- Fallon Health (Worcester, MA)
- …or follow us on Facebook, Twitter and LinkedIn. Brief summary of purpose: The Nurse Case Manager (NCM) is an integral part on an interdisciplinary team focused on ... policies and processes o Knowledge of and compliance with HEDIS and Medicare 5 Star measure processes, performing member...advanced) degree in nursing or a health care related field preferred. License : Active, unrestricted license as a… more
- UnitedHealth Group (Phoenix, AZ)
- Position is Hybrid and based in Phoenix (Time spent in the field , working from home and occasionally in the office for meetings or training) For those who want to ... providers to improve STARS measure performance Provide analytical interpretation and STARS/ HEDIS performance summaries to provider groups Be the subject matter… more
- 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
- Veterans Affairs, Veterans Health Administration (Jacksonville, NC)
- …all dimension requirements for Nurse III; OR a Master's degree in *related field with BSN and two years of specialized nursing experience, one of which is ... Summary The Fayetteville VA Medical Center is hiring a Registered Nurse for the PACT Outpatient team located at our Jacksonville CBOC location. The RN selected for… more
- Veterans Affairs, Veterans Health Administration (Elizabeth City, NC)
- …all dimension requirements for Nurse III; OR a Master's degree in *related field with BSN and two years of specialized nursing experience, one of which is ... limited to: Patient Aligned Care Team (PACT) Outpatient Staff Registered Nurse (RN) is responsible for providing competent, evidence-based gender-specific primary… more
- Defense Health Agency (San Diego, CA)
- **Overview** ** Nurse (Clinical) - GS-0610-11 - Naval Medical Center San Diego** **This is a Direct Hire Authority (DHA) solicitation utilizing the DHA for Certain ... located at Naval Medical Center San Diego. Incumbent will serve as Nurse (Clinical) providing care within the pediatrics department.** **A recruitment or relocation… more
- Humana (Richmond, VA)
- …put health first** Humana Healthy Horizons in Virginia is seeking a Quality Compliance Nurse Professional 2 who will be focused on ensuring quality and safety of ... and research to support quality assurance. The Quality Compliance Nurse Professional 2 work assignments are varied and frequently...or bachelor's degree in health administration or a related field . + One (1) or more years of experience… more
- Defense Health Agency (Fort Irwin, CA)
- **Overview** **Practical Nurse - FT Irwin,CA** **About the Position: This position is located at Weed Army Community Hospital in Fort Irwin, California.** Fort Irwin ... following link: https://www.usajobs.gov/Help/working-in-government/benefits/ **Responsibilities** Serves as a Licensed Practical Nurse for a Defense Health Agency (DHA) Medical Treatment… more
- CenterWell (Atlanta, GA)
- …Schedule** : Full-time/40 Hours per Week/Monday through Friday **Job Type** : Field -based Nurse Practitioner, Primary Care House Calls **Assigned Territory** : ... part of our caring community and help us put health first** The Nurse Practitioner applies advanced education and clinical competencies to achieve optimal patient… more
- Fallon Health (Berkshire, MA)
- …or follow us on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The Nurse Case Manager (NCM) is an integral part on an interdisciplinary team focused ... policies and processes o Knowledge of and compliance with HEDIS and Medicare 5 Star measure processes, performing member...advanced) degree in nursing or a health care related field preferred. **License** : Active, unrestricted license as a… more
- Centene Corporation (Augusta, ME)
- …providers at large IPA and/or group practices. Serves to collaborate with providers in the field , to improve HEDIS measures and provides education for HEDIS ... deficiencies impacting plan compliance to meeting State and Federal standards for HEDIS . Conducts telephonic outreach, while embedded in the providers' offices, to… more
- Centene Corporation (Carson City, NV)
- …and member locations._** **_Ideal candidates will have:_** + **_Experience with Quality/ HEDIS measures_** + **_Strong communication skills with comfort speaking to ... plan providers regarding quality initiatives and key quality performance indicators. Shares HEDIS , CAHPS, HOS, Part D and Administrative Operations reports and gap… more
- LifePoint Health (Ishpeming, MI)
- …(NCQA) structure and standards, Health Plan Employer Data and Information Set ( HEDIS ). Knowledge of how to use computerized statistical methods in CQI context. ... process management initiatives. Skill in consistently meeting requirements of NCQA, HEDIS and other regulators and accreditors. Skill in using computer capabilities… more
- UPMC (Media, PA)
- …in Exton, PA), and involves a combination of time in the office, in the field at provider sites, and working remotely from home. Travel requirements ebb and flow due ... to quality management and improvement in compliance with NCQA, HEDIS , URAC, and the Commonwealth of Pennsylvania Department of...for professional and staff development plan. + Licensed Registered Nurse (BSN is a bonus) or Masters Degree (licensure… more
- Centene Corporation (New York, NY)
- …benefits including a fresh perspective on workplace flexibility. **Quality and HEDIS data analysis and reporting experience preferred.** **Position Purpose:** Plans, ... **Education/Experience:** Associate's degree in Nursing, Public Health, or related clinical field , or equivalent experience. 2+ years clinical experience or managed… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Registered Nurse Care Coordinator, Quality Management Full Time, 80 Hours Per Pay Period, Day Shift Occasional travel as needed About Us Covenant Medical ... abreast of most recent changes in quality related to HEDIS measures, CMS Conditions of Participation, MIPS and other...services within the scope of practice as a registered nurse meeting all required standards both legal and regulatory.… more
- Humana (Sterling Heights, MI)
- …health strategy, design innovative programs, and reduce health disparities. + Oversee HEDIS , CAHPS, and MDHHS required measure reporting and evaluation. + Ensures ... education, public health, health administration, health policy, business or a related field . + Minimum five (5) years of experience in Quality Improvement/Quality… more
- University of Miami (Miami, FL)
- …supervises advance d practice providers (APPs) ( ie, Advanced Registered Nurse Practitioners, Physician Assistants etc.). Key responsibilities of this position ... + Completion of Medicare annual wellness exam documentation preferred + Knowledge of HEDIS Quality Care Gaps - review and closure preferred + Knowledge of… more
- CVS Health (Trenton, NJ)
- …Microsoft Office products and VPN. **Preferred Qualifications** + Understanding of HEDIS performance measures + Diagnosis and procedure coding experience **Preferred ... Licensure / Certifications** + Licensed Allied Health Professional, or Licensed Registered Nurse + Certified Six Sigma Green Belt + Certified Professional in… more
- CVS Health (Lansing, MI)
- …a related role. + 2+ years Process Improvement experience related to HEDIS measures + In-depth knowledge of healthcare regulations, clinical operations, quality ... VPN. **Preferred Qualifications:** + Licensed Allied Health Professional or Licensed Registered Nurse + Coding or Sales background + Certified Six Sigma Green Belt… more
