• Pride Global (Minneapolis, MN)
    …Experience with HEDIS software tools and working with HEDIS auditors Medical record review experience Russell Tobin / Pride Global offers eligible ... courses and training content for full-time employees and contractors engaged in HEDIS operations. This individual will collaborate with subject matter experts and… more
    Upward (07/07/25)
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  • MedStar Health (Washington, DC)
    …focus on HEDIS preferred and Previous experience with prior authorization review processes preferred and Previous use or knowledge of Cerner or MedConnect ... requests and other departmental initiatives. Collects all pertinent information for Medical Reviewers ( Medical Directors and Health Plan pharmacists) to… more
    Upward (07/16/25)
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  • Lead Abstractor, HEDIS /Quality Improvement…

    Molina Healthcare (TX)
    …which includes ongoing review of records submitted by providers and the annual HEDIS medical record review . + Leads meetings with vendors for the ... Improvement Lead Abstractor conducts data collection and abstraction of medical records for HEDIS projects,...lead role in the coordination and preparation of the HEDIS medical record review more
    Molina Healthcare (07/17/25)
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  • Abstractor, HEDIS /Quality Improvement…

    Molina Healthcare (Cincinnati, OH)
    …includes ongoing review of records submitted by providers and the annual HEDIS medical record review . + Participates in meetings with vendors ... team functions to conduct data collection and abstraction of medical records for HEDIS projects,...minimum over read standards. **Job Duties** + Coordinates the HEDIS medical record review more
    Molina Healthcare (07/17/25)
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  • HEDIS Coordinator 1

    TEKsystems (Long Beach, CA)
    Description The Clinical Quality team oversees and is responsible of HEDIS medical record review pursuit and overall HEDIS submission. The HEDIS ... will be responsible for conducting provider outreach during the HEDIS season for medical record ...provider offices & hospitals to request medical records for Medicare PPO population. * Record more
    TEKsystems (07/25/25)
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  • HEDIS Reviewer II

    US Tech Solutions (May, OK)
    …the screenings. * Search for relevant HEDIS records from databases, review medical records using HEDIS technical specification criteria or ... collection, and review of medical records to abstract clinical information for HEDIS ...offices as needed to schedule/confirm appointments, follow up on medical record submission, and provide patient rosters… more
    US Tech Solutions (05/07/25)
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  • HEDIS Clinical Coordinator I & II

    Somatus (Mclean, VA)
    …related to the outreach, collection, and accurate data entering of medical records and service data according to HEDIS / Somatus Technical Specifications. ... be to analyze and process the information collected and review the applicable medical records ...or Vocational Nurse. + 1-3 years experience working in HEDIS or medical records . +… more
    Somatus (07/25/25)
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  • HEDIS Overreader Registered Nurse

    Insight Global (Philadelphia, PA)
    …position in PA or NJ. This is a fully remote position and requires previous HEDIS review experience. This person will be responsible for Quality Check of FDC/ ... 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 or LPNs (Field…

    Insight Global (Philadelphia, PA)
    …providers Scan/Upload/Download medical records from onsite reviews daily Medical record abstraction into database from onsite visit, assigned remote ... from providers via fax, abstraction & entry of medical records assigned by a Clinical Quality... review experience or experience with Utilization Review , Quality, Medical Record auditing… more
    Insight Global (07/01/25)
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  • * HEDIS Reviewer III

    NTT DATA North America (IL)
    …Summary: Participates in the collection and review of medical records to abstract clinical information for HEDIS quality reporting. Training will be ... the assignment. This position interprets relevant clinical criteria through review of medical records , annotates...offices as needed to schedule/confirm appointments, follow up on medical record submission, and provide patient rosters… more
    NTT DATA North America (07/02/25)
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  • Quality Management Clinical Nurse - Facility Site…

    UCLA Health (Los Angeles, CA)
    …including inspections of clinical areas, patient care practices, and administrative processes + Review medical records of services in preparation for health ... Key responsibilities include: + Travel to various clinic sites and schedule and conduct medical record and facility site audits + Conduct thorough facility site… more
    UCLA Health (07/14/25)
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  • Utilization Review - Registered Nurse

    Community Health Systems (Naples, FL)
    …on performance improvement of the UR KPI's. Ensures proper and accurate medical record documentation. **Essential Functions** + Reviews new admissions using ... Primarily responsible for the collection and confirmation of accurate documentation in the Medical Record + Works with healthcare providers to ensure complete… more
    Community Health Systems (07/12/25)
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  • Clinical Quality and Risk Liaison LVN

    Dignity Health (Bakersfield, CA)
    …action plans to address the needs and barriers in collaboration with providers. - Performs medical record review or audits as needed. - Document provider, ... Liaison provides education and acts as a resource for HEDIS measures, appropriate medical record ...work experience of 2 years related HEDIS record collection and measures improvement with analytical review more
    Dignity Health (07/16/25)
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  • Medical Director - Dsnp/MMP

    CVS Health (Tallahassee, FL)
    …care of patients with severe, complex, and/or treatment resistant illnesses through peer review and educational interventions. * Work with medical director teams ... focusing on inpatient care management, clinical coverage review , member appeals clinical review , ...multiple stakeholders. * Help achieve or exceed all applicable HEDIS , Stars and local state performance targets and goals… more
    CVS Health (07/18/25)
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  • Medication Therapy Management (MTM) Technician

    Prime Therapeutics (Lincoln, NE)
    …to support the Centers for Medicare & Medicaid Services (CMS) Star and HEDIS quality measure programs, including but not limited to: Medication Therapy Management ... qualified members' medications and disease states related to the Star and HEDIS quality measures programs and processes. **Responsibilities** + Receive inbound and… more
    Prime Therapeutics (07/16/25)
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  • Chief Medical Officer--Aetna Better Health…

    CVS Health (Lansing, MI)
    …enablement. 4. Have oversight of the design, development, and deployment of Care Models and review medical care provided to Enrollees and medical aspects of ... driving clinical excellence, achieving measurable health outcomes, and supporting quality and medical management in a highly matrixed environment. The CMO will also… more
    CVS Health (07/18/25)
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  • Practical Nurse

    Defense Health Agency (Fort Irwin, CA)
    …and routes of administration. Review requires transcription of information to medical records and official school forms. Documents administration on required ... ( HEDIS ) metrics, procedure preparation, wellness screening paperwork, etc. Review patient appointments, 24-78 hours prior to scheduled appointment and identifies… more
    Defense Health Agency (07/10/25)
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  • Lead Medical Support Assistant

    Veterans Affairs, Veterans Health Administration (Hampton, VA)
    …in the clinic unit area. Responsibilities VA Careers - Lead Medical Support Assistant: https://youtube.com/embed/UJO\_XH5uCLs Total Rewards of a Allied Health ... assessments, assigning work, and assuring proper staffing coverage; evaluating training records ; and determining training needs of MSAs. Responsible for scheduling… more
    Veterans Affairs, Veterans Health Administration (07/15/25)
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  • MA Quality Performance, Pop Health Boise Clinics…

    Trinity Health (Boise, ID)
    …Population Health Team is now hiring for a compassionate and adaptable Medical Assistant! This position will support the Boise area family medicine clinics! ... initiatives (Gaps In Care Closure) focused on Quality measures ( HEDIS ). + This position will be primarily located at...be flexible day to day. + The Saint Alphonsus Medical Group is a multi-specialty, physician-led organization focused on… more
    Trinity Health (07/11/25)
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  • Registered Nurse (Family/Internal Medicine)

    Adelante (Goodyear, AZ)
    …to find additional resources to support patient care. Administrative Responsibilities + Obtain medical records , labs & diagnostics results as needed. + Align ... individuals with the education and resources necessary for managing their medical conditions effectively. EXPECTATIONS Every Adelante Healthcare employee will strive… more
    Adelante (07/04/25)
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