- Centene Corporation (Salem, OR)
- …for provider improvement and gap closure. Educates provider practices on appropriate HEDIS measures, medical record documentation guidelines, and HEDIS ICD-10 ... more
- Highmark Health (Harrisburg, PA)
- …to meet program targets across the practices' P4V programs such as ACA, Medicare STARS, HEDIS and risk revenue for all payers. (25%) + Collaborates with EHR teams in ... more
- Healthfirst (NY)
- …+ Clinical license: LPN, RN , LMSW or LCSW + Multiple years of HEDIS review experience for both Medicaid and Medicare lines of business + Medical record review ... more
- Catholic Health (West Seneca, NY)
- …The Medical Assistant is under the clinical supervision of the Licensed Practical Nurse , Registered Nurse , Nurse Practitioner, Physician Assistant ... more
- University of Miami (Miami, FL)
- …Providers supervises advance d practice providers (APPs) ( ie, Advanced Registered Nurse Practitioners, Physician Assistants etc.). Key responsibilities of ... more
- Queen's Health System (Kamuela, HI)
- …**A. EDUCATION/CERTIFICATION AND LICENSURE:** * Current Hawaii State license as a Registered Nurse . * Bachelor's degree in Nursing. * Master's degree ... 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
- CVS Health (Harrisburg, PA)
- …outreaches our Medicare population to improve medication adherence and/or HEDIS diabetes and blood pressure control, providing education and addressing ... more
- Elevance Health (TN)
- …life through home-care and community based services. **Clinical Quality Consultant Nurse Practitioner** **Location: This position is primarily a Remote role.** Work ... more
- Molina Healthcare (Phoenix, AZ)
- …Certification, Association** + Certified Professional in Health Quality (CPHQ) + Nursing License ( RN may be preferred for specific roles) + Certified HEDIS ... more
- Molina Healthcare (Rochester, NY)
- …market desirable. **Preferred License, Certification, Association** + Active, unrestricted State Registered Nursing ( RN ) license in good standing. + Utilization ... more
- Elevance Health (Cerritos, CA)
- …to ensure high-quality care to members and achievement of company HEDIS performance. Implements strategies that meet clinical, quality, and network improvement ... more
- Elevance Health (St. Rose, LA)
- …Performs monthly, quarterly, annual and ad hoc medical record reviews such as HEDIS and CPG compliance. + Conducts quality of care investigations and using criteria ... more
- Whidbey General Hospital (Coupeville, WA)
- …data for the Medical Staff Office for credentialing providers. + Assist Quality Review RN with data to help clinic managers understand what gaps need to be closed ... more
- Catholic Health (Kenmore, NY)
- …an accredited school of nursing. + Maintains a current New York State Professional RN license + Completion of an accredited program for Nurse Practitioners. + ... more
- Independent Health (Buffalo, NY)
- …and as requested by the Director. **Qualifications** + Bachelor's degree or Registered Nursing License ( RN ) required. Master's degree preferred. An additional ... more
- Centene Corporation (Jefferson City, MO)
- …and implementation of care management processes to ensure NCQA, URAC, and HEDIS measures + Develop and implement standardization in measuring and monitoring ... more
- Catholic Health (Niagara Falls, NY)
- …an accredited school of nursing. + Maintains a current New York State Professional RN license + Completion of an accredited program for Nurse Practitioners. + ... more
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