• 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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  • HEDIS Coordinator- Remote (Must be Located…

    UPMC (Pittsburgh, PA)
    …Quality Assurance (NCQA) HEDIS requirements preferred.Licensure, Certifications, and Clearances: + Registered Nurse ( RN ) *Current licensure either in the ... the Novellus Care Gap Management Application and/or Biometric Application for HEDIS measure compliance. + Registered nurse , minimum of 5 years of health care… more
    UPMC (12/12/25)
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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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  • HEDIS - Quality Practice Advisor

    Centene Corporation (Springfield, IL)
    …that meets directly with provider groups based in the Chicago area to discuss HEDIS performance and strategize ways to improve performance, up to 75% travel. Typical ... sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides education for ...following required: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN , APRN, HCQM, CHP, CPHQ, CPC, CPC-A or CBCS… more
    Centene Corporation (12/12/25)
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  • HEDIS Network Analyst

    Commonwealth Care Alliance (Boston, MA)
    011230 CA-Provider Engagement & Performance **Position Summary:** The HEDIS Network Analyst will support CCA's ability to meet and surpass critical Quality ... **Essential Duties & Responsibilities:** + **Conduct weekly tracking of Quality/ HEDIS metrics, specifically focused on Initiation and Engagement of Alcohol or… more
    Commonwealth Care Alliance (10/18/25)
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  • Senior Specialist, Member & Community…

    Molina Healthcare (OH)
    …within the department and/or collaboratively with other departments. Please include any HEDIS /Quality experience on your resume. This experience is important for the ... Certified Professional in Health Quality (CPHQ) + Nursing License ( RN may be preferred for specific roles) + Certified... may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees:… more
    Molina Healthcare (10/19/25)
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  • Quality Improvement HEDIS - LPN

    Centene Corporation (Phoenix, AZ)
    …in quality function in a healthcare setting. **License/Certification:** LPN, LVN, RN , PA, or LCSW license preferred. CPHQ (Certified Professional in Healthcare ... Quality) preferred. This is a 100% remote position, candidate must reside in Arizona. Pay Range: $33.03 - $59.47 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition… more
    Centene Corporation (11/19/25)
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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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  • Pediatric RN - Quality Practice Advisor

    Centene Corporation (Surfside Beach, SC)
    …provider groups based in South Carolina to discuss and improve HEDIS performance. Typical daily tasks will include creating/using PowerPoint presentations, ... South Carolina, (2) have a pediatric background, and (3) an active RN license.** Additional Details: * Department: MED-Quality Improvement * Business Unit: Absolute… more
    Centene Corporation (12/07/25)
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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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  • 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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  • 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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  • 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 (09/17/25)
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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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  • RN Care Coordinator II

    Covenant Health Inc. (Knoxville, TN)
    Overview Registered Nurse Care Coordinator, Quality Management Full Time, 80 Hours Per Pay Period, Day Shift About Us Covenant Medical Group employs or manages ... a proud member of Covenant Health! Position Summary: The RN Care Coordinator II is responsible for integrating evidenced...coordination services within the scope of practice as a registered nurse meeting all required standards both… more
    Covenant Health Inc. (10/10/25)
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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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  • RN Care Manager Complex Pediatric Care…

    Molina Healthcare (Yonkers, NY)
    …behavioral health setting, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The Care Manager RN provides support for care management/care coordination activities...such as asthma, diabetes, and ADHD. Skilled in closing HEDIS and preventive care gaps through proactive outreach and… more
    Molina Healthcare (12/03/25)
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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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  • Ops Advanced Practice RN Specialist

    MyFlorida (St. Petersburg, FL)
    …and Excellence in all aspects of their work. The OPS Advanced Practice Registered Nurse Specialist is responsible for providing comprehensive health care to ... OPS ADVANCED PRACTICE RN SPECIALIST - 64952403 Date: Dec 3, 2025...and other divisions regarding clinical issues. + Comply with HEDIS measure, Meaningful Use standards, productivity standards, and selected… more
    MyFlorida (12/03/25)
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