• Sr. HEDIS Coordinator

    Somatus (Mclean, VA)
    …and mental well-being + Community engagement opportunities + And more! The Sr. HEDIS Coordinator will perform the functions related to the outreach, collection, ... entering of medical records and service data according to HEDIS / Somatus Technical Specifications. The primary focus of...Responsibilities + Coordinate, complete, and update management on all HEDIS processes and results. + Work with providers and… more
    Somatus (04/25/24)
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  • Clinical Quality Project Coordinator

    Healthfirst (New York, NY)
    The Clinical Quality Project Coordinator is responsible for supporting Healthfirst initiatives and regulatory requirements related to HEDIS quality improvement. ... Church Street, New York. Duties and Responsibilities: + Support providers with HEDIS care gap closures through member outreach and appointment scheduling + Educate… more
    Healthfirst (03/14/24)
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  • Quality Improvement Coordinator

    Humana (Columbia, SC)
    …caring community and help us put health first** The Quality Improvement Coordinator participates in quality improvement (QI) activities for the South Carolina Humana ... medical record review and committee preparations. The Quality Improvement Coordinator performs member and provider outreach calls, medical record audits… more
    Humana (04/24/24)
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  • Population Health Coordinator Full Time

    LifePoint Health (Ishpeming, MI)
    The Population Health Coordinator is responsible for providing outreach and education/training to drive quality outcomes and overall health status across the health ... (NCQA) structure and standards, Health Plan Employer Data and Information Set ( HEDIS ). Knowledge of how to use computerized statistical methods in CQI context.… more
    LifePoint Health (04/20/24)
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  • Health Advocate- Call Coordinator , Healthy…

    CVS Health (Springfield, IL)
    …Health Advocate p rovides support for Healthcare Effectiveness Data and Information Set ( HEDIS ) quality initiatives by performing the following: + Work on one or ... data elements in the CRM tool to support medical record chasing for HEDIS medical record documentation of services. + Provides members with the right information… more
    CVS Health (03/10/24)
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  • Quality Auditor Service Coordinator

    Humana (Indianapolis, IN)
    …and help us put health first** The Quality Auditor Service Coordinator "/Quality Improvement Professional 2 implements quality improvement programs for all lines ... and promote independence through a collaborative relationship with the Care Coordinator , member, and caregiver. + Identify transition opportunities and work closely… more
    Humana (04/06/24)
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  • Grievance And Appeals Coordinator

    Randstad US (Columbus, OH)
    grievance and appeals coordinator . + columbus , ohio + posted april 10, 2024 **job details** summary + $19.99 - $20 per hour + temp to perm + high school + category ... client of Randstad's has an immediate opening for an experienced Grievance and Appeals Coordinator . This is a hybrid role located in Columbus, OH. First month would… more
    Randstad US (04/11/24)
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  • Quality Improvement Coordinator

    Apicha Community Health Center (New York, NY)
    …and persons living with HIV. We are currently seeking a Quality Improvement Coordinator to work at our Manhattan location. Position Summary: The Quality Improvement ... Coordinator (QIC) is a member of the Department of...strongly preferred); Knowledge of medical terminology required; Knowledge of HEDIS /QUARR and/or UDS Measures preferred; Proficiency in MS Office,… more
    Apicha Community Health Center (04/14/24)
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  • Record Acquisition Coordinator - Medical…

    Health First (Rockledge, FL)
    …reporting functions, such as the Healthcare Effectiveness Data and Information Set ( HEDIS ) and Risk Adjustment chart requests as well as medical record requests ... with provider offices to obtain the medical records. The Record Acquisition Coordinator 's responsibility is to procure selective medical records from the care… more
    Health First (03/30/24)
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  • Grievance & Appeals Coordinator I

    TEKsystems (Los Angeles, CA)
    Hiring for Grievance and appeals Coordinator Tek Systems is currently hiring for Healthcare program coordinators for one of top healthcare company in Florida.  ... including data entry, tracking, organizing, and researching information Assist with HEDIS production functions including data entry, calls to providers offices, and… more
    TEKsystems (04/17/24)
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  • Grievance & Appeals Coordinator I

    TEKsystems (Woodland Hills, CA)
    Hiring For Grievance and Appeals Coordinator TekSystems is currently hiring for Healthcare program coordinators for one of top healthcare company in CA, Description: ... including data entry, tracking, organizing, and researching information Assist with HEDIS production functions including data entry, calls to providers offices, and… more
    TEKsystems (04/17/24)
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  • RN Quality Ambulatory Care Coordinator

    Catholic Health Initiatives (Lexington, KY)
    **Overview** The RN Quality Ambulatory Care Coordinator is responsible for supporting the quality initiatives of the clinically integrated network. These functions ... claims auditing._ + _Validate clinical documentation in conjunction with contracted HEDIS measures and best practices._ + _Access clinical documentation for… more
    Catholic Health Initiatives (03/08/24)
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  • Lead Quality Improvement Coordinator

    Centene Corporation (Columbia, SC)
    …or RN for this position. + Field questions and escalated issues related to HEDIS and NCQA. + Monitor team performance. + Recognize and anticipate issues to report ... to the Manager. + Conduct monthly audits to identify trends. + With the Manager, develop actions for improvement based on identified trends. + Create reports and presentations for meetings. + Gather, analyze, and complete reports for Manager for review. +… more
    Centene Corporation (04/05/24)
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  • Grievance & Appeals Coordinator I

    Centene Corporation (Phoenix, AZ)
    …data entry, tracking, organizing, and researching information + Assist with HEDIS production functions including data entry, calls to provider's offices, and ... claims research. + Manage large volumes of documents including copying, faxing and scanning incoming mail **Education/Experience:** High school diploma or equivalent. Associate's degree preferred. 2+ years grievance or appeals, claims or related managed care… more
    Centene Corporation (04/05/24)
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  • FNP/PA-C - Bilingual Spanish - CenterWell…

    Centerwell (Phoenix, AZ)
    …D, Care Coach Nurse, MA, Behavioral health specialist, Quality based Coder, Referral Coordinator and more. Our approach allows us to provide an unmatched experience ... environment. + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators. **Use your skills to make an impact** **Required… more
    Centerwell (04/10/24)
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  • NP/PA - CenterWell - IPA

    Centerwell (Las Vegas, NV)
    …D, Care Coach Nurse, MA, Behavioral health specialist, Quality based Coder, Referral Coordinator and more. Our approach allows us to provide an unmatched experience ... to IPA Physicians and Advanced Practice Providers on Medicare documentation guidelines, HEDIS /Quality measures, and clinic workflows that align with Value Based Care… more
    Centerwell (01/31/24)
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  • Nurse Practitioner - Elite Health

    Conviva (Sarasota, FL)
    …D, Care Coach Nurse, MA, Behavioral health specialist, Quality based Coder, Referral Coordinator and more. Our approach allows us to provide an unmatched experience ... Medicare guidelines and coverage. + Spanish is needed + Knowledge of HEDIS quality indicators. **Additional Information:** + Guaranteed base salary + quarterly bonus… more
    Conviva (04/20/24)
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  • Nurse Practitioner - Conviva - East

    Conviva (Port Orange, FL)
    …D, Care Coach Nurse, MA, Behavioral health specialist, Quality based Coder, Referral Coordinator and more. Our approach allows us to provide an unmatched experience ... Medicare guidelines and coverage. + Bilingual is a plus + Knowledge of HEDIS quality indicators. **Additional Information:** + Guaranteed base salary + annual bonus… more
    Conviva (04/19/24)
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  • CenterWell - Nurse Practitioner - Richmond Road

    Centerwell (Lexington, KY)
    …D, Care Coach Nurse, MA, Behavioral health specialist, Quality based Coder, Referral Coordinator and more. Our approach allows us to provide an unmatched experience ... Medicare guidelines and coverage. * Bilingual is a plus * Knowledge of HEDIS quality indicators. **Additional Information:** * Guaranteed base salary + annual bonus.… more
    Centerwell (04/18/24)
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  • Nurse (RN/LPN) Floor Supervisor

    Sea Mar Community Health Centers (Seattle, WA)
    …referrals according to the utilization management guidelines when the referral coordinator is unavailable. + Coordinate transfer of acute patients when ordered ... regulatory requirements including, but not limited to: JCAHO, NPSG, Department of Health, HEDIS , PET and contractual obligations. + The RN/LPN may be required to… more
    Sea Mar Community Health Centers (04/17/24)
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