- Ventura County (Ventura, CA)
- …case managing complex cases, disease managing certain population, performing utilization review , supervising HEDIS documentation, and writing required analyses ... of their licensure, providing case management, disease management, and utilization review functions, to responsibilities associated with HEDIS and NCQA-oriented… more
- The Cigna Group (Mobile, AL)
- …manage relationships with participating provider practices. Maintain detailed understanding of HEDIS / STAR/ CAHPS performance measures. Develop and maintain a ... and metrics for customers and communicates to provider + Review STAR summary gap report (daily) by payor +...include primary care physician and specialist appointment scheduling + Nurse notifies PCP daily of admissions and discharges +… more
- The Cigna Group (Philadelphia, PA)
- …manage relationships with participating provider practices. Maintain detailed understanding of HEDIS / STAR performance measures. Develop and maintain a process to ... None **Qualifications** : + Current Licensure as a registered nurse , in the state of residency. in good standing....can be a combination of LVN/RN licensure) + Previous HEDIS and/or CMS STARs experience a plus + **Bilingual**… more
- Centene Corporation (Omaha, NE)
- …field or equivalent work experience within a managed care environment related to HEDIS record review , quality improvement, medical coding or transferable skill ... or related field. Candidate Experience: Required: 1+ year of experience in related HEDIS medical record review or quality improvement with experience in data… more
- Centerwell (Newport News, VA)
- …a part of our caring community and help us put health first** The Nurse Practitioner provides health promotion and maintenance through the diagnosis and treatment of ... and determining the best course of action. Responsibilities: The Nurse Practitioner (NP) works in our team-based care environment....Leadership. + Meets with RMD about quality of care, review of outcome data, policy, procedure, and records issues.… more
- Elevance Health (Rancho Cordova, CA)
- …you a check, or ask you for payment as part of consideration for employment. **Wellness Nurse Consultant** + Job Family: MED > Licensed Nurse + Type: Full time + ... Rancho Cordova + California, Oakland + California, Vacaville **Description** **Wellness Nurse Consultant** **Sign Bonus: $5000** At **Federal Health Products and… more
- Conviva (Sarasota, FL)
- …experience. \#EliteHealth **Use your skills to make an impact** **Responsibilities:** The Nurse Practitioner (NP) works in our team-based care environment. We are a ... team consists of doctors, advanced practice professionals, Pharm D, Care Coach Nurse , MA, Behavioral health specialist, Quality based Coder, Referral Coordinator and… more
- Conviva (Port Orange, FL)
- …team supporting patient's physical, emotional, and social wellness. **Responsibilities:** The Nurse Practitioner (NP) works in our team-based care environment. We ... team consists of doctors, advanced practice professionals, Pharm D, Care Coach Nurse , MA, Behavioral health specialist, Quality based Coder, Referral Coordinator and… more
- Centerwell (Lexington, KY)
- …and providing a positive and welcoming environment for all. **Responsibilities:** The Nurse Practitioner (NP) works in our team-based care environment. We are a ... team consists of doctors, advanced practice professionals, Pharm D, Care Coach Nurse , MA, Behavioral health specialist, Quality based Coder, Referral Coordinator and… more
- Centerwell (Mesa, AZ)
- …focused on teamwork and providing a positive and welcoming environment for all. The Nurse Practitioner (NP) works in our team-based care environment. We are a value ... team consists of doctors, advanced practice professionals, Pharm D, Care Coach Nurse , MA, Behavioral health specialist, Quality based Coder, Referral Coordinator and… more
- MyFlorida (St. Petersburg, FL)
- AUTONOMOUS ADVANCED PRACTICE REG NURSE - 64003693 Date: Mar 25, 2024 Location: ST PETERSBURG, FL, US, 33701 The State Personnel System is an E-Verify employer. For ... 825692 Agency: Department of Health Working Title: AUTONOMOUS ADVANCED PRACTICE REG NURSE - 64003693 Pay Plan: Career Service Position Number: 64003693 Salary:… more
- Centerwell (Houston, TX)
- …team supporting patient's physical, emotional, and social wellness. The Cardiology Nurse Practitioner serves as a health-care provider who specializes in diagnosis, ... follow-up of patients with any suspected or known heart diseases. The Nurse Practitioner work assignments involve outpatient office and telehealth visits, curbside… more
- InnovaCare (Ponce, PR)
- …record reviews in accordance with the policies and procedures. Performs medical record review in physician's offices of selected HEDIS sample. Performs follow ... passion and customer focus to the business. POSITION DESCRIPTION The Quality Specialist Nurse is responsible for monitoring quality of care and services delivered to… more
- Actalent (Tigard, OR)
- …entry, medical terminology, health care Top Skills Details: HEDIS ,medical record,quality improvement,member outreach,medicare,chart review ,NCQA Additional Skills ... group practices. Serves to collaborate with providers in the field to improve HEDIS measures and provides education for HEDIS measures and coding. Supports… more
- Actalent (Chattanooga, TN)
- …and meet & maintain acceptable performance goals Responsibilities: Responsibilities: The contract nurse is responsible for retrieval, review , and abstraction of ... and reliable transportation are required for project participation. Skills: registered nurse , supplemental data collection, HEDIS , computer, EMR Top Skills… more
- Actalent (Chattanooga, TN)
- …data in preparation for the HEDIS audit in 2025. + The contract nurse is responsible for retrieval, review , and abstraction of medical record data, required ... for multiple and complex STARS and HEDIS measures as well as entering the data into...+ This will include performing either on-site medical record review at physician offices or in the company's office.… more
- Actalent (Johnson City, TN)
- …project. Please see below for details and qualifications! Description: + The contract nurse is responsible for retrieval, review , and abstraction of medical ... record data, required for multiple and complex STARS and HEDIS measures as well as entering the data into...+ This will include performing either on-site medical record review at physician offices or in the office +… more
- Apex Health Solutions (Houston, TX)
- …their staff to ensure health plan goals are met as it relates to HEDIS /STARs and Risk Adjustment. This position coaches a practice staff to improve patient outcomes ... Professional Coder (CPC) Certified Professional in Healthcare Quality (CPHQ) Licensed Vocational Nurse (LVN) Registered Nurse (RN) EXPERIENCE : Mi nimum five… more
- Commonwealth Care Alliance (Boston, MA)
- …adhering to CCA Policies and Procedures and within scope of licensure. + Evaluate HEDIS Measure Gaps and work towards closure of gaps in clinical practice and in ... specialty services, LTSS coordinators, Aging Service Access Points (ASAPs), visiting nurse services, care attendants, member designated contacts, and next of kin.… more
- Centerwell (Atlanta, GA)
- …with assigned nurse practitioners on management of complex patients. + Review all acute utilization events, with goal of reducing unnecessary utilization. + Use ... operation, nights, and/or weekends.** This position will provide chart review for 3-5 hours per month. Additionally, this role...action. + Provide collaborating agreements for up to 4 nurse practitioners in the state of Georgia including but… more