- 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
- 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 (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
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …reviewers. He/she will assist the Program Manager in the training of all temporary HEDIS review staff and will provide direct supervision of temporary staff as ... to meet our accreditation and regulatory requirements. Job Responsibilities: The HEDIS Medical Record Specialist will assist the Program Manager in preparing… more
- Veterans Affairs, Veterans Health Administration (Wilmington, NC)
- …of accreditation and regulatory activities.- Healthcare Effectiveness Data and Information Set ( HEDIS ) Measures The Quality Nurse is also responsible and ... Summary The Quality Nurse is accountable to the Assistant Chief, Quality...He/she may also interact with employees of external peer review organizations, accrediting bodies, community healthcare entities, veteran service… more
- 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
- The Cigna Group (Baltimore, MD)
- …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 4) Proficient level of experience with Microsoft Office… more
- 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
- CenterWell (Madison, TN)
- …part of our caring community and help us put health first** The Nurse Practitioner (VSP/PT) applies advanced education and clinical competencies to achieve optimal ... patient outcomes. The Nurse Practitioner (VSP/PT) works on problems of diverse scope...Leadership. . Meets with RMD about quality of care, review of outcome data, policy, procedure, and records issues.… more
- CenterWell (Frankfort, KY)
- …teamwork and providing a positive and welcoming environment for all. Responsibilities: The Nurse Practitioner (NP) works in our team-based care environment. We are a ... team consists of doctors, advanced practice professionals, Pharm D, Care Coach Nurse , MA, Behavioral health specialist, Quality based Coder, Referral Coordinator and… more
- 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 (Sun City, AZ)
- …teamwork and providing a positive and welcoming environment for all. The Nurse Practitioner (VSP/PRN) 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
- Commonwealth Care Alliance (Boston, 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
- Elevance Health (Walnut Creek, 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
- Centene Corporation (Jefferson City, MO)
- …field or equivalent work experience within a managed care environment related to HEDIS record review , quality improvement, medical coding or transferable skill ... or related field. Candidate Experience: Required: 1+ year of experience in related HEDIS medical record review or quality improvement with experience in data… more
- Sea Mar Community Health Centers (Aberdeen, WA)
- …in the Care Team Huddle to ensure the collection of all relative clinic forms, quality/ HEDIS measures, lab and x-ray reports and review of the Patient Manager ... not limited to: Joint Commission, NPSG, Department of Health, HEDIS , PCMH, QI and other contractual obligations. + Demonstrates...Ability to attend up to four (4) in-person lab skills/ review days within a three-hour drive of their workplace.… more
- HCA Healthcare (Salt Lake City, UT)
- …high-risk, multi-morbidity patient populations.** **What qualifications you will need:** + Registered Nurse + Graduate of an accredited college of nursing + Working ... Medical Home (PCMH), government programs (CMS), accountable care organizations (ACOs), HEDIS , and experience with payor cost sharing initiatives + Excellent oral… more
- University of Miami (Miami, FL)
- …preferred + Completion of Medicare annual wellness exam documentation preferred + Knowledge of HEDIS Quality Care Gaps - review and closure preferred + Knowledge ... faculty or staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . APP, Supervisor -… more
- Dignity Health (Bakersfield, CA)
- …as assigned. **Qualifications** **Minimum Qualifications:** - CA Clinical licensure (Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Clinical ... clinical and non-clinical quality management staff. - 3 years HEDIS measures reporting and experience in CMS Stars, P4P,...Value Based Payment Programs. - 3 years Medical record review project management. - Bachelor's degree or equivalent in… more
- VNS Health (Manhattan, NY)
- …interdepartmental quality improvement activities such as development and engagement, clinical review , clinical risk management, and patient satisfaction. Serves as a ... care providers or specialist to address non-adherence and/or clinical diagnosis for HEDIS /QARR exclusion. + Participates and leads improvement teams and projects and… more
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