- 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
- 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 (Boston, MA)
- …Duties & Responsibilities: * Knowledge of Medicare Star Rating methodology; NCQA HEDIS measures; CAHPS and HOS surveys * Intermediate to advanced knowledge of ... Health, Health Care Administration, Health Economics, or a related field with strong emphasis in data analysis. Education Desired:...in a health plan. * Experience working in Stars ( HEDIS , HOS, CAHPS) at a large national or regional… more
- Molina Healthcare (Las Vegas, NV)
- …Advanced degree in Nursing, Public Health, Health Administration, Social Work, or related field + HEDIS reporting or collection + CAHPS improvement experience + ... Certified Professional in Health Quality (CPHQ) + Nursing License ( RN may be preferred for specific roles) + Certified... may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees:… more
- Veterans Affairs, Veterans Health Administration (Jacksonville, NC)
- Summary The Fayetteville VA Medical Center is hiring a Registered Nurse for the PACT Outpatient team located at our Jacksonville CBOC location. The RN ... career today. Responsibilities The Patient Aligned Care Team (PACT) Registered Nurse is a member of the...Care Provider, Nurse Care Manager, Licensed Practical Nurse , Health Technician, and Clerical Associate. The RN… more
- Veterans Affairs, Veterans Health Administration (Elizabeth City, NC)
- …but are not limited to: Patient Aligned Care Team (PACT) Outpatient Staff Registered Nurse ( RN ) is responsible for providing competent, evidence-based ... level degree in Nursing may have opportunity to become registered as a nurse with a state...Nurse III; OR a Master's degree in *related field with BSN and two years of specialized nursing… more
- Centene Corporation (Augusta, ME)
- …Master Social Work (LMSW); Certified Social Worker (C-SW); Licensed Social Worker (LSW); Licensed Registered Nurse ( RN ) preferred. Pay Range: $26.50 - $47.59 ... IPA and/or group practices. Serves to collaborate with providers in the field , to improve HEDIS measures and provides education for HEDIS measures and… 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 ... coordination services within the scope of practice as a registered nurse meeting all required standards both...or CPHQ OR Bachelors degree in Nursing or related field . Apply/Share Job Title RN CARE COORDINATOR… more
- Molina Healthcare (Fort Worth, TX)
- …and/or interpretation + Certified Professional in Health Quality (CPHQ) + Nursing License ( RN may be preferred for specific roles) + Certified HEDIS Compliance ... Auditor (CHCA) To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing Molina Healthcare offers a competitive benefits and compensation package Molina Healthcare is an Equal… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... All Levels + Associates degree required. Bachelor's degree preferred. + Active NYS RN or Registered Dietician or Physical Therapist licensure required; or LMSW;… more
- Centene Corporation (Des Moines, IA)
- …provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides education for HEDIS measures, ... plan compliance to meet State and Federal standards for HEDIS and documentation standards. Acts as a resource for...following required: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN , APRN, HCQM, CHP, CPHQ, CPC, CPC-A or CBCS… more
- Centene Corporation (Raleigh, NC)
- …health insurance experience required; 2+ years of quality experience preferred. **License/Certification:** Registered Nurse ( RN ), Licensed Practical Nurse ... market trends and oversee functions of quality improvement programs for HEDIS , CAHPS, and/or HOS strategy and related quality improvement activities. Assists… more
- LifePoint Health (Ishpeming, MI)
- …action. Preferred: Quality Improvement License: Licensed Practical Nurse (LPN) or Registered Nurse ( RN ) Certifications: Basic Life Support Health Care ... (NCQA) structure and standards, Health Plan Employer Data and Information Set ( HEDIS ). Knowledge of how to use computerized statistical methods in CQI context.… more
- UPMC (Media, PA)
- …of Quality Management. + Responsible for professional and staff development plan. + Licensed Registered Nurse (BSN is a bonus) or Masters Degree (licensure is a ... a combination of time in the office, in the field at provider sites, and working remotely from home....to quality management and improvement in compliance with NCQA, HEDIS , URAC, and the Commonwealth of Pennsylvania Department of… more
- CVS Health (Tallahassee, FL)
- …And we do it all with heart, each and every day. **This is a Field based role requiring 50% travel with in the state of Florida. Candidates must reside ... work both internally and externally with some travel time in the field to assigned provider offices. **Required Qualifications** + Bachelor's degree in healthcare… more
- Fallon Health (Berkshire, MA)
- … 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...**Experience:** * 1+ years of clinical experience as a Registered Nurse managing chronically ill members or… more
- Humana (Sterling Heights, MI)
- …+ Master's Degree. + CPHQ (Certified Professional in Healthcare Quality) Certification. + Registered nurse ( RN ), physician or physician's assistant licensed ... health strategy, design innovative programs, and reduce health disparities. + Oversee HEDIS , CAHPS, and MDHHS required measure reporting and evaluation. + Ensures… more
- Humana (Richmond, VA)
- …Virginia.** + An active, unrestricted licensed Practical Nurse (LPN) or a licensed Registered Nurse ( RN ) with an active, unrestricted license in the ... Healthy Horizons in Virginia is seeking a Quality Compliance Nurse Professional 2 who will be focused on ensuring...or bachelor's degree in health administration or a related field . + One (1) or more years of experience… more
- UCLA Health (Los Angeles, CA)
- …work effectively with common office software, coding software, and EMR systems, required + Registered Nurse ( RN ) or clinical qualifications a plus + ... HCPCS coding systems required + Knowledge of Medicare Advantage STARS/ HEDIS program and NCQA technical specifications, required + Six...Bachelor's degree (healthcare or relevant field ) or equivalent experience/training Note: Skills may be subject… more
- University of Miami (Miami, FL)
- …Providers supervises advance d practice providers (APPs) ( ie, Advanced Registered Nurse Practitioners, Physician Assistants etc.). Key responsibilities of ... + Completion of Medicare annual wellness exam documentation preferred + Knowledge of HEDIS Quality Care Gaps - review and closure preferred + Knowledge of… more