Payment Integrity Nurse – Medicare Advantage
W@H South Carolinaremote
Posted today · via Workday
About this role
Summary We are currently hiring for a Payment Integrity Nurse – Medicare Advantage to join BlueCross BlueShield of South Carolina. In this role as an Payment Integrity Nurse, you will monitor/implement quality improvement/management activities, conduct specific medical reviews as necessary, analyzes findings, makes recommendations for corrective actions, and prepares formal documentation for compliance with applicable standards/regulations, perform Health Plan Employer Data Information Set data collection (HEDIS), and National Committee for Quality Assurance (NCQA) accreditation activities. Description Location: This position is full-time (40 hours/week) Monday-Friday from 8:00am-4:30pm and will be fully remote after 4-8 weeks of on-site training.…
Read the full description on 001 Blue Cross And Blue Shield Of South Carolina's site →
What we'd score you on
reqspace match rubricFive dimensions, recruiter-grade. Upload your resume and we'll generate a written explanation of where you fit and where the gaps are.
1
Skills match
We compare your skills against the role requirements.
2
Level fit
We check your title trajectory against the seniority signal of the role.
3
Domain experience
Your work in the role's domain matters more than your years total. We weight recent and direct experience.
4
Recency
A skill you used last quarter weighs more than one from five years ago. We grade on recency, not lifetime.
5
Location fit
This role is remote-eligible — we factor in your stated location and time-zone overlap.
Score yourself on this role.
Free · no card · written explanation included
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