• HEDIS RN - Quality Auditor

    US Tech Solutions (Newark, NJ)
    …of related experience, preferably in the healthcare industry. + **Active New Jersey Registered Nurse ( RN ) License required.** **Skills:** + Knowledge of ... months contract with potential extends or Convert** **Job Description:** + The HEDIS Nurse Auditor is responsible for conducting quality audits related to state… more
    US Tech Solutions (11/20/25)
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  • Quality RN

    CenterWell (North Charleston, SC)
    …excellence **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) without restriction in applicable state + ... community and help us put health first** The Quality RN Professional responsible for the development, implementation and management...clinical nursing experience + Proven work experience as a HEDIS Nurse or similar role in healthcare… more
    CenterWell (10/16/25)
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  • Quality RN - Hoffner

    CenterWell (Orlando, FL)
    …excellence **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) without restriction in applicable state + ... RN experience **Preferred Qualification** + Strong knowledge of HEDIS /Stars/CMS + Bachelor's Degree in Nursing + 3+ years...unless otherwise specified + Proven work experience as a HEDIS Nurse or similar role in healthcare… more
    CenterWell (11/19/25)
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  • Quality Improvement RN - New Smyrna/Daytona

    CenterWell (New Smyrna Beach, FL)
    …operational excellence **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) without restriction in Florida + 5+ ... us put health first** The Stars Improvement Clinical Professional ( RN ): + Collaborates with market leadership, and quality improvement...clinical nursing experience + Proven work experience as a HEDIS Nurse or similar role in healthcare… more
    CenterWell (10/16/25)
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  • Sr. HEDIS Coordinator- Remote (Must…

    UPMC (Pittsburgh, PA)
    …outside of the realm of Treatment, Payment, or Operations are appropriately logged. + Registered nurse with BSN. + Minimum of 2 years experience working as ... Health Plan has an exciting opportunity for a Sr. HEDIS Coordinator position in the Quality Improvement department. This...Pittsburgh or surrounding area to be considered! The Sr. HEDIS Coordinator will assists with the management of … more
    UPMC (12/12/25)
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  • Urgent Care Registered Nurse

    InGenesis (Fremont, CA)
    InGenesis is seeking an Urgent Care Registered Nurse to join our team in support of our client. In this essential role, you will collaborate with physicians and ... a diverse, often underserved population. As an urgent care registered nurse and physician extender, you'll assess...Improvement & Population Health: * Contribute to UDS and HEDIS measure performance through proactive panel management. * Help… more
    InGenesis (10/18/25)
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  • Nurse Manager ( RN or LPN)

    Sea Mar Community Health Centers (Tacoma, WA)
    …up to 10 pounds and occasionally lift and/or move up to 50 pounds. Requirements: + Registered Nurse , BSN, ADN and licensed to practice nursing in the State of ... - Posting #25738 Salary Rate: $74,958.09 (LPN) - $92,444.35 ( RN ) Position Summary: Full-time Nurse Manager (...Focus clinic efforts on patient satisfaction, clinical quality measures, HEDIS , and Meaningful Use standards. + Provide annual MA… more
    Sea Mar Community Health Centers (10/28/25)
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  • Nurse Manager ( RN or LPN)

    Sea Mar Community Health Centers (Puyallup, WA)
    …and occasionally lift and/or move up to 50 pounds. Requirements: + Must be a Registered Nurse , BSN, LPN or equivalent and licensed to practice nursing in the ... vaccine organization Nurse Manager - Posting #26096 Nurse Manager RN Annual Salary: $85,470.00 ...or hospitals + Focus clinic efforts on quality measures, HEDIS , and Meaningful Use standards + Provide annual MA… more
    Sea Mar Community Health Centers (11/10/25)
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  • Senior Medical Management Nurse - VCHCP

    Ventura County (Ventura, CA)
    …CNA_MOA_2023-2028.pdf (ventura.org) (https://vcportal.ventura.org/CEO/HR/MOA/docs/CNA\_MOA\_2023-2028.pdf) PAYROLL TITLE: Senior Registered Nurse - Ambulatory ... Care DISTINGUISHING CHARACTERISTICS: The Senior Registered Nurse -Ambulatory Care series is distinguished from other nursing classifications in that they are… more
    Ventura County (12/07/25)
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  • Nurse Manager ( RN or LPN)

    Sea Mar Community Health Centers (Lacey, WA)
    …for the following position(s): Sea Mar is a mandatory COVID-19 and flu vaccine organization Nurse Manager ( RN or LPN) - Posting #27416 Hourly Rate: $36.04 - ... Salary: $74,958.09 - 92,444.35 (depending on license/experience) Position Summary: Full-time Nurse Manager position available for our Lacey Medical Clinic, may also… more
    Sea Mar Community Health Centers (12/16/25)
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  • RN

    Catholic Health Services (Melville, NY)
    Overview Position Summary: The Registered Nurse provides safe, direct patient care utilizing the nursing process in the ambulatory setting. The RN provides ... clinical leadership and is a resource for staff. The Registered Nurse must show an uncompromising commitment...staff meetings and huddles as appropriate. + Participates in Hedis , GPRO, and other quality programs as needed +… more
    Catholic Health Services (12/16/25)
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  • Senior Stars Clinical Consultant RN

    Humana (Gainesville, FL)
    …operational excellence **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) without restriction in Florida + 5 ... and is not fully remote. The Senior Stars Improvement, Clinical Professional ( RN ) is responsible for the development, implementation and management oversight of the… more
    Humana (12/07/25)
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  • Utilization Review RN

    Community Health Systems (Naples, FL)
    Join us as a ** Registered Nurse ( RN ) - Utilization Review position** at Physicians Regional Collier Unit: Utilization Review Shift: Mon-Fri (this is an ... nursing experience required + 1-2 years of experience in HEDIS , MIPS, PQRS, ACO, STARS programs preferred **Knowledge, Skills...patient-centered service and continuous improvement. **Licenses and Certifications** + RN - Registered Nurse -… more
    Community Health Systems (11/20/25)
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  • Value Based Care Management Senior Analyst…

    Health Care Service Corporation (Mobile, AL)
    …healthcare outcomes for customers. **Required Job Qualifications:** + Current Licensure as a registered nurse , in the state of residence in good standing. + ... utilization management position (experience can be a combination of LVN/ RN licensure) + Previous HEDIS and/or CMS...a combination of LVN/ RN licensure) + Previous HEDIS and/or CMS STARs experience a plus. **Preferred Job… more
    Health Care Service Corporation (10/28/25)
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  • Health Plan Nurse Coordinator

    Actalent (Santa Barbara, CA)
    …+ Experience with HEDIS medical record abstraction. Additional Skills & Qualifications + Registered Nurse ( RN ) license. + Bilingual skills in Spanish may ... Health Plan Nurse CoordinatorJob Description The Health Plan Nurse Coordinator is a Registered Nurse assigned to various Health Services operational… more
    Actalent (12/11/25)
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  • RN Case Manager - Value Based Service Org…

    University of Southern California (Alhambra, CA)
    …InterQual guidelines, and Medicaid/Medicare contracts and benefit systems. Required Licenses/Certifications: + Req Registered Nurse - RN (CA DCA) + Req Basic ... the status and processing of requests received from ambulatory care management nurse . 8. Assesses ongoing discharge planning needs and documents is computer system… more
    University of Southern California (11/19/25)
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  • Case Manager, Maternity ( RN or LMSW)

    Excellus BlueCross BlueShield (Rochester, NY)
    …varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... being met, such as NYS DOH, CMS, NCQA, and HEDIS , serving as internal auditor within the group. +...Associates degree required. Bachelor's degree preferred. + Active NYS RN or Registered Dietician or Physical Therapist… more
    Excellus BlueCross BlueShield (11/26/25)
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  • Nurse Case Manager - Senior Care Options…

    Fallon Health (Worcester, MA)
    …care related field preferred. **License** : Active, unrestricted license as a Registered Nurse in Massachusetts **Certification** : Certification in Case ... Program policies and processes Knowledge of and compliance with HEDIS and Medicare 5 Star measure processes, performing member...**Experience:** * 1+ years of clinical experience as a Registered Nurse managing chronically ill members or… more
    Fallon Health (12/23/25)
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  • Health Plans Licensed Practical Nurse LPN…

    Banner Health (AZ)
    …employment settings by including remote and hybrid opportunities. As a **Licensed Practical Nurse (LPN)** for **Banner Health Plans** , you will be an integral part ... This position is also responsible for assisting the QM RN with the investigation and research of quality of...analysis of data from medical records in accordance with HEDIS specifications. Actively works with the HEDIS more
    Banner Health (11/27/25)
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  • Senior Specialist, Quality Program Management…

    Molina Healthcare (Tucson, AZ)
    …quality investigations, preferably in a managed care setting, or equivalent experience * Registered Nurse . License must be active and unrestricted in state of ... improvement experience. * Knowledge of Healthcare Effectiveness Data Information Set ( HEDIS ) and National Committee for Quality Assurance (NCQA). * Strong attention… more
    Molina Healthcare (11/20/25)
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