- Actalent (Chicago, IL)
- Job Title: HEDIS Review SpecialistJob Description - Will be calling out to providers and doctors' offices to retrieve medical information and ask any follow-up ... audits and provider clean-up. - Will be part of the HEDIS team during the Jan-May season. Review medical records from all 5 states. Abstracting 6 medical records… more
- 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
- Actalent (Dallas, TX)
- Description: We are seeking a dedicated and meticulous HEDIS Nurse to assist with the collection, analysis, and presentation of healthcare data. The HEDIS ... deep understanding of healthcare systems and regulations. Ultimately, the HEDIS Nurse ensures that our healthcare services...standards and/or custom or other measure set standards * Review medical records and abstract data for HEDIS… more
- Providence (Beaverton, OR)
- …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
- Robert Half Accountemps (San Antonio, TX)
- Description We are seeking a quick-thinking and detail-oriented HEDIS Nurse Chart Abstractor who is passionate about healthcare and improving service delivery ... the development of new data processes to improve overall HEDIS measures. Responsibilities: + Review and abstract...to HIPAA privacy rules and regulations. Requirements + Registered Nurse (RN) or Licensed Practical Nurse (LPN)… 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
- Robert Half Accountemps (San Antonio, 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
- 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
- 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
- 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 (Philadelphia, PA)
- …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 (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
- MyFlorida (Defuniak Springs, FL)
- SENIOR LICENSED PRACTICAL NURSE - 64036829 Date: Nov 4, 2024 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... Agency: Department of Health Working Title: SENIOR LICENSED PRACTICAL NURSE - 64036829 Pay Plan: Career Service Position Number:...the end of the clinic visit. + Performs Chart Review as directed for QA/QI. + Documents lab work… more
- CenterWell (Wichita, KS)
- …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 (Las Vegas, NV)
- …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 (Austin, TX)
- …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
- Humana (Columbus, OH)
- …requires US citizenship for this position.** The **Clinical Quality Registered Nurse (RN)** collects and reviews records, summarizes issues, works with Medical ... Coordinates case presentations and presents to Patient Safety Peer Review Committee. Audits quality cases for compliance and participates...years of clinical nursing experience + Active RN (Registered Nurse ) license in state of employment + 2 or… 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
- University of Miami (Miami, FL)
- …patient population + Completion of Medicare annual wellness exam documentation + Knowledge of HEDIS Quality Care Gaps - review and closure + Knowledge of ... 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) . Advanced Practice Registered… more
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