- Highmark Health (Harrisburg, PA)
- …to meet program targets across the practices' P4V programs such as ACA, Medicare STARS, HEDIS and risk revenue for all payers. (25%) + Collaborates with EHR teams in ... more
- Healthfirst (NY)
- …+ Clinical license: LPN, RN , LMSW or LCSW + Multiple years of HEDIS review experience for both Medicaid and Medicare lines of business + Medical record review ... more
- Centene Corporation (Harrisburg, PA)
- …Health insurance experience required; 1+ year quality experience preferred. **License/Certification:** Registered Nurse , Licensed Practical Nurse , Licensed ... more
- Catholic Health (West Seneca, NY)
- …The Medical Assistant is under the clinical supervision of the Licensed Practical Nurse , Registered Nurse , Nurse Practitioner, Physician Assistant ... more
- Humana (Raleigh, NC)
- …Quality leadership. **Use your skills to make an impact** **Required Qualifications** + Active Registered Nurse license in the state of Virginia or obtain a ... more
- University of Miami (Miami, FL)
- …Providers supervises advance d practice providers (APPs) ( ie, Advanced Registered Nurse Practitioners, Physician Assistants etc.). Key responsibilities of ... more
- Queen's Health System (Kamuela, HI)
- …QUALIFICATIONS: A. EDUCATION/CERTIFICATION AND LICENSURE: * Current Hawaii State license as a Registered Nurse . * Bachelor's degree in Nursing. * Master's degree ... more
- UCLA Health (Los Angeles, CA)
- Description The Quality Management Clinical Nurse Specialist is responsible for conducting comprehensive facility site reviews (FSRs) to ensure compliance with ... more
- Catholic Health Services (Melville, NY)
- …to the position. Position Requirements and Qualifications Education: Degree from an accredited Nurse Practitioner program Current NYS RN and Current NYS Nurse ... more
- Molina Healthcare (Savannah, GA)
- …market desirable. **Preferred License, Certification, Association** + Active, unrestricted State Registered Nursing ( RN ) license in good standing. + Utilization ... more
- Elevance Health (San Juan, PR)
- …its affiliated companies, they serve more than 118 million people. **Clinical Nurse Adherence** **Location:** This position will work a hybrid model (3-4 days/week ... more
- Whidbey General Hospital (Coupeville, WA)
- …data for the Medical Staff Office for credentialing providers. + Assist Quality Review RN with data to help clinic managers understand what gaps need to be closed ... more
- Elevance Health (MO)
- …managing clinical program development for population-based clinical quality measures, including HEDIS within a clinical area and across Medicaid line of business. ... more
- Elevance Health (Cerritos, CA)
- …to ensure high-quality care to members and achievement of company HEDIS performance. Implements strategies that meet clinical, quality, and network improvement ... more
- Catholic Health (Kenmore, NY)
- …an accredited school of nursing. + Maintains a current New York State Professional RN license + Completion of an accredited program for Nurse Practitioners. + ... more
- Independent Health (Buffalo, NY)
- …and as requested by the Director. **Qualifications** + Bachelor's degree or Registered Nursing License ( RN ) required. Master's degree preferred. An additional ... more
- Centene Corporation (Jefferson City, MO)
- …and implementation of care management processes to ensure NCQA, URAC, and HEDIS measures + Develop and implement standardization in measuring and monitoring ... more
- Catholic Health (Niagara Falls, NY)
- …an accredited school of nursing. + Maintains a current New York State Professional RN license + Completion of an accredited program for Nurse Practitioners. + ... more