• Utilization Review Registered Nurse

    Community Health Systems (Naples, FL)
    …meet deadlines. + Effective written and verbal communication skills. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact ... **Job Summary** Under the direction of the UR Director/ Manager the UR Nurse reviews all...2-4 years clinical practice experience required + Experience in HEDIS , MIPS, PQRS, ACO, STARS preferred **Knowledge,… more
    Community Health Systems (04/25/25)
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  • Lead Overreader, HEDIS Abstraction…

    Molina Healthcare (Columbus, OH)
    …managed care experience. + Advanced knowledge of HEDIS and NCQA. ** PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Active RN license for the State(s) of ... HEDIS review and results. + Works with the Manager to monitor accuracy of abstracted records as required...SKILLS & ABILITIES:** * 5 years experience in healthcare Quality/ HEDIS specific to overreading ** PREFERRED EXPERIENCE:** +… more
    Molina Healthcare (04/11/25)
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  • Nurse Manager ( RN or LPN)

    Sea Mar Community Health Centers (Tacoma, WA)
    Nurse Manager - Posting #25738 Salary Rate: $74,958.09 (LPN) - $92,444.35 ( RN ) Position Summary: Full-time Nurse Manager ( RN or LPN) position ... a Patient Centered Medical Home (PCMH) level III. The Nurse Manager works in conjunction with Health...experience in nursing supervision as well as management experience preferred . + Ideal candidates would be Registered more
    Sea Mar Community Health Centers (04/29/25)
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  • Quality RN Professional - Cutler Bay

    CenterWell (Miami, FL)
    …operational excellence **Use your skills to make an impact** **Required Qualifications** + 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...clinical nursing experience + Proven work experience as a HEDIS Nurse or similar role in healthcare… more
    CenterWell (05/02/25)
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  • Quality RN Professional

    CenterWell (Houston, TX)
    …excellence **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) without restriction in applicable state + ... community and help us put health first** The Quality RN Professional is responsible for the development, implementation and...clinical nursing experience + Proven work experience as a HEDIS Nurse or similar role in healthcare… more
    CenterWell (04/08/25)
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  • Nurse Manager ( RN or LPN)

    Sea Mar Community Health Centers (Puyallup, WA)
    …a mandatory COVID-19 and flu vaccine organization Nurse Manager - Posting #26096 Nurse Manager RN Annual Salary: $85,470.00 Nurse Manager LPN ... Annual Salary: $74,958.09 Position Summary: Full-time Nurse Manager position available for our Medical Clinic in Puyallup,...up to 50 pounds. Requirements: + Must be a Registered Nurse , BSN, LPN or equivalent and… more
    Sea Mar Community Health Centers (02/12/25)
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  • Case Manager , RN or Licensed…

    Excellus BlueCross BlueShield (Rochester, NY)
    …Levels + Associates degree required. Bachelor's degree preferred . + Active NYS RN or Registered Dietician or Physical Therapist licensure required; or LMSW; ... varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist,… more
    Excellus BlueCross BlueShield (05/01/25)
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  • Manager , Health Plan Quality Interventions…

    Molina Healthcare (Columbus, OH)
    …surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Health Plan Quality Interventions is responsible for developing, ... implementing, and monitoring the success of quality improvement interventions. The Manager works to coordinate resources and training within the health plan and… more
    Molina Healthcare (04/25/25)
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  • Nurse Manager ( RN or LPN)

    Sea Mar Community Health Centers (Aberdeen, WA)
    …for the following position(s): Sea Mar is a mandatory COVID-19 and flu vaccine organization Nurse Manager ( RN or LPN) - Posting #27454 Hourly Rate: $36.04 ... Salary: $74,958.09 - 92,444.35 (depending on license/experience) Position Summary: Full-time Nurse Manager position available for our Aberdeen Medical Clinic.… more
    Sea Mar Community Health Centers (04/11/25)
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  • Nurse Manager , RN

    Sea Mar Community Health Centers (Lakewood, WA)
    …for the following position(s): Sea Mar is a mandatory COVID-19 and flu vaccine organization Nurse Manager , RN - Posting #26919 Annual Salary: $85,470.00 - ... $92,444.35 Position Summary: Full-time Nurse Manager position available for our Lakewood...or hospitals + Focus clinic efforts on quality measures, HEDIS , and Meaningful Use standards + Provide annual MA… more
    Sea Mar Community Health Centers (03/27/25)
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  • LPN/ RN Clinical Manager

    ChenMed (Maple Heights, OH)
    …related field preferred + Active and good standing Licensed Practical Nurse (LPN) in current state of employment **OR** a nationally accredited Certified Medical ... great people to join our team. The Center Clinical Manager (CCM) is an active leadership role responsible for...of business strategies that increase revenue and quality ratings ( HEDIS /STARS/Clinical Gaps) and support our core model. + Develops… more
    ChenMed (04/24/25)
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  • Community Care Nurse Case Manager

    Fallon Health (Worcester, MA)
    …field preferred . **License** : Active, unrestricted license as a Registered Nurse in Massachusetts **Certification** : Certification in Case Management ... Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The Nurse Case Manager (NCM) is an integral...**Experience:** * 1+ years of clinical experience as a Registered Nurse managing chronically ill members or… more
    Fallon Health (04/16/25)
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  • Manager Population Health - Sharp Health…

    Sharp HealthCare (San Diego, CA)
    …Nursing; California Registered Nurse ( RN ) - CA Board of Registered Nursing; Certified Case Manager (CCM) - Commission for Case Manager ... Nurse ( RN ) - CA Board of Registered Nursing -REQUIRED ** Preferred Qualifications** + 2...Case Manager (CCM) - Commission for Case Manager Certification - PREFERRED **Other Qualification Requirements** +… more
    Sharp HealthCare (04/30/25)
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  • Manager , Quality Improvement, Clinical

    CenterWell (Dallas, TX)
    …experience, m **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) without restriction in Florida + 5+ years ... and help us put health first** **Job Profile Summary** The Manager , Stars Improvement, Clinical responsible for the development, implementation and management… more
    CenterWell (04/08/25)
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  • Nurse Case Manager - Community Care…

    Fallon Health (Worcester, MA)
    …field preferred **License/Certifications:** + Active, unrestricted license as a Registered Nurse in Massachusetts; current Driver's license and reliable ... Facebook, Twitter and LinkedIn** **Brief Summary of Purpose:** The Nurse Case Manager (NCM) is an integral...**Experience:** + 1+ years of clinical experience as a Registered Nurse managing chronically ill members or… more
    Fallon Health (04/19/25)
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  • Manager Clinical Quality Improvements

    Dignity Health (Bakersfield, CA)
    …special projects as assigned. **Qualifications** **Minimum Qualifications:** - CA Clinical licensure ( Registered Nurse ( RN ), Licensed Vocational Nurse ... system/national level in the population health space. **Position Summary:** The Manager , Clinical Quality Improvement, is responsible for leading multiple large… more
    Dignity Health (04/11/25)
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  • Practice Transformation Specialist

    Apex Health Solutions (Houston, TX)
    …(CPC) Certified Professional in Healthcare Quality (CPHQ) Licensed Vocational Nurse (LVN) Registered Nurse ( RN ) ABOUT APEX HEALTH SOLUTIONS Apex Health ... Value Based Healthcare processes. The PTS reports to the Manager , Practice Transformation. The PTS is responsible for providing...health plan goals are met as it relates to HEDIS /STARs and Risk Adjustment. This position coaches a practice… more
    Apex Health Solutions (04/12/25)
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  • Manager Corporate Wellness

    AmeriHealth Caritas (Newtown Square, PA)
    …Experience:;** + Bachelor's degree in Health related field preferred + Master's Degree + Registered Nurse , LSW, LCSW, LPC, MPH; ; ; ;; + 5 to 10 years ... services. Discover more about us at www.amerihealthcaritas.com . The Manager oversees centralized Corporate functions of the Wellness-RROT (Rapid Response… more
    AmeriHealth Caritas (04/24/25)
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  • Clinical Quality Manager

    Healthfirst (NY)
    …+ Clinical license: LPN, RN , LMSW or LCSW + Multiple years of HEDIS review experience for both Medicaid and Medicare lines of business + Medical record review ... chronic disease management + Assists in writing member and/or provider articles on HEDIS , QARR, Medicare Advantage, and/or health promotions for the HF newsletter +… more
    Healthfirst (02/08/25)
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  • Quality Improvement Supervisor, Clinical

    CenterWell (Miami Beach, FL)
    …excellence **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) without restriction in applicable state + ... across the following areas: + Quality/clinical management and population health + HEDIS and Stars performance + Operational improvements + Financial performance and… more
    CenterWell (04/08/25)
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