• HEDIS Registered Nurse or LPNs…

    Insight Global (Philadelphia, PA)
    Job Description A client of Insight Globals is looking for HEDIS RNs or LPNs for a partially remote contract position in PA and NJ. PARTIALLY remote position as it ... abstraction & entry of medical records assigned by a Clinical Quality Lead nurse . Miles will be reimbursed for any travel. Computer equipment, encrypted zip drives… more
    Insight Global (10/01/24)
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  • Hedis Nurse - RN Required- 100%…

    Actalent (Dallas, TX)
    Description: We are seeking a dedicated and meticulous HEDIS Nurse to assist with the collection, analysis, and presentation of healthcare data. The HEDIS ... deep understanding of healthcare systems and regulations. Ultimately, the HEDIS Nurse ensures that our healthcare services...Preferred Qualifications: - Bachelor's degree in Nursing or related field . - Certification in HEDIS or healthcare… more
    Actalent (11/02/24)
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  • Registered Nurse - Outpatient Clinics

    Veterans Affairs, Veterans Health Administration (Augusta, GA)
    …all dimension requirements for Nurse III; OR a Master's degree in *related field with BSN and two years of specialized nursing experience, one of which is ... Summary The Registered Nurse is assigned to a designated unit and...devises strategies to improve Healthcare Effective Data Information Sets ( HEDIS ) metrics, clinical reminders, panel access, timely encounter closures,… more
    Veterans Affairs, Veterans Health Administration (10/26/24)
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  • Quality Improvement (RN) - Maternity (OB/GYN)

    Molina Healthcare (Ypsilanti, MI)
    **JOB DESCRIPTION** _For this position we are seeking a (RN) Registered Nurse who must live and have a current active unrestricted RN license in the state of MI_ ... compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist, Quality Improvement (Registered Nurse ) contributes to one or more of these quality… more
    Molina Healthcare (10/20/24)
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  • Nurse Practitioner - Gwinnett

    CenterWell (Norcross, GA)
    …Schedule** : Full-time/40 Hours per Week/Monday through Friday **Job Type** : Field -based Nurse Practitioner, Primary Care House Calls **Assigned Territory** : ... part of our caring community and help us put health first** The Nurse Practitioner applies advanced education and clinical competencies to achieve optimal patient… more
    CenterWell (10/30/24)
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  • Nurse Case Manager - Boston - Mileage…

    Fallon Health (Boston, MA)
    …or follow us on Facebook, Twitter and LinkedIn** **Brief Summary of Purpose:** The Nurse Case Manager (NCM) is an integral part on an interdisciplinary team focused ... and Program policies and processes + Knowledge of and compliance with HEDIS and Medicare 5 Star measure processes, performing member education, outreach, and… more
    Fallon Health (10/09/24)
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  • Wellness Nurse Consultant

    Elevance Health (Rancho Cordova, CA)
    **Wellness Nurse Consultant** **Sign Bonus: $5000** At **Federal Health Products and Services - FHPS** , a proud member of the Elevance Health, Inc. family of ... work from your home office when not in the field . The individual is required to live in the...the territory/market that they will work in._ The **Wellness Nurse Consultant** position is responsible for developing and recommending… more
    Elevance Health (10/11/24)
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  • Patient Care Advocate

    Centene Corporation (Springfield, IL)
    …providers at large IPA and/or group practices. Serves to collaborate with providers in the field , to improve HEDIS measures and provides education for HEDIS ... deficiencies impacting plan compliance to meeting State and Federal standards for HEDIS . Conducts telephonic outreach, while embedded in the providers' offices, to… more
    Centene Corporation (11/01/24)
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  • Patient Care Advocate

    Actalent (Detroit, MI)
    …outreach and face-to-face interaction. This role involves collaborating with providers in the field to improve HEDIS measures, providing education on HEDIS ... deficiencies impacting plan compliance with State and Federal standards for HEDIS and conduct telephonic outreach to members needing preventive services.… more
    Actalent (11/01/24)
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  • Clinical Quality Coordinator (RN)

    Centene Corporation (Trenton, NJ)
    …services across the continuum of care to support both direct and indirect HEDIS care gap closure. + Coordinate services between Primary Care Physician (PCP), ... to the appropriate resources. + Support direct care gap closure of HEDIS measures through member outreach, assessment, and documentation of member status. +… more
    Centene Corporation (11/06/24)
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  • Quality Improvement Specialist (Hybrid)

    VNS Health (Manhattan, NY)
    …actions. Identifies performance and process improvement opportunities to improve HEDIS /QARR, Star ratings and Incentive programs, as applicable. Assists management ... all product lines, including but not limited to NCQA HEDIS , NYSDOH QARR, Quality Scorecard, IPRO Projects, and CMS...and current registration to practice as a registered professional nurse in New York State preferred Current registration to… more
    VNS Health (10/15/24)
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  • Senior Quality Improvement Professional

    Humana (Tallahassee, FL)
    …needs **Use your skills to make an impact** **Required Qualifications:** + Active licensed nurse in the state of Florida or Enhanced Nurse License Compact, eNLC, ... deadlines + Understanding of healthcare quality measures such as CAHPS, NCQA, HEDIS , etc. + Ability to build strong relationships and collaborate with… more
    Humana (10/31/24)
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  • EPSDT Coordinator - Pediatrics

    Molina Healthcare (Grand Rapids, MI)
    …assisting Members with scheduling transportation to appointments; reviewing EPSDT and HEDIS data to inform targeted interventions to increase utilization of ... **Job Qualifications** **REQUIRED EDUCATION** : Completion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR… more
    Molina Healthcare (10/20/24)
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  • Principal Consultant Strategic Decision…

    Penn Medicine (Philadelphia, PA)
    …to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means ... to push the thinking. The Principal Consultant will support Senior Penn Medicine nurse leaders and stakeholders on issues of broad importance to ensure timely,… more
    Penn Medicine (08/31/24)
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  • Supervisor, Transitional Care Services

    LA Care Health Plan (Los Angeles, CA)
    …care as demonstrated through identifying clinical priorities and outcomes (eg HEDIS , etc.). Assist in the development and implementation of communication strategies ... other duties as assigned. Education Required Associate's Degree in Nursing or Related Field Master's Degree in Social Work or Related Field Education Preferred… more
    LA Care Health Plan (10/26/24)
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  • APP, Supervisor - General Internal Medicine - Full…

    University of Miami (Miami, FL)
    …supervises advance d practice providers (APPs) ( ie, Advanced Registered Nurse Practitioners, Physician Assistants etc.). Key responsibilities of this position ... + Completion of Medicare annual wellness exam documentation preferred + Knowledge of HEDIS Quality Care Gaps - review and closure preferred + Knowledge of… more
    University of Miami (09/17/24)
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  • Senior EPSDT Quality Professional

    Humana (Oklahoma City, OK)
    …Professional must meet** **one** **of the following requirements:** **Unrestricted Registered Nurse in the State of Oklahoma OR** **Physician's Assistant OR** ... health services, public health, or health care administration or another related field OR** **Certified Professional in Health Care Quality (CPHQ) OR** **Certified… more
    Humana (10/29/24)
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  • Data Science Analyst I-Geriatric and Palliative…

    Mount Sinai Health System (New York, NY)
    …Sinai Health System. **Qualifications** + BA or BS degree minimum, in a relevant field of study; Masters degree preferred. + 2 years minimum is preferred in ... Medicare regulations and related reporting requirements, such as STARS,QARR, MMCOR, MEDS, RAPS and HEDIS is a strong plus. + Experience working in a health plan or… more
    Mount Sinai Health System (10/17/24)
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  • Temporary Integrated Transitional Care Specialist

    ManpowerGroup (Rancho Cucamonga, CA)
    …Telecommute (once or twice a month onsite)** **Key Responsibilities:** 1. Assist the Nurse or Social worker in identifying Members who are appropriate to transition ... IEHP's Quality Program goals including, but not limited to, HEDIS , CAHPS, and NCQA Accreditation. **Responsibilities:** **Qualifications:** **Education &… more
    ManpowerGroup (10/11/24)
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  • Center Clinical Manager

    ChenMed (Philadelphia, PA)
    …and execution of business strategies that increase revenue and quality ratings ( HEDIS /STARS/Clinical Gaps) and support our core model. + Develops protocols and ... in Business or Healthcare Administration or a healthcare related field preferred + Active and good standing Licensed Practical... preferred + Active and good standing Licensed Practical Nurse (LPN) in current state of employment **OR** a… more
    ChenMed (09/06/24)
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