• UNIVERSITY HEALTH (San Antonio, TX)
    …Information Technician (RHIT), Registered Health Information Administrator (RHIA), and/or Registered Nurse (s) ( RN ) are highly preferred. recblid ... for Medicare and Medicaid Services (CMS), Agency for Healthcare Research and Quality (AHRQ), National Committee for Quality Assurance (NCQA) that promotes… more
    Appcast IO CPC (11/18/25)
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  • HEDIS RN - Quality

    US Tech Solutions (Newark, NJ)
    …potential extends or Convert** **Job Description:** + The HEDIS Nurse Auditor is responsible for conducting quality audits related to state audits, ... HEDIS measures, and quality -related complaints and referrals. + This role also supports...preferably in the healthcare industry. + **Active New Jersey Registered Nurse ( RN ) License required.**… more
    US Tech Solutions (08/22/25)
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  • Clinical Nurse Auditor

    Providence (WA)
    …practices during the audit season, which runs approximately February through mid-May. The RN auditor will successfully complete HEDIS training prior to ... reflects the Sisters of Providence mission and philosophy. The RN auditor will communicate in a collaborative...them. **Required Qualifications:** + Degree in Nursing + Oregon Registered Nurse License + 5+ years clinical… more
    Providence (11/18/25)
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  • Senior Overreader, HEDIS / Quality

    Molina Healthcare (Omaha, NE)
    …assist with ad hoc projects. **Job Duties** + Performs the role of the HEDIS medical record review overreader/ auditor which includes ongoing review of records ... Training Team, Regional HEDIS team, vendors and HEDIS auditors regarding quality and HEDIS...**O** **C** **I** **A** **TI** **O** **N** **:** Active RN license for the State(s) of employment **PHY** **S**… more
    Molina Healthcare (10/18/25)
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  • Specialist, Member & Community Interventions…

    Molina Healthcare (OH)
    …maintain critical program milestones, deadlines, and/or deliverables + Participates in quality / HEDIS improvement activities, meetings, and discussions with and ... in Medicaid managed care + Certified Professional in Health Quality (CPHQ) + Nursing License ( RN may... may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current… more
    Molina Healthcare (09/21/25)
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  • Senior Specialist, Member & Community…

    Molina Healthcare (OH)
    …within the department and/or collaboratively with other departments. Please include any HEDIS / Quality experience on your resume. This experience is important for ... reporting, analysis, and/or interpretation + Certified Professional in Health Quality (CPHQ) + Nursing License ( RN may... may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current… more
    Molina Healthcare (10/19/25)
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  • Case Manager, Pediatrics ( Registered

    Excellus BlueCross BlueShield (Rochester, NY)
    …varied clinical expertise (ex. Social Work, Behavioral Health, Respiratory Therapy, Registered Dietitian, Registered Nurse , Medical Director, Pharmacist, ... health care services. Examples may include: Utilization Management, Quality , Behavioral Health, Pharmacy, Registered Dietitian and...being met, such as NYS DOH, CMS, NCQA, and HEDIS , serving as internal auditor within the… more
    Excellus BlueCross BlueShield (11/03/25)
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  • Senior Specialist, Quality Interventions/QI…

    Molina Healthcare (Rockford, IL)
    …License, Certification, Association** + Active, unrestricted Certified Professional in Health Quality (CPHQ) + Active, unrestricted Nursing License ( RN may ... **JOB DESCRIPTION** **Job Summary** Molina's Quality Improvement function oversees, plans, and implements new...be preferred for specific roles) + Active, unrestricted Certified HEDIS Compliance Auditor (CHCA) To all current… more
    Molina Healthcare (11/09/25)
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  • Senior Specialist, Quality Program…

    Molina Healthcare (MA)
    …reporting, analysis, and/or interpretation + Active, unrestricted Certified Professional in Health Quality (CPHQ) + Active, unrestricted Nursing License ( RN may ... **Job Description** **Job Summary** The Senior Specialist, Quality Program Management and Performance implements new and...be preferred for specific roles) + Active, unrestricted Certified HEDIS Compliance Auditor (CHCA) To all current… more
    Molina Healthcare (10/26/25)
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