• 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 (12/31/24)
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  • HEDIS Quality Improvement Analyst I

    Medical Mutual of Ohio (Brooklyn, OH)
    …Works with IT and Clinical Nurse staff to aid in the loading of HEDIS data and collection of medical records. Works closely with HEDIS vendor support to ... specifications for the annual Healthcare Effectiveness Data and Information Set ( HEDIS ) lifecycle processes for all lines of business (Commercial, Marketplace,… more
    Medical Mutual of Ohio (12/04/24)
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  • LCSW / LCPC / PMH-BC - HEDIS Clinical…

    Centene Corporation (Springfield, IL)
    …function of this role is making telephonic outreach to members to help close HEDIS gaps. This is a work-from-home, hybrid-remote role with very limited (up to 10%) ... Illinois-based Registered Nurses (RN) or Licensed Clinical Social Workers (LCSW) with HEDIS quality improvement experience. The schedule is 8-4:30 or 5 PM central… more
    Centene Corporation (01/10/25)
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  • Nurse Practitioner

    CenterWell (Covington, 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 (01/29/25)
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  • Wellness Nurse Consultant

    Elevance Health (Wallingford, CT)
    **Wellness Nurse Consultant** **Sign Bonus: $5000** **Federal Employee Program - FEP** , a proud member of the Elevance Health, Inc. family of companies, it is a ... 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 (02/01/25)
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  • Associate Quality Practice Advisor

    Centene Corporation (Jefferson City, MO)
    …sites in regards to the National Committee for Quality Assurance (NCQA) HEDIS measures. Provides education for HEDIS measures, appropriate medical record ... deficiencies impacting plan compliance to meet State and Federal standards for HEDIS . + Under general guidance form Senior Quality Practice Advisors and management,… more
    Centene Corporation (01/10/25)
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  • Patient Care Advocate

    Centene Corporation (Honolulu, HI)
    …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 (02/01/25)
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  • Provider Quality Liaison

    Centene Corporation (Little Rock, AR)
    …plan providers regarding quality initiatives and key quality performance indicators. Shares HEDIS , CAHPS, HOS, Part D and Administrative Operations reports and gap ... providers with existing resources to educate provider practices in appropriate HEDIS (Healthcare Effectiveness Data and Information Set) measures, medical record… more
    Centene Corporation (01/10/25)
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  • Quality Improvement Coordinator - Behavioral…

    Centene Corporation (Olympia, WA)
    …plan goals including applicable Healthcare Effectiveness Data and Information Set ( HEDIS ) measures and program evaluation (trilogy documents) for behavioral health + ... and grievances **Education/Experience:** Associate's degree in Nursing or other related field of study. 2+ years' experience in Clinical Nursing or Behavioral… more
    Centene Corporation (01/17/25)
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  • Process Improvement Specialist (Clinical)

    Centene Corporation (New Orleans, LA)
    …all clinical initiatives including, case and disease management, behavioral health and HEDIS outcome measures + Evaluate the analysis and responses on all quality ... policies and standards **Education/Experience:** Bachelor's degree in Healthcare, related field , or equivalent experience. 5+ years of process improvement… more
    Centene Corporation (01/16/25)
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  • Senior Quality Improvement Professional

    Humana (Tallahassee, FL)
    …experience + Understanding of healthcare quality measures such as CAHPS, NCQA, HEDIS , etc. + Previous Health Plan quality experience + Intermediate to Advanced ... Word, Excel and PowerPoint, **Preferred Qualifications** + Active licensed nurse in the state of Florida or Enhanced ...action + Master's degree in business, healthcare, or related field + Experience with QI methodologies (ie, IHI model… more
    Humana (01/31/25)
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  • Manager Clinical Quality Improvements

    Dignity Health (Bakersfield, CA)
    …as assigned. **Qualifications** **Minimum Qualifications:** - CA Clinical licensure (Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Clinical ... of clinical and non-clinical quality management staff. - 3 years HEDIS measures reporting and experience in CMS Stars, P4P, ACO and… more
    Dignity Health (01/11/25)
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  • EPSDT Coordinator (Must Reside in MS, LPN/LVN…

    Molina Healthcare (Jackson, MS)
    …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 (01/09/25)
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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 (01/11/25)
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  • Health Coach (On-Site) ~ Central Valley Health…

    Trinity Health (Fresno, CA)
    …requirements of Medicare STARS, Healthcare Effectiveness Data and Information Set ( HEDIS ), and Hierarchical Condition Categories (HCC) with provider staff to ... 1. Bachelor's degree in Nursing, Health Education, or related field is required. High school diploma or equivalent and...or equivalent and current licensure as a Licensed Vocational Nurse (LVN) in the State of California and three… more
    Trinity Health (01/07/25)
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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 (12/17/24)
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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 (01/28/25)
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  • Clinical Manager

    ChenMed (Cleveland, OH)
    …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 (01/24/25)
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  • Quality Training Educator, Physician Support…

    Ascension Health (Zionsville, IN)
    …**Location:** Hybrid Bachelor's degree in health care administration, business or related field or Bachelor's degree in Nursing or related fieldpreferred. 5+ years ... or clinical education experience, preferably in quality management preferred. Nurse Clinical Informaticist, preferred Quality improvement experience 3 years or… more
    Ascension Health (01/18/25)
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  • Data Science Analyst III - Mount Sinai Health…

    Mount Sinai Health System (New York, NY)
    …in project initiatives. **Qualifications** BA or BS degree required in a relevant field of study; Master?s degree preferred. 7 years minimum, higher 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 (12/12/24)
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