- Humana (Columbus, OH)
- …reviews and supports the staff involved in HEDIS hybrid season review. The Quality Compliance Nurse works to gain more information about members ... caring community and help us put health first** The Quality Compliance Nurse helps in...your skills to make an impact** **Required Qualifications** + Registered Nurse ( RN ) license +… more
- Molina Healthcare (Columbus, OH)
- …EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES** : + Minimum 10 years experience in quality compliance / HEDIS operations, customer service or provider service ... **Job Description** **Job Summary** The AVP, Quality & Risk Adjustment is responsible for leading...plan and executes on interventions that will improve CAHPS, HEDIS and HOS scores. Responsible for monitoring Part D… more
- Molina Healthcare (Columbus, OH)
- …direction and implementation of NCQA accreditation surveys and federal/state QI compliance activities. ** Quality Improvement, HEDIS , Healthcare experience ... License ( RN may be preferred for specific roles) + Active, unrestricted Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you are… more
- CVS Health (New Albany, OH)
- …expense reimbursement policy. Preferred Qualifications : Oklahoma residency preferred Oklahoma-licensed registered nurse preferred OR be certified as a Certified ... full accountability for business/financial results related to following as appropriate: HEDIS reporting, quality of care, accreditation activities and/or member… more
- Evolent Health (Columbus, OH)
- …+ 1-2 years of experience working with a global workforce and a working knowledge of clinical quality metrics such as HEDIS and NCQA preferred. + 2 - 4 years of ... results, and collaborating with others. **Collaboration Opportunities** : The Lead Nurse of Utilization Management is responsible for assisting the UM Manager… more