• Suzanne Snell Human Resources and Recruiting Solutions (Newport Beach, CA)
    …job Registered Nurse (Bi-Lingual- Spanish) Seeking candidates for a HEDIS STARS Registered Nurse (Bi-Lingual- Spanish) position for our Healthcare ... includes fulfilling select CMS quality metrics that require documentation by a licensed registered nurse . Compensation & Benefits: Hourly rate of pay is $30-40… more
    Upward (07/25/25)
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  • CenterWell Primary Care (North Miami Beach, FL)
    …Required Qualifications Bilingual proficiency in English and Haitian Creole is required. Licensed Registered Nurse ( RN ) without restriction in Florida 5+ ... us put health first The Stars Improvement, Clinical Professional ( RN ) is responsible for the development, implementation and management...of clinical nursing experience Proven work experience as a HEDIS Nurse or similar role in healthcare… more
    Upward (07/17/25)
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  • UnitedHealth Group (Phoenix, AZ)
    …education can be substituted/is equivalent to one year of experience. Required Qualifications: Registered Nurse (within AZ and/or a compact state) 4+ years of ... us to start Caring. Connecting. Growing together. The Sr. Clinical Quality Consultant RN will drive consistency, efficient processes and share best practices, in a… more
    Upward (07/16/25)
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  • Peak Vista Community Health Centers (Colorado Springs, CO)
    …Employee Assistance Program https://www.peakvista.org/resources/benefits-summary Job Summary: The Quality Assurance Registered Nurse ( RN ) is responsible for ... CHPA, AAAHC and other regulatory entities. The Quality Assurance RN works closely with the Quality Oversight RN...to include governing bodies such as AAAHC, HRSA & HEDIS . Compliance with HIPAA and all applicable rules and… more
    Upward (07/17/25)
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  • Healthmap Solutions (Fayetteville, NC)
    …health, for those who need us most. Position Summary The Clinical Nurse Liaison is responsible for developing and maintaining long-term relationships with ... process improvement in provider workflows, Kidney Health Management interventions and HEDIS /STAR measures for identified areas of provider low performance Identify… more
    Upward (07/17/25)
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  • Community Health Centers of the Central Coast (Santa Maria, CA)
    …care plan. Coordinates with the Care Team (Primary Care Provider, Health Educator, Registered Dietitian, RN , Behavioral Health Provider, Director of Nursing, or ... to perform the essential functions. EDUCATION and/or EXPERIENCE Graduation from an accredited Registered Nursing program. Current RN license issued by the State… more
    Upward (07/14/25)
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  • Fallon Health (Worcester, MA)
    …care related field preferred. License : Active, unrestricted license as a Registered Nurse in Massachusetts Certification : Certification in Case Management ... policies and processes o Knowledge of and compliance with HEDIS and Medicare 5 Star measure processes, performing member...transportation Experience: *1+ years of clinical experience as a Registered Nurse managing chronically ill members or… more
    Upward (07/19/25)
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  • Molina Healthcare (Long Beach, CA)
    …(CPHQ) Nursing License ( RN may be preferred for specific roles) Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you are interested ... Nursing, Public Health, Health Administration, Social Work, or related field HEDIS reporting or collection CAHPS improvement experience State QI experience Medicaid… more
    Upward (07/24/25)
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  • Autonomize Inc (Austin, TX)
    …training and adoption strategies; support frontline change management. Required Qualifications RN (active or retired) with 10+ years in payer operations (UM, ... Case Management, Quality, HEDIS /STARS, etc.) with experience across Commercial, Medicare, Medicare Advantage, and Medicaid plans. Proven cross-functional leadership… more
    Upward (07/25/25)
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  • Elevance Health (Walnut Creek, CA)
    …to ensure high-quality care to members and achievement of company HEDIS performance. Implements strategies that meet clinical, quality, and network improvement ... an equivalent background. Current, valid, independent, and unrestricted license such as RN , LCSW, LMFT, LMHC, LPC, or Licensed Psychologist (as allowed by applicable… more
    Upward (07/18/25)
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  • UnitedHealth Group (Brooklyn, NY)
    …working in the Healthcare industry Knowledge of Risk Adjustment and/or HEDIS /Stars Proficient using MS Office Tools (Excel [Pivot tables, excel functions], ... Coder / CPC-A; equivalent certifications CRC certification Nursing background ie LPN, RN , NP 4+ years of clinic or hospital experience and/or managed care… more
    Upward (07/04/25)
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  • UnitedHealth Group (Waterbury, CT)
    …Home Base Medical Care, part of the Optum family of businesses, is seeking a Nurse Practitioner or Physician Assistant to join our team in New Haven County, CT. ... in ongoing meetings pertaining to patient care and clinical excellence Implements HEDIS measure campaigns and other quality initiatives to ensure the highest… more
    Upward (07/07/25)
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  • Baptist Health (New Albany, IN)
    …unrestricted driver's license and ability to drive to multiple locations. RD, CDE, RN with CDE, Registered Dietitian, Diabetes, Educator, Dietitian, AADE If you ... would like to be part of a growing family focused on supporting clinical excellence, teamwork and innovation, we urge you to apply now! Baptist Health is an Equal Employment Opportunity employer. more
    Upward (06/28/25)
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  • UnitedHealth Group (Syracuse, NY)
    …of Nurse Practitioner or Physician Assistant accredited program Current state RN license if Nurse Practitioner Current NP or PA license Certification ... Home Base Medical Care, part of the Optum family of businesses, is seeking a Nurse Practitioner or Physician Assistant to join our team in Syracuse, NY. Optum is a… more
    Upward (06/28/25)
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  • HEDIS Overreader Registered

    Insight Global (Philadelphia, PA)
    …to a patient's health plans to make sure it meets a patient's care needs. The HEDIS nurse focuses solely on using HEDIS measuring criteria to review health ... Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ . Skills and Requirements Previous HEDIS review experience Active RN License or… more
    Insight Global (07/01/25)
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  • HEDIS Registered Nurse

    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
    Insight Global (07/01/25)
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  • Lead Abstractor, HEDIS /Quality Improvement…

    Molina Healthcare (TX)
    …Lead Abstractor conducts data collection and abstraction of medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The ... lead role in the coordination and preparation of the HEDIS medical record review which includes ongoing review of...**O** **C** **I** **A** **TI** **O** **N** **:** Active RN license for the State(s) of employment **PHY** **S**… more
    Molina Healthcare (07/17/25)
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  • Abstractor, HEDIS /Quality Improvement…

    Molina Healthcare (Cincinnati, OH)
    …of HEDIS and NCQA **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Active RN license for the State(s) of employment **STATE SPECIFIC REQUIREMENTS:** **PHYSICAL ... to conduct data collection and abstraction of medical records for HEDIS projects, HEDIS like projects and supplemental data collection. The abstraction team will… more
    Molina Healthcare (07/17/25)
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  • Registered Nurse , RN

    Hackensack Meridian Health (Tinton Falls, NJ)
    …mission to transform healthcare and serve as a leader of positive change. The ** Registered Nurse , RN Community Based Care Management** provides direct ... in Nursing. **Licenses and Certifications Required** : + NJ State Professional Registered Nurse License. **Licenses and Certifications Preferred** : +… more
    Hackensack Meridian Health (05/22/25)
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  • Temporary, HEDIS Analyst

    Commonwealth Care Alliance (Boston, MA)
    …other states will not be considered at this time._** **Position Summary:** The HEDIS Network Analyst will support CCA's ability to meet and surpass critical Quality ... **Essential Duties & Responsibilities:** + **Conduct weekly tracking of Quality/ HEDIS metrics, specifically focused on Initiation and Engagement of Alcohol or… more
    Commonwealth Care Alliance (07/26/25)
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