- 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
- Providence (OR)
- …Assistant, or Licensed Practical Nurse + 1+ years' experience in the medical field as a Medical Assistant, Certified Nurse Assistant, or Licensed Practical ... empower them._** **Providence Health Plan is calling a Coding Quality Auditor, HEDIS who will:** + Be responsible for conducting clinical quality audits/overreads… more
- 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
- 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
- CenterWell (Atlanta, 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
- 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 (Springfield, IL)
- …market trends and oversee functions of quality improvement programs for HEDIS , CAHPS, and/or HOS strategy and related quality improvement activities. Assists ... conclusions to determine appropriate solutions. + Conduct evaluations to assist with HEDIS gap closure, CAHPS and/or HOS performance and assess for potential pilot… more
- Molina Healthcare (NM)
- **_JOB TITLE: Sr. Specialist, Quality Improvement RN (REGISTERED NURSE )_** **JOB DESCRIPTION** **Job Summary** Molina's Quality Improvement function oversees, plans, ... compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist, Quality Improvement (Registered Nurse ) contributes to one or more of these quality… more
- 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
- 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
- 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
- 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
- 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
- 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
- Bayer (Detroit, MI)
- …and may not align to evidence-based guidelines. Key foundations are:* HEDIS measurements* Quality metrics* Real world evidence* Establish evidence-based pathways.* ... services* Review of process to identify gaps post implementation.* Lead and coordinate field sales pull through. **WHO YOU ARE** Bayer seeks an incumbent who… more
- Molina Healthcare (GA)
- …Master's degree in Nursing, Gerontology, Public Health, Social Work or related field . **Required Experience** + 5+ years of managed healthcare experience, including ... to population health and case management program requirements, as well as HEDIS and STARs._ **Preferred License, Certification, Association** Any of the following:… more
- UCLA Health (Los Angeles, CA)
- …required + A Certified Risk Adjustment Coder (CRC), required + Registered Nurse (RN) or clinical qualifications a plus + Bachelor's degree (healthcare or ... relevant field ) or equivalent experience/training + Five or more years...HCPCS coding systems required + Knowledge of Medicare Advantage STARS/ HEDIS program and NCQA technical specifications, required + Knowledge… more
- 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
- 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
- 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