical Validation Auditor

Elevance Health -
Indianapolis, IN

Apply Now

Job Details

Full-time
$86,560 - $129,840 a year
5 days ago

Benefits

Employee stock purchase plan
Paid holidays
Disability insurance
Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
401(k) matching
Life insurance

Qualifications

RN License
DRG

Full Job Description

Location: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

The Patient Safety DRG 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 Related Group (DRG) paid claims.

How you'll make a difference:

Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines, and objectivity in the performance of medical audit activities. Draws on advanced ICD-10 coding expertise, mastery of clinical guidelines, and industry knowledge to substantiate conclusions.
Utilizes audit tools, auditing workflow systems and reference information to generate audit determinations and formulate detailed audit findings letters.
Maintains accuracy and quality standards as established by audit management.
Identifies potential documentation and coding errors by recognizing aberrant coding and documentation patterns such as inappropriate billing for readmissions, inpatient admission status, and Hospital-Acquired Conditions (HACs).
Suggests and develops high quality, high value, concept and or process improvement and efficiency recommendations.

Minimum Requirements:

Requires current, active, unrestricted Registered Nurse license in applicable state(s).
Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5 years of experience working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG; or any combination of education and experience, which would provide an equivalent background.

Preferred skills, qualifications and experiences:

One or more of the following certifications are preferred: Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC.
Experience with third party DRG Coding and/or Clinical Validation Audits or hospital clinical documentation improvement experience preferred.
Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing guidelines, payer reimbursement policies, and coding terminology preferred.

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $86,560 to $129,840

Locations: Minnesota; Cleveland, Ohio and Columbus, Ohio

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, paid time off, stock, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act

Apply Now

Refine Your Search

quality improvement nurse jobs in fishers in

Patient Safety DRG Clinical Validation Auditor

LPN Licensed Practical Nurse

QMA Qualified Medication Aide Part Time

QMA Qualified Medication Aide

Patient Safety DRG Clinical Validation Auditor

Quality Assurance Nurse (RN) - Hybrid in Greenfield, IN

Clinical Quality Specialist

Nurse

LPN/RN for Corporate Wellness Screenings

Clinical Nurse Specialist

RCS-Quality Expert CC

MA/Phleb for Corporate Wellness Screenings

Behavioral Health Therapist - Masters Level

Inserv Coordinator/IP Nurse

Patient Care Coordinator - (RN)

Clinical Quality Improvement Coordinator

Trauma Registrar

STAFF NURSE II -INFUSION CENTER

Nursing Program Development Specialist

Ambulatory Care Pharmacist

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