Job Search Results for RN

Insight Global is seeking experienced DRG Auditors to join a remote healthcare organization. The DRG Revenue Integrity Auditor will perform Diagnostic Related Group (DRG) validation and quality... More audits on inpatient charts to ensure accurate coding and compliance with federal regulations. This is a remote opportunity and the salary for this role is 95-115k based on the candidates years of experience. Key Responsibilities:Conduct thorough chart reviews to validate that assigned codes accurately reflect the patient?s clinical picture.Utilize ICD-10-CM and ICD-10-PCS coding systems to ensure proper code sequencing and accuracy.Validate Present on Admission (POA) indicators, Severity of Illness (SOI), Risk of Mortality (ROM), Hierarchical Condition Category (HCC) capture, Case Mix Index (CMI), and other coding factors.Apply current clinical criteria including MCG, InterQual, payer clinical policy bulletins, CMS guidelines, NCDs, and LCDs.Adhere to coding guidelines and Clinical Documentation Improvement (CDI) best practices as endorsed by ACDIS and AHIMA.Compose and send queries when documentation is insufficient or unclear.Identify query opportunities and ensure accurate code assignment and sequencing.Maintain high-quality standards in chart reviews to accurately reflect the patient?s condition.Stay current with medical coding guidelines and industry developments.Assist in developing training materials and provide onboarding support to new hires.Support project data analysis, reporting, and feedback for internal teams and external clients.Maintain professional conduct and ensure the confidentiality of Protected Health Information (PHI).Meet or exceed established production and quality metrics.Attend all required meetings and training sessions.May be asked to audit clients? CDI programs, including query reviews and coding analysis.Responsible for maintaining access credentials for company systems and EMRs.Perform other duties as assigned by management.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

Insight Global is looking for an Insurance Case Manager to join their client's team in the Lafayette, LA area. This role involves oversight of medical care for worker's compensation patients through... More in-person and telephonic communication, ensuring treatment plans are appropriate, cost-effective, and medically necessary while coordinating with healthcare providers and employers. It also requires travel to attend patient visits, discharge planning meetings, and assist with securing necessary medical equipment and services.75-80K DOEWe 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

To utilize the nursing process to care and/or counsel individuals in the promotion and maintenance of health and the prevention of illness and injury. Using a systematic critical-thinking approach to... More guide data gathering, assessment, nursing judgment, intervention and evaluation of human responses to actual and potential health problems through activities such as health teaching, health counseling and the provision of care supportive and restorative of life and supportive of a peaceful death. To identify patient needs using the American Association of Critical Care Nurses (AACN) Synergy Model. To delegate, coordinate and manage all aspects of nursing care provided to the patient, their family and our community in a timely and cost-effective manner. To deliver patient care in collaboration with the patient, their family and all members of the health care team and with the knowledge of a licensed physician, psychologist, podiatrist, and/or dentist.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

The CRNA provides anesthesia care in collaboration with surgeons and other healthcare professionals in an outpatient or clinic setting. This role includes preoperative assessment, anesthesia... More administration, intraoperative monitoring, and postoperative pain management. The CRNA ensures patient safety and comfort throughout the perioperative process.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

Insight Global is looking for an Insurance Case Manager to join their client's team in the Northern LA area. This role involves oversight of medical care for worker's compensation patients through... More in-person and telephonic communication, ensuring treatment plans are appropriate, cost-effective, and medically necessary while coordinating with healthcare providers and employers. It also requires travel to attend patient visits, discharge planning meetings, and assist with securing necessary medical equipment and services.75-80K DOEWe 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

Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100% remote. This person should have an extensive background in either facility-based nursing, clinical documentation,... More 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. The salary is 95K.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

The Clinical Informaticist acts as a Subject Matter Expert (SME) in clinical data and quality measurement, providing critical support to clinical evaluators, product teams, and data validation... More initiatives. Duties include but are not limited to:?Serve as a clinical SME for NC HealthConnex solution teams, providing insights on clinical concepts and data use cases.?NCQA Data Aggregator Validation ProgramoSupport clinical evaluators with interpretation and validation of clinical resources and content.oProvide clinical expertise and guidance in support of the NCQA Data Aggregator Validation program activities, including primary source validation (PSV) processesoAssist with preparation, submission, and maintenance of documentation required for DAV certification.?Digital Quality Measurement (dQM)oSupport the implementation and operationalization of the dQM engine.oAssist with aligning clinical data sources and formats to quality measurement specifications.?Data Quality ImprovementoCollaborate with technical and clinical teams to identify and resolve data quality issues.oProvide recommendations for improving the accuracy, completeness, and usability of clinical data within NC HealthConnex systems.?Product Development SupportoContribute to new product development and enhancements by offering clinical perspectives that inform technical design.oParticipate in product testing and validation for clinical functionality.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

Insight Global is hiring for a Remote Care Manager to support our micro clinic operations in Raleigh, NC. You will work in a virtual setting with providers, paramedics, and patients to partner in the... More care continuum process. You will lead the clinical onboarding of new contracts, handle referrals & authorizations, and ensure seamless communication with all stakeholders.Responsibilities will include: ? Develop and monitor care plans in collaboration with multiple providers, adjusting as needed? Follow up on interventions to prevent unnecessary ER visits and hospital admissions? Serve as the primary liaison between patients, families, and healthcare staff to ensure seamless communication? Navigate multiple healthcare platforms including EHRs, payer portals, billing software, and patient messaging systems? Ensure timely and accurate documentation across systems to support care continuity and compliance? Verify provider participation, coverage, and pre-authorization requirements with insurance administrators and healthcare facilities? Optimize client contracts and referral workflows to enhance scalability and efficiency in care coordination? Schedule and manage appointments, follow-ups, and referrals to specialists and services? Educate patients on conditions, medications, and treatment plans to promote understanding and adherence? Track patient progress and address barriers to treatment plan complianceWe 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

Insight Global is seeking a DRG Validation Auditor for one of our clients to sit 100% remote. This person should have an extensive background in either facility-based nursing, clinical documentation,... More 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. The salary is 95K.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

The Clinical EMR Trainer works directly with the clinical leadership team and staff to provide support for implementation and training for the electronic medical record. Conducts and coordinates a... More variety of training sessions, workshops, and seminars. Collaborates with IS and clinical areas to facilitate training of clinical technology and computer applications throughout the hospital. Collaborates with other Educators/CNS-s to ensure staff support, continuing education and training materials that provide support for appropriate documentation in the EMR of quality patient care that meets specialty and other regulatory standards.This role will be responsible for IP/OP Provider (Physician/NP/PA/etc) training as well as training for the ancillary areas listed (Willow/Pharmacy, Beaker/Lab, Radiant/Imaging, Beacon/Oncology. Serves as an active member as the Clinical EMR Trainer on hospital committees related to clinical education. Acts as a role model for professional nursing practice and a link between technology and clinical areas. Participates in Clinical Applications OnCall rotationsWe 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