• Quality Improvement ( RN ) - Maternity…

    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 ... QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist, Quality Improvement ( Registered Nurse ) contributes to one or more of… more
    Molina Healthcare (10/20/24)
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  • LPN or RN Nurse Case Manager

    The Cigna Group (Bloomfield, CT)
    …requires working onsite at providers office. **Experience** : + Current Licensure as a registered nurse , in the state of residence in good standing. + Associates ... case-management, or utilization management position (experience can be a combination of LVN/ RN licensure) + Previous HEDIS and/or CMS STARs experience a… more
    The Cigna Group (10/10/24)
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  • Nurse Manager ( RN or LPN)

    Sea Mar Community Health Centers (Tacoma, WA)
    Nurse Manager - Posting #25738 Salary Rate: $74,958.09 (LPN) - $92,444.35 ( RN ) Position Summary: Full-time Nurse Manager ( RN or LPN) position ... a Patient Centered Medical Home (PCMH) level III. The Nurse Manager works in conjunction with Health...experience in nursing supervision as well as management experience preferred . + Ideal candidates would be Registered more
    Sea Mar Community Health Centers (10/30/24)
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  • Nurse Manager ( RN or LPN)

    Sea Mar Community Health Centers (Puyallup, WA)
    …a mandatory COVID-19 and flu vaccine organization Nurse Manager - Posting #26096 Nurse Manager RN Annual Salary: $85,470.00 Nurse Manager LPN ... Annual Salary: $74,958.09 Position Summary: Full-time Nurse Manager position available for our Medical Clinic in Puyallup,...up to 50 pounds. Requirements: + Must be a Registered Nurse , BSN, LPN or equivalent and… more
    Sea Mar Community Health Centers (08/14/24)
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  • Nurse Manager ( RN or LPN)

    Sea Mar Community Health Centers (Vancouver, WA)
    …for the following position(s): Sea Mar is a mandatory COVID-19 and flu vaccine organization Nurse Manager ( RN or LPN) - Posting #26861 Hourly Rate: $36.04 ... Annual Salary: $74,958.09 - 92,444.35 (depending on experience) Position Summary: Full-time Nurse Manager position available for our Vancouver - Salmon Creek… more
    Sea Mar Community Health Centers (09/12/24)
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  • RN -Utilization Management

    ERP International (Nellis AFB, NV)
    **Overview** ERP International is seeking ** Registered Nurse ( RN ) Utilization Managers** for full-time positions in support of theMike O'Callaghan Military ... admissions, including all eligible beneficiaries, to civilian hospitals and notifies Clinical Nurse Case Manager and Patient Administration Element as required.… more
    ERP International (11/02/24)
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  • Nurse Case Manager - Boston…

    Fallon Health (Boston, MA)
    …field preferred **License/Certifications:** + Active, unrestricted license as a Registered Nurse in Massachusetts; current Driver's license and reliable ... Facebook, Twitter and LinkedIn** **Brief Summary of Purpose:** The Nurse Case Manager (NCM) is an integral...**Experience:** + 1+ years of clinical experience as a Registered Nurse managing chronically ill members or… more
    Fallon Health (10/09/24)
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  • Senior Manager , Practice Innovation

    University of Virginia (Charlottesville, VA)
    …. + Graduate of an accredited program of clinical specialty; ie MD, DO, RN , Pharmacy, Social Work or Therapy Services preferred . **Experience:** + Minimum of ... to develop relevant in-person and online educational trainings on priority HEDIS quality measures, complex diagnosis documentation for improved risk adjustment, and… more
    University of Virginia (11/07/24)
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  • Clinical Nurse , Federal Employee Program…

    Blue KC (Workman, MN)
    …Knowledge of NCQA guidelines and state and federal regulations + Valid and active Registered Nurse compact licensure in Missouri and/or Kansas + Case Management ... or within 3 years of transferring into the Case Manager role + Membership of local Case Management Society...Office applications such as Word, Excel and Power Point ** Preferred Qualifications:** + Bachelor's degree in nursing with minimum… more
    Blue KC (11/05/24)
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  • Manager Quality and Patient Safety

    Penn Medicine (Bala Cynwyd, PA)
    …Cape May & Somers Point)** Summary: The Quality and Patient Safety Manager participates in the planning, implementation and evaluation of the quality, patient ... safety and operational performance improvement program. The Manager serves as the project manager for...hire. + If applicant holds a clinical license (eg RN ), proof of active licensure is required. Education or… more
    Penn Medicine (09/27/24)
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  • Supervisor, Transitional Care Services

    LA Care Health Plan (Los Angeles, CA)
    …Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and ... Worker (LCSW) - Active, current and unrestricted California License Licenses/Certifications Preferred Certified Case Manager (CCM) Required Training Physical… more
    LA Care Health Plan (10/26/24)
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  • Specialist, Provider Engagement (Remote in Detroit…

    Molina Healthcare (Flint, MI)
    …Professional in Health Quality (CPHQ) + Nursing License ( RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) + Experience ... for key performance measurement activities. **Experience with quality, providers and HEDIS is very important for this position. Please highlight this experience… more
    Molina Healthcare (10/18/24)
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  • Sr Specialist, Quality Interventions/QI Compliance…

    Molina Healthcare (AZ)
    … Education** Preferred field: Clinical Quality, Public Health or Healthcare. ** Preferred Experience** + Experience in Quality/ HEDIS . + 1 year of health ... in Health Quality (CPHQ) + Active, unrestricted Nursing License ( RN may be preferred for specific roles)...preferred for specific roles) + Active, unrestricted Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees:… more
    Molina Healthcare (10/10/24)
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  • Specialist, Quality Interventions/QI Compliance…

    Molina Healthcare (West Seattle, WA)
    …Certified Professional in Health Quality (CPHQ) + Nursing License ( RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all ... NCQA accreditation surveys and federal/state QI compliance activities. Experience with QUALITY/ HEDIS is important for this position. Please include any experience in… more
    Molina Healthcare (10/04/24)
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  • CenterWell Physician Lead

    CenterWell (Jackson, MS)
    …to the strategic intent Overseeing other clinicians which includes Physicians, Advanced Registered Nurse Practitioners (ARNP), and Physicians Assistants (PA) in: ... per Month (PMPM) costs while maintaining high quality care + Optimizing network; preferred network specialists - contributing to the identification of preferred more
    CenterWell (10/30/24)
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  • Senior Provider Engagement Specialist

    Molina Healthcare (Seattle, WA)
    …Certified Professional in Health Quality (CPHQ) * Nursing License ( RN may be preferred for specific roles) * Certified HEDIS Compliance Auditor (CHCA) To all ... activities and results to identify opportunities for improvement. + Surfaces to Manager and Director any gaps in processes that may require remediation. +… more
    Molina Healthcare (10/27/24)
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  • Public Health Educator/Senior Strategist

    ERP International (Camp Pendleton, CA)
    …strategies. * Collaborate with the Healthcare Effectiveness Data and Information Set ( HEDIS ) Clinical Quality Teams on a monthly basis to evaluate primary, ... tertiary prevention efforts relating to all NHCP/NMRTC Camp Pendleton-specific HEDIS metrics of success as informed by Command for...and Command no show rates. * The PHP Program Manager shall develop an overarching training program detailing PHP… more
    ERP International (09/17/24)
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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 ... is the territory/market that they will work in._ The **Wellness Nurse Consultant** position is responsible for developing and recommending customized, group-specific… more
    Elevance Health (10/11/24)
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  • Clinical Data Audit Consultant

    Centene Corporation (Sacramento, CA)
    …and quality measures + Reviews, analyzes, and interprets data for required HEDIS , URAC, NCQA compliance, and related reporting for clinical service teams + ... + Supports Clinical Supervisors in tracking of monthly Care Manager audit results + Works with Data Analysis Department...Masters in Social Work, Counseling, Nursing, or related field preferred + Three to five years case management or… more
    Centene Corporation (10/24/24)
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  • Behavioral Health Clinical Quality Audit Analyst…

    Elevance Health (Seven Fields, PA)
    …delegated responsibilities. ** Preferred Qualifications:** + Prefer LCSW, LSW, LPC or RN license + Strong knowledge of ASAM and substance use disorder experience ... annual and ad hoc medical record reviews such as HEDIS and CPG compliance. + Conducts quality of care...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
    Elevance Health (10/04/24)
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