• HEDIS Registered Nurse

    Insight Global (Philadelphia, PA)
    Job Description A client of Insight Globals is looking for HEDIS RNs or LPNs for a partially remote contract position in PA and NJ. PARTIALLY remote position as it ... abstraction & entry of medical records assigned by a Clinical Quality Lead nurse . Miles will be reimbursed for any travel. Computer equipment, encrypted zip drives… more
    Insight Global (12/31/24)
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  • HEDIS Lead

    Elevance Health (Atlanta, GA)
    …timelines. + Collaborates with multiple departments and external vendor to annually field a new HEDIS pursuit application **Minimum Requirements:** Requires an ... in healthcare field and minimum of 2 years experience with HEDIS activity coordination or working with Managed/Acute/Provider Care environment, including 2 years… more
    Elevance Health (01/08/25)
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  • LCSW / LCPC / PMH-BC - HEDIS Clinical…

    Centene Corporation (Springfield, IL)
    …Health assignments, experience in Behavioral health, alcohol and or substance use disorders. preferred RN - Registered Nurse - State Licensure and/or Compact ... and standards **Education/Experience:** Graduate from an Accredited School of Nursing ( Registered Nurse ), required Bachelor's Degree Bachelor's degree in social… more
    Centene Corporation (01/10/25)
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  • Registered Nurse - Outpatient…

    Veterans Affairs, Veterans Health Administration (Augusta, GA)
    Summary The Registered Nurse is assigned to a...Nurse III; OR a Master's degree in *related field with BSN and two years of specialized nursing ... the Nurse Manager for the area. The Registered Nurse understands professional practice standards and...the continuum of care. Spinal Cord Serves as the RN Team Leader for a team of patients with… more
    Veterans Affairs, Veterans Health Administration (10/26/24)
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  • Patient Care Advocate

    Centene Corporation (Trenton, NJ)
    …Social Work (LMSW); Certified Social Worker (C-SW); Licensed Social Worker (LSW); Licensed Registered Nurse ( RN ) preferred.Pay Range: $26.50 - $47.59 per ... IPA and/or group practices. Serves to collaborate with providers in the field , to improve HEDIS measures and provides education for HEDIS measures and… more
    Centene Corporation (01/10/25)
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  • Clinical Quality Management Director - Hybrid -…

    The Cigna Group (Scottsdale, AZ)
    …**Education:** Master's degree in Public Health, Healthcare Administration, Nursing, or a related field . Clinical licensure preferred (eg, RN , MD, or similar). + ... of clinical quality initiatives, studies, and pilots to improve HEDIS (C) results, patient experience, enterprise quality opportunities. Analyzes results… more
    The Cigna Group (01/01/25)
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  • Quality Specialist ( RN )

    Stanford Health Care (Palo Alto, CA)
    …CMS, US News & World Report, HEDIS , PQRS). **Licenses and Certifications** + CA- RN ( Registered Nurse ) . **These principles apply to ALL employees:** ... or certifications is qualifying + Bachelor's degree in a work-related discipline/ field from an accredited college or university **Experience Qualifications** + Three… more
    Stanford Health Care (12/13/24)
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  • Associate Quality Practice Advisor

    Centene Corporation (Jefferson City, MO)
    …Licensed Marital and Family Therapist (LMFT), Licensed Certified Social Worker (LCSW), Licensed Registered Nurse ( RN ), Acute Care Nurse Practitioner ... sites in regards to the National Committee for Quality Assurance (NCQA) HEDIS measures. Provides education for HEDIS measures, appropriate medical record… more
    Centene Corporation (01/10/25)
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  • EPSDT Coordinator (Must Reside in MS, LPN/LVN…

    Molina Healthcare (Jackson, MS)
    …assisting Members with scheduling transportation to appointments; reviewing EPSDT and HEDIS data to inform targeted interventions to increase utilization of ... **Job Qualifications** **REQUIRED EDUCATION** : Completion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR… more
    Molina Healthcare (01/09/25)
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  • Quality Practice Advisor

    Centene Corporation (Springfield, IL)
    …provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides education for HEDIS measures, ... plan compliance to meet State and Federal standards for HEDIS and documentation standards. Acts as a resource for...all policies and standards Ideal candidate will have an RN license in IL. This position is remote with… more
    Centene Corporation (01/10/25)
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  • Manager Clinical Quality Improvements

    Dignity Health (Bakersfield, CA)
    …special projects as assigned. **Qualifications** **Minimum Qualifications:** - CA Clinical licensure ( Registered Nurse ( RN ), Licensed Vocational Nurse ... of clinical and non-clinical quality management staff. - 3 years HEDIS measures reporting and experience in CMS Stars, P4P, ACO and… more
    Dignity Health (11/13/24)
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  • Clinical Documentation Integrity Specialist…

    UCLA Health (Los Angeles, CA)
    …Specialist (CCS) certification, required + A Certified Risk Adjustment Coder (CRC), required + Registered Nurse ( RN ) or clinical qualifications a plus + ... Bachelor's degree (healthcare or relevant field ) or equivalent experience/training + Five or more years...HCPCS coding systems required + Knowledge of Medicare Advantage STARS/ HEDIS program and NCQA technical specifications, required + Knowledge… more
    UCLA Health (11/11/24)
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  • Analyst, Quality Interventions/QI Compliance…

    Molina Healthcare (IA)
    …files, the analysis of quality metric data, including, but not limited to, HEDIS , STARS, etc., the analysis of medical records data, etc. **JOB QUALIFICATIONS** ... chart equivalent). **Preferred Education** Master's Degree or higher in a clinical field , Public Health or Healthcare. **Preferred Experience** + 1 year of… more
    Molina Healthcare (12/19/24)
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  • Specialist, Provider Engagement (Remote in MI)

    Molina Healthcare (Flint, MI)
    …for key performance measurement activities. **Experience with quality, providers and HEDIS is very important for this position. Please highlight this experience ... in healthcare with 1 year experience in health plan quality improvement ( HEDIS ), managed care or equivalent experience. + Demonstrated solid business writing… more
    Molina Healthcare (10/18/24)
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  • Quality Nurse - Performance Measures

    Veterans Affairs, Veterans Health Administration (Wilmington, NC)
    …dimensions:- Practice- Professional Development- Collaboration- Scientific InquiryIn addition, this registered nurse is accountable and responsible for ... to the Assistant Chief, Quality & Safety. The Quality Nurse is a registered professional nurse...and regulatory activities.- Healthcare Effectiveness Data and Information Set ( HEDIS ) Measures The Quality Nurse is also… more
    Veterans Affairs, Veterans Health Administration (01/03/25)
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  • APP, Supervisor - General Internal Medicine - Full…

    University of Miami (Miami, FL)
    …Providers supervises advance d practice providers (APPs) ( ie, Advanced Registered Nurse Practitioners, Physician Assistants etc.). Key responsibilities of ... + Completion of Medicare annual wellness exam documentation preferred + Knowledge of HEDIS Quality Care Gaps - review and closure preferred + Knowledge of… more
    University of Miami (12/17/24)
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  • Risk Adjustment Provider Programs Specialist

    Medical Mutual of Ohio (OH)
    …+ **Medical /clinical background highly desirable.** **Professional Certification(s)** + ** Registered Nurse preferred** + **Certified Professional Coder (CPC) ... _Collaborates with internal departments on risk adjustment coding strategies, HEDIS performance, provider performance, and other corporate quality initiatives.… more
    Medical Mutual of Ohio (12/06/24)
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  • Senior EPSDT Quality Professional

    Humana (Oklahoma City, OK)
    …Compliance Professional must meet** **one** **of the following requirements:** **Unrestricted Registered Nurse in the State of Oklahoma OR** **Physician's ... health services, public health, or health care administration or another related field OR** **Certified Professional in Health Care Quality (CPHQ) OR** **Certified… more
    Humana (10/29/24)
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  • HealthCare Management Services Director

    Elevance Health (NV)
    …quality initiatives and activities including clinical indicators reporting, focus studies, and HEDIS reporting. + Serves as liaison to state regulatory agencies. + ... + Requires a BA/BS degree in a health care field and a minimum of 8 years clinical experience...experience:** + Managed care experience is a must + RN , LCSW, or LPC preferred. National Committee for Quality… more
    Elevance Health (12/18/24)
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  • Specialist, Quality Management (Remote in Arizona)

    Molina Healthcare (AZ)
    …quality management compliance activities. Please make sure to include any healthcare/ HEDIS /quality metric experience on your resume. We are moving quickly to ... managed care or equivalent experience. * Demonstrated experience with Quality, HEDIS , RA or equivalent. * Demonstrated solid business writing experience. *… more
    Molina Healthcare (12/29/24)
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