• Quality Improvement ( RN )…

    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
    Molina Healthcare (10/20/24)
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  • HEDIS Nurse (Remote)

    Actalent (Austin, TX)
    Actalent is currently hiring for Remote HEDIS Nurses ( RN /LPN)! Job Description: + Lead data collection and abstraction for company quality measures, ... standards + Review medical records and abstract data for HEDIS and other measure sets in compliance ...related to abstractions and over-reads Qualifications: + Experience in quality initiatives including HEDIS project, study analysis,… more
    Actalent (11/22/24)
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  • Remote - HEDIS Nurse

    Actalent (Columbia, SC)
    …in US ! Job Description: + Lead data collection and abstraction for company quality measures, including HEDIS , CMS, CHIPRA and/or any other custom measurements. ... standards + Review medical records and abstract data for HEDIS and other measure sets in compliance ...and over-reads .Qualification : + 1+ years of Performing HEDIS expereince Mandatory + Having Compact RN more
    Actalent (11/24/24)
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  • Sr Specialist, Quality Improvement…

    Molina Healthcare (NM)
    **_JOB TITLE: Sr. Specialist, Quality Improvement RN ( REGISTERED NURSE )_** **JOB DESCRIPTION** **Job Summary** Molina's Quality Improvement function ... federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Senior Specialist, Quality Improvement ( Registered Nurse ) contributes to one… more
    Molina Healthcare (11/10/24)
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  • Registered Nurse - Operating Room

    ERP International (Eglin AFB, FL)
    **Overview** ERP International is seeking a ** Registered Nurse ( RN )** for a full-time position in support of the **Operating Room** at theEglin Hospital, ... achievement of optimal outcomes in relation to clinical care, quality and cost effectiveness. * Ensure compliance ...to include elective, urgent and emergency procedures. The OR nurse will assess, plan, implement, and evaluate nursing care… more
    ERP International (11/20/24)
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  • Senior Medical Management Nurse - VCHCP

    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
    Ventura County (11/12/24)
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  • RN -Utilization Management

    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
    ERP International (11/02/24)
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  • Program Manager - Clinical Program Design…

    Molina Healthcare (GA)
    **_JOB TITLE: Program Manager: HCS, Clinical Program Design, REGISTERED NURSE_** **Job Summary** Molina Healthcare Services (HCS) works with members, providers and ... HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of… more
    Molina Healthcare (11/14/24)
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  • Quality Practice Advisor

    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
    Centene Corporation (09/24/24)
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  • Sr Specialist, Quality Interventions/QI…

    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 (10/10/24)
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  • Specialist, Quality Interventions/QI…

    Molina Healthcare (Tacoma, 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
    Molina Healthcare (10/04/24)
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  • Patient Care Advocate

    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
    Centene Corporation (11/16/24)
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  • Quality Program Strategist II

    Centene Corporation (Springfield, IL)
    …insurance experience required; 2+ years of quality experience preferred. **License/Certification:** Registered Nurse ( RN ), Licensed Practical Nurse , ... workplace flexibility. **Position Purpose:** Identify market trends and oversee functions of quality improvement programs for HEDIS , CAHPS, and/or HOS strategy… more
    Centene Corporation (11/23/24)
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  • Director, Clinical Data Acquisition (Remote)

    Molina Healthcare (MI)
    …License ( RN may be preferred for specific roles) * Certified HEDIS Compliance Auditor (CHCA) **PHYSICAL DEMANDS:** Working environment is generally favorable ... as operations subject matter expert and lead for Molina Plan quality improvement HEDIS operations using a defined roadmap, timeline and key performance… more
    Molina Healthcare (11/09/24)
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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 ... medical group. - 5 years of oversight/supervision/management/leadership of clinical and non-clinical quality management staff. - 3 years HEDIS measures reporting… more
    Dignity Health (11/13/24)
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  • Senior EPSDT Quality Professional

    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
    Humana (10/29/24)
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  • Manager, Transitional Care Management Pop Health

    Trinity Health (Boise, ID)
    …Regional Medical Campus. **SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE:** Must possess a Registered Nurse License. Bachelor of Science degree in nursing required ... of Population Health, this position leads a highly skilled RN team to improve community health and wellbeing during...manager (CCM) exam in 1 year of hire date. Quality (STARs/ HEDIS ). **ESSENTIAL FUNCTIONS:** Knows, understands, incorporates,… more
    Trinity Health (11/20/24)
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  • Supervisor, Transitional Care Services

    LA Care Health Plan (Los Angeles, CA)
    …Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and ... Conduct monthly audit activity via program's performance reporting standards to maintain quality care of members and compliance to regulatory requirements.… more
    LA Care Health Plan (10/26/24)
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  • SCO Nurse Case Manager-Lowell/Lawrence Area

    Fallon Health (Lawrence, MA)
    …related field preferred **License/Certifications:** + Active, unrestricted license as a Registered Nurse in Massachusetts; current Driver's license and reliable ... and Program policies and processes + Knowledge of and compliance with HEDIS and Medicare 5 Star...**Experience:** + 1+ years of clinical experience as a Registered Nurse managing chronically ill members or… more
    Fallon Health (11/09/24)
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  • Senior Manager, Practice Innovation

    University of Virginia (Charlottesville, VA)
    …stakeholders to develop relevant in-person and online educational trainings on priority HEDIS quality measures, complex diagnosis documentation for improved risk ... quality metric performance. + Maintains thorough knowledge and understanding of the HEDIS quality measures, their nuances and the specifications to adequately… more
    University of Virginia (11/07/24)
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