- 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 ... 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, ... more
- UCLA Health (Los Angeles, CA)
- Description The Quality Management Clinical Nurse Specialist is responsible for conducting comprehensive facility site reviews (FSRs) to ensure compliance with ... more
- Elevance Health (IN)
- …through home-care and community based services. **CareBridge Clinical Quality Consultant Nurse Practitioner** **Location: This position is primarily a Remote role.** ... more
- Fallon Health (Worcester, 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 ... 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 ... more
- Defense Health Agency (Oklahoma City, OK)
- **Overview** **Advanced Practice Registered Nurse , Tinker AFB, Oklahoma** Tinker AFB is located in Oklahoma City, Oklahoma. Oklahoma City offers all of the culture, ... more
- CenterWell (Hermitage, TN)
- …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 ... 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 ... more
- Fallon Health (Worcester, 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 ... more
- Elevance Health (South Portland, ME)
- **Wellness Nurse Consultant** **$5000 Sign-on Bonus** **Federal Employee Program - FEP** , a proud member of the Elevance Health, Inc. family of companies, it is a ... more
- VNS Health (Manhattan, NY)
- …+ Leads the clinical audit team, ensuring compliance with Medicare STARS, HEDIS /QARR, and regulatory requirements. + Develops forms, record abstracts, reports, and ... more
- Apex Health Solutions (Houston, TX)
- …their staff to ensure health plan goals are met as it relates to HEDIS /STARs and Risk Adjustment. This position coaches a practice staff to improve patient outcomes ... more
- CenterWell (Tallahassee, FL)
- …possible. Responsibilities: * Act as a collaborating physician for several nurse practitioners or physician assistants, including completing regular chart review ... 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 ... more
- CareFirst (Baltimore, MD)
- …Milliman Care Guidelines (MCG) to act as a resource to conduct concurrent review for medical necessity and appropriate level of care for Commercial and Government ... more
- Centene Corporation (Tacoma, WA)
- …ensure compliance with customer expectations and lead clinical quality initiatives. Review clinical information for appeals to determine medical necessity of ... more
- Sharp HealthCare (San Diego, CA)
- …**Shift Start Time** **Shift End Time** Master's Degree in Nursing; California Registered Nurse (RN) - CA Board of Registered Nursing; Certified Case Manager (CCM) - ... 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 ... more
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