• Quality Management Nurse Consultant

    CVS Health (Phoenix, AZ)
    …time. The QM Nurse Consultant is a work at home role. Experienced HEDIS record review nurse will be responsible for obtaining, reviewing, abstracting, ... and affordable. **Position Summary** This is a fulltime Quality Management Nurse Consultant opportunity within Arizona. The working schedule is Monday- Friday… more
    CVS Health (10/26/24)
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  • Clinical Nurse Auditor, HEDIS

    Providence (WA)
    …facilitation, data analysis and or case review + Experience working as a Nurse supporting a minimum of one HEDIS Audit season **Why Join Providence Health ... empower them._** **Providence Health Plan is calling a Clinical Nurse Auditor, HEDIS who will:** + Be...specifications for the Healthcare Effectiveness and Data Information Set ( HEDIS ) program + Conduct Audits, which include review more
    Providence (10/30/24)
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  • HEDIS Overreader Registered Nurse

    Insight Global (Philadelphia, PA)
    …patient's care needs. The HEDIS nurse focuses solely on using HEDIS measuring criteria to review health plans in accordance with healthcare facility ... in PA or NJ. This is a fully remote position and requires previous HEDIS review experience. This person will be responsible for Quality Check of FDC/ HEDIS more
    Insight Global (10/01/24)
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  • HEDIS Registered Nurse or LPNs…

    Insight Global (Philadelphia, PA)
    …) Strong computer skills Ability to occasionally travel to local providers Previous HEDIS review experience or experience with Utilization Review , Quality, ... Description A client of Insight Globals is looking for HEDIS RNs or LPNs for a partially remote contract...of medical records assigned by a Clinical Quality Lead nurse . Miles will be reimbursed for any travel. Computer… more
    Insight Global (10/01/24)
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  • Remote - HEDIS Nurse

    Actalent (Columbia, SC)
    …results to HEDIS standards and/or custom or other measure set standards + Review medical records and abstract data for HEDIS and other measure sets in ... Immediate hiring for "Remote HEDIS Nurses" in US ! Job Description: +...data collection and abstraction for company quality measures, including HEDIS , CMS, CHIPRA and/or any other custom measurements. +… more
    Actalent (11/24/24)
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  • HEDIS Nurse (Remote)

    Actalent (Austin, TX)
    …results to HEDIS standards and/or custom or other measure set standards + Review medical records and abstract data for HEDIS and other measure sets in ... Actalent is currently hiring for Remote HEDIS Nurses (RN/LPN)! Job Description: + Lead data...data collection and abstraction for company quality measures, including HEDIS , CMS, CHIPRA and/or any other custom measurements. +… more
    Actalent (11/22/24)
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  • HEDIS Nurse - REMOTE

    Actalent (Austin, TX)
    …CMS, and CHIPRA * Assess vendor-delegated abstraction activities and compare results to HEDIS standards and/or custom * Review medical records and abstract data ... and vendors Additional Skills & Qualifications * Recent experience with HEDIS , NCQA, Quality Initiatives/Standards. * Previous HEDIS abstraction/overread… more
    Actalent (11/09/24)
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  • Coding Quality Auditor, HEDIS *Remote

    Providence (OR)
    …using objective specifications for the Healthcare Effectiveness and Data Information Set ( HEDIS ) program + Conduct Audits inclusive of review of outpatient ... **Providence Health Plan is calling a Coding Quality Auditor, HEDIS who will:** + Be responsible for conducting clinical...GED Equivalency + Licensure / Certification: Medical Assistant, Certified Nurse Assistant, or Licensed Practical Nurse +… more
    Providence (11/16/24)
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  • HEDIS Quality LPN

    Robert Half Accountemps (Houston, TX)
    …a short-term contract employment opportunity. Responsibilities: * Assist in medical records review to identify Star/ HEDIS opportunities for the medical staff. * ... /STARs. * Perform datamining tasks. Requirements . Licensed Practical Nurse . Minimum 2 year HEDIS experience and/or knowledge . Solid knowledge of managed care… more
    Robert Half Accountemps (11/21/24)
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  • Senior Medical Management Nurse - VCHCP

    Ventura County (Ventura, CA)
    …years of full-time experience in Case Management, Disease Management, Quality Assurance, HEDIS and/or Utilization Review . NECESSARY SPECIAL REQUIREMENTS + Must ... Senior Medical Management Nurse - VCHCP Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4591361) Apply  Senior Medical Management Nurse -… more
    Ventura County (11/12/24)
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  • Registered Nurse - Outpatient Clinics

    Veterans Affairs, Veterans Health Administration (Augusta, GA)
    Summary The Registered Nurse is assigned to a designated unit and is accountable to the Nurse Manager for the area. The Registered Nurse understands ... tracks, devises strategies to improve Healthcare Effective Data Information Sets ( HEDIS ) metrics, clinical reminders, panel access, timely encounter closures, other… more
    Veterans Affairs, Veterans Health Administration (10/26/24)
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  • Registered Nurse -In Home Primary Care-…

    The Cigna Group (Houston, TX)
    …about their care options and make specific recommendations based on their goals 4. Review paperwork for patients to ensure it meets all requirements 5. Explain test ... and participates in patient education and outreach tied to HEDIS initiatives 4. Works to improve access to care...needed 3) 3+ years of experience as a Registered Nurse with experience in internal medicine or adult medicine… more
    The Cigna Group (11/22/24)
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  • LPN or RN Nurse Case Manager (Onsite…

    The Cigna Group (Bloomfield, CT)
    …manage relationships with participating provider practices. Maintain detailed understanding of HEDIS / STAR performance measures. Develop and maintain a process to ... knowledge- able to type 35WPM. + Knowledge of utilization review requirements and procedures. + Knowledge of current health...office. **Experience** : + Current Licensure as a registered nurse , in the state of residence in good standing.… more
    The Cigna Group (10/10/24)
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  • Quality Improvement (RN) - Maternity (OB/GYN)

    Molina Healthcare (Ypsilanti, MI)
    …Quality Reporting + Performs the lead role in the coordination and preparation of the HEDIS medical record review which includes ongoing review of records ... _For this position we are seeking a (RN) Registered Nurse who must live and have a current active...submitted by providers and the annual HEDIS medical record review . The Senior Specialist… more
    Molina Healthcare (10/20/24)
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  • Nurse Practitioner Bilingual Spanish…

    CenterWell (Sun City, AZ)
    …focused on teamwork and providing a positive and welcoming environment for all. The Nurse Practitioner (NP) works in our team-based care environment. We are a value ... team consists of doctors, advanced practice professionals, Pharm D, Care Coach Nurse , MA, Behavioral health specialist, Quality based Coder, Referral Coordinator and… more
    CenterWell (11/25/24)
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  • Nurse Practitioner

    CenterWell (Savannah, GA)
    …on teamwork and providing a positive and welcoming environment for all. The Nurse Practitioner (NP) works in our team-based care environment. We are a value-based ... team consists of doctors, advanced practice professionals, Pharm D, Care Coach Nurse , MA, Behavioral health specialist, Quality based Coder, Referral Coordinator and… more
    CenterWell (11/22/24)
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  • Nurse Practitioner / Physician Assistant…

    CenterWell (Sun City, AZ)
    …teamwork and providing a positive and welcoming environment for all. The Nurse Practitioner (VSP/PT) provides health promotion and maintenance through the diagnosis ... team consists of doctors, advanced practice professionals, Pharm D, Care Coach Nurse , MA, Behavioral health specialist, Quality based Coder, Referral Coordinator and… more
    CenterWell (11/19/24)
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  • Primary Care Nurse Practitioner/Physician…

    Commonwealth Care Alliance (Springfield, MA)
    …etc. + Identify and initiate a plan to meet quality, STAR, and HEDIS measures. + Conduct Annual Visits with patients, taking a detailed history, performing ... or hospitalization. Such visits include a detailed history of present illness, review of systems, physical exam, ordering of appropriate studies and tests,… more
    Commonwealth Care Alliance (11/26/24)
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  • SCO Nurse Case Manager-Lowell/Lawrence Area

    Fallon Health (Lawrence, 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 ... providers and office staff and may lead care plan review with providers and care team as applicable +...policies and processes + Knowledge of and compliance with HEDIS and Medicare 5 Star measure processes, performing member… more
    Fallon Health (11/09/24)
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  • Wellness Nurse Consultant

    Elevance Health (Sacramento, 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 (11/12/24)
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