- Molina Healthcare (Columbus, OH)
- …objectives. + Preferred License, Certification, Association + Certified Professional in Health Quality (CPHQ) + Certified HEDIS Compliance Auditor (CHCA) ... and implementation of NCQA accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Manager, Health Plan Quality … more
- CommonSpirit Health Mountain Region (Centennial, CO)
- … Nurse ( RN ) licensure required + Registered Nurse ( RN ) licensure required + Supports quality improvement HEDIS measures and clinical ... compliance to meet State and Federal standards for HEDIS . Supports the development and implementation of quality... HEDIS . Supports the development and implementation of quality improvement interventions and audits. * Advises and educates… more
- CenterWell (Prairieville, LA)
- …excellence **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) without restriction in applicable state + ... caring community and help us put health first** The Quality RN Professional responsible for the development,...+ Proven work experience as a HEDIS Nurse or similar role in healthcare quality … more
- CenterWell (Miami, FL)
- …operational excellence **Use your skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) without restriction in Florida + 5+ ... evaluation of variable factors. The Stars Improvement Clinical Professional ( RN ): + Collaborates with market leadership, and quality...+ Proven work experience as a HEDIS Nurse or similar role in healthcare quality … more
- Peak Vista (Colorado Springs, CO)
- …Job Summary: The Population Health & Quality Assurance Registered Nurse ( RN ) is responsible for organizational ... functions and responsibilities of the Quality Assurance RN . + Knowledge of Regulatory Compliance to...to include governing bodies such as AAAHC, HRSA & HEDIS . Compliance with HIPAA and all applicable… more
- Elevance Health (Seven Fields, PA)
- …annual and ad hoc medical record reviews such as HEDIS and CPG compliance . + Conducts quality of care investigations and using criteria closes case ... **JR150201 Behavioral Health Clinical Quality Auditor Analyst Sr** The Behavioral Health Clinical...Skills, Capabilities, and Experiences:** + Active PA, LCSW, LBS, RN , LPC, LMFT, or LSW licensure is needed per… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Registered Nurse Care Coordinator, Quality Management Full Time, 80 Hours Per Pay Period, Day Shift Occasional travel as needed Covenant Medical ... development of practice guidelines and clinical pathways that support quality improvement activities. The RN Care Coordinator...coordination services within the scope of practice as a registered nurse meeting all required standards both… more
- Molina Healthcare (Columbus, OH)
- …. Clinical experience is needed for positions that are focused on Accreditation, Compliance , HEDIS Interventions, Potential Quality of Care issues, and ... + Possesses a strong knowledge in data acquisition processes, HEDIS and quality performance management across all...Degree in a related field **Preferred License, Certification, Association** RN with Quality Background is preferred To… more
- Centene Corporation (Harrisburg, PA)
- …Bachelor's degree in Nursing and 2 - 4 years of related experience. **License/Certification:** + RN - Registered Nurse - State Licensure and/or Compact State ... with chronic condition management, helping to reduce complications and cost, and increase quality outcomes with care gap closures and HEDIS measures. After… more
- Centene Corporation (Houston, TX)
- …providers and supports provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides ... compliance to meet State and Federal standards for HEDIS and documentation standards. Acts as a resource for...maintains provider clinical relationship across product lines. + Maintains Quality KPI and maintains good standing with HEDIS… more
- Centene Corporation (Oklahoma City, OK)
- …- FRIDAY, 8AM - 5PM CENTRAL TIME ZONE. IDEAL APPLICANT WILL BE A NURSE WITH HEDIS BACKGROUND.** **Position Purpose:** Establishes and fosters a healthy working ... supports provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk...compliance to meet State and Federal standards for HEDIS and documentation standards. Acts as a resource for… more
- Molina Healthcare (Los Angeles, CA)
- …+ Nursing License ( RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you are interested ... and implementation of NCQA accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Analyst, Quality Improvement (QI)… more
- ChenMed (Maple Heights, OH)
- …office center operations, which may include but is not limited to: clinical quality , compliance , human resources, patient experience and direct team member ... with the development and execution of business strategies that increase revenue and quality ratings ( HEDIS /STARS/Clinical Gaps) and support our core model. +… more
- Centene Corporation (Raleigh, NC)
- …insurance experience required; 2+ years of quality experience preferred. **License/Certification:** Registered Nurse ( RN ), Licensed Practical Nurse , ... in North Carolina.** **Position Purpose:** Identify market trends and oversee functions of quality improvement programs for HEDIS , CAHPS, and/or HOS strategy and… more
- Centene Corporation (Little Rock, AR)
- …Social Work (LMSW); Certified Social Worker (C-SW); Licensed Social Worker (LSW); Licensed Registered Nurse ( RN ) preferred.Pay Range: $26.50 - $47.59 per ... education for HEDIS measures and coding. Supports the implementation of quality improvement interventions and audits in relation to plan providers. Assists in… more
- Centene Corporation (Tacoma, WA)
- …or Healthcare Administration required **Experience in Behavioral Healthcare field preferred:** Registered Nurse ( RN ) certification, Licensed Mental Health ... Care or Healthcare Administration required. Experience in Behavioral Healthcare field required. Registered Nurse ( RN ), Licensed Clinical Social Worker… more
- Molina Healthcare (Provo, UT)
- …+ Nursing License ( RN may be preferred for specific roles) + Certified HEDIS Compliance Auditor (CHCA) To all current Molina employees: If you are interested ... and implementation of NCQA accreditation surveys and federal/state QI compliance activities. **KNOWLEDGE/SKILLS/ABILITIES** The Specialist, Quality Interventions/… more
- Humana (Baton Rouge, LA)
- …your skills to make an impact** **Required Qualifications** + Bachelor Degree + Louisiana-licensed registered nurse OR advanced practice registered nurse ... across the function or segment. The Director, Quality Improvement monitors quality investigations and compliance processes. **Role Overview:** + Manages … more
- Fallon Health (Worcester, MA)
- …care related field preferred. **License** : Active, unrestricted license as a Registered Nurse in Massachusetts **Certification** : Certification in Case ... and Program policies and processes o Knowledge of and compliance with HEDIS and Medicare 5 Star...**Experience:** * 1+ years of clinical experience as a Registered Nurse managing chronically ill members or… more
- Dignity Health (Bakersfield, CA)
- …special projects as assigned. **Qualifications** **Minimum Qualifications:** - CA Clinical licensure ( Registered Nurse ( RN ), Licensed Vocational Nurse ... medical group. - 5 years of oversight/supervision/management/leadership of clinical and non-clinical quality management staff. - 3 years HEDIS measures reporting… more