- Actalent (Dallas, TX)
- …vendors when required * Perform other quality initiatives as necessary Qualifications: - Registered Nurse ( RN ) license. - Experience with HEDIS ... Description: We are seeking a dedicated and meticulous HEDIS Nurse to assist with the...that our healthcare services maintain a high level of quality , effectiveness, and compliance with regulatory standards.… more
- Molina Healthcare (Ypsilanti, MI)
- …federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist, Quality Improvement ( Registered Nurse ) contributes to one ... **JOB DESCRIPTION** _For this position we are seeking a ( RN ) Registered Nurse who must...Professional in Health Quality (CPHQ) + Certified HEDIS Compliance Auditor (CHCA) + Registered… more
- Actalent (Des Moines, IA)
- Job Title: HEDIS Quality Management Consultant Job Description Support the Quality Management team during the upcoming HEDIS season by reviewing, ... claims research, provider outreach, and create medical record requests. Ensure compliance with HEDIS audit and technical specification standards.… more
- Actalent (Atlanta, GA)
- Description: Position Purpose: Lead data collection and abstraction for company quality measures, including HEDIS , CMS, CHIPRA and/or any other custom ... standards * Review medical records and abstract data for HEDIS and other measure sets in compliance ...initiatives as necessary Requirements: MUST HAVE experience working prior HEDIS seasons Must have a current RN … more
- 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 ... be auditing EMRs. - Will be part of the Quality Department for the Medicare Team, working alongside full-time...and provider clean-up. - Will be part of the HEDIS team during the Jan-May season. Review medical records… more
- Humana (Columbus, OH)
- …Government Business government contract requires US citizenship for this position.** The **Clinical Quality Registered Nurse ( RN )** collects and reviews ... and presents to Patient Safety Peer Review Committee. Audits quality cases for compliance and participates in...or more years of clinical nursing experience + Active RN ( Registered Nurse ) license in… more
- Elevance Health (Seven Fields, PA)
- …annual and ad hoc medical record reviews such as HEDIS and CPG compliance . + Conducts quality of care investigations and using criteria closes case ... Location: Seven Fields, PA; Hermitage, PA Responsible for participating in on-site quality external audits such as NCQA, AAHC and EQRO, and prepares audits of… more
- Sutter Health (Sacramento, CA)
- …Description** : **EDUCATION:** Bachelor's: public health, nursing, **CERTIFICATION & LICENSURE:** RN - Registered Nurse of California **TYPICAL EXPERIENCE:** 8 ... includes compliance to standards of the National Committee on Quality Assurance (NCQA), Integrated Healthcare Association (IHA), Centers for Medicare and… more
- Northern Light Health (Brewer, ME)
- …obtain information, support, and promote cooperation and collaboration. Credentials + Required Registered Nurse or CST Education + Required Bachelor's Degree 8 ... This includes, but is not limited to, MIPS, eCQMs, HEDIS and CGCAHPS for ambulatory quality and...reading or writing. + Prolonged periods of sitting. Position Quality Program Coordinator/ RN or CSTLocation Req ID… more
- Molina Healthcare (UT)
- …. Clinical experience is needed for positions that are focused on Accreditation, Compliance , HEDIS Interventions, Potential Quality of Care issues, and ... strong knowledge in risk adjustment programs and processes, data acquisition processes, HEDIS and quality performance management across all LOBs. Some… more
- Ventura County (Ventura, CA)
- …care services to County employees and their covered dependents. The Senior Registered Nurse -Ambulatory Care series is distinguished from other nursing ... amount of supervision commensurate with their experience. PAYROLL TITLE: Senior Registered Nurse - Ambulatory Care AGENCY/DEPARTMENT: Health Care Agency… more
- ERP International (Nellis AFB, NV)
- **Overview** ERP International is seeking ** Registered Nurse ( RN ) Utilization Managers** for full-time positions in support of theMike O'Callaghan Military ... Utilization Management activities and functions by using MTF specific Quality Improvement processes to identify areas for review from...* Must be able to interpret data to ensure compliance with requirements for length of stay, obtain needed… more
- Centene Corporation (Jefferson City, MO)
- …providers and supports provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides ... compliance to meet State and Federal standards for HEDIS and documentation standards. Acts as a resource for...maintains provider clinical relationship across product lines. + Maintains Quality KPI and maintains good standing with HEDIS… more
- Carle (Urbana, IL)
- …EDUCATIONAL REQUIREMENTS College Diploma in Nursing CERTIFICATION & LICENSURE REQUIREMENTS Registered Professional Nurse ( RN ) License Illinois upon ... RN - Coordinator + Department: HA - Quality...on schedule. + Collaborate with Star Coordinators to ensure compliance with CMS quality improvement requirements. +… more
- Molina Healthcare (AZ)
- …and provides direction and implementation of NCQA accreditation surveys and federal/state QI compliance activities. **A background in quality / HEDIS is very ... License ( RN may be preferred for specific roles) + Active, unrestricted Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you are… more
- Molina Healthcare (West Seattle, WA)
- …provides direction and implementation of NCQA accreditation surveys and federal/state QI compliance activities. Experience with QUALITY / HEDIS is important ... in Quality / HEDIS on your application. **KNOWLEDGE/SKILLS/ABILITIES** The Specialist, Quality Interventions/ QI Compliance contributes to one or more of… more
- Centene Corporation (Springfield, IL)
- …Master Social Work (LMSW); Certified Social Worker (C-SW); Licensed Social Worker (LSW); Licensed Registered Nurse ( RN ) preferred. Pay Range: $25.97 - $46.68 ... education for HEDIS measures and coding. Supports the implementation of quality improvement interventions and audits in relation to plan providers. Assists in… more
- Actalent (Detroit, MI)
- …Social Worker (LMSW), Certified Social Worker (C-SW), Licensed Social Worker (LSW), Licensed Registered Nurse ( RN ). About Actalent Actalent is a global ... interventions and audits. The advocate will assist in resolving deficiencies impacting plan compliance with State and Federal standards for HEDIS and conduct… more
- Centene Corporation (Columbia, SC)
- …workplace flexibility. **Position Purpose:** Lead data collection and abstraction for company quality measures, including HEDIS , CMS, CHIPRA and/or any other ... standards + Review medical records and abstract data for HEDIS and other measure sets in compliance ...assistant, medical coding or data management experience. Experience in quality initiatives (including HEDIS project, study analysis,… more
- Humana (Oklahoma City, OK)
- …a part of our caring community and help us put health first** The Senior Quality Compliance Professional uses quality compliance and improvement tools ... EPSDT services and close gaps in care for Oklahoma Medicaid enrollees. The Senior Quality Compliance Professional has proven data analysis skills and a strong… more