Job Search Results for Nursing

DRG Auditor

Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100% remote. The work authorization is not specified and the salary ranges anywhere from $80,000-$95,000. This person... More should have an extensive background in either facility-based nursing, clinical documentation, and/or inpatient coding and has a high level of understanding of reimbursement guidelines specifically an understanding of the MS-DRG, AP-DRG, and APR-DRG payment systems. This position is responsible for auditing inpatient medical records and generating high-quality recoverable claims for the benefit of our client and their clients. They are responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding and DRG assignment accuracy. Below are the key responsibilities for this role:?Integrates medical chart coding principles, clinical guidelines, and objectivity in the performance of medical audit activities. Draws on advanced ICD-10 coding expertise, clinical guidelines, and industry knowledge to substantiate conclusions. Performs work independently.?Utilizes the clients proprietary auditing systems with a high level of proficiency to make audit determinations and generate audit letters.?Maintains production goals set by the audit operations management team.?Achieves the expected level of accuracy and quality set by the audit for the auditing concept, for valid claim identification and documentation (letter writing).?Identifies potential claims outside of the concept where additional recoveries may be available. Suggests and develops high-quality, high-value concepts and or process improvement, tools, etc.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Remote Sr. Clinical Data Analyst

Clinical Quality and Performance Data Analyst: Telecommute with designated workplace inside home and reliable hardwired high speed internet access.There are a total of 4 team members one of which is... More out hence the need for the contractor. 2 developers and one data visualization expert.Work hours are 8-4 central. I would like to see 2 rounds of interviews the first being phone the last via video.A detail-oriented and experienced Data Analyst for our Clinical Quality Analytics team. This role is responsible for analyzing clinical data to support HEDIS? measure improvement, and member outreach initiatives for both the commercial and the Individual and Family Plan members. The ideal candidate will have a strong understanding of healthcare data, clinical workflows, and regulatory requirements, and will work closely with clinical leaders and quality teams to deliver actionable insights that improve Health Plan Ratings.________________________________________Key Responsibilities:? Analyze clinical data from our Gaps In Care database, marketing outreach, member surveys, and other sources to identify trends, gaps, and opportunities.? Develop and maintain dashboards and reports to monitor clinical performance, quality metrics, and HPR opportunities.? Collaborate with clinical stakeholders to define and track key performance indicators (KPIs) aligned with strategic goals.? Support clinical quality initiatives such as HEDIS? reporting, and curating lists for member outreach.? Perform cohort analysis, risk stratification, and predictive analytics.? Ensure data accuracy, integrity, and compliance with HIPAA and other regulatory standards.? Translate complex clinical data into clear, actionable insights for non-technical audiences.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less

Salesforce Business Analyst

We are seeking a dynamic and driven Business Analyst to join our team in building a clinically integrated Care Management platform using Salesforce Health Cloud. In this high-impact role, you will... More work closely with clinical, operational, and technical stakeholders to gather and document business requirements, translating complex healthcare workflows into scalable solutions. Your day will involve crafting user stories, process flows, and acceptance criteria to guide development teams, while actively supporting sprint planning, backlog grooming, and user acceptance testing sessions. You?ll manage dependencies across internal and external teams, contribute to change management and training initiatives to ensure successful platform adoption, and continuously evaluate performance to recommend enhancements that improve health outcomes and accelerate interoperability.We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.Less