Hedis Review Nurse jobs in Los Angeles, CA

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FSR Nurse Coordinator

L.A. Care Health Plan 10 reviews - Los Angeles, CA
The FSR (Facility Site Review) Nurse Coordinator will be responsible for the coordination of facility site review processes and delegation activities....

Medical Director for Medical Claims and Code Edit Review

Molina Healthcare 126 reviews - Long Beach, CA
Reviews cases with concurrent review nurses. Reviews quality referred issues, focused reviews and recommends corrective actions....

Travel Registered Nurse Case Manager

Medical Staffing Network Care Management - Los Angeles, CA
Review admissions for appropriateness. Please be advised that we are only considering nurses with the following:....

LVN, Clinical Claims Review

HealthCare Partners 73 reviews - Torrance, CA
Responsible for review, research and complete retrospective clinical claims review for Commercial, Senior and Medi-Cal products....

Santa Monica Utilization Review RN - Managed Care

CareNational Healthcare Services, LLC - Santa Monica, CA
The Utilization Review Nurse is responsible for utilization management and utilization review for prospective, concurrent, or retrospective review....
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Healthcare Assistant - Long Beach (Temp-to-Perm)

Morgan Stephens - Long Beach, CA
Registered Nurse - RN / LVN:. Coordinates the preparation of the annual HEDIS medical record review project which includes Chase MOCK refinement, test run and...
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Clinical HEDIS Practice Advisor - Registered Nurse (RN)

WellCare 103 reviews - Cypress, CA
Required 2 years of experience in directly related HEDIS medical record review and/or Quality Improvement with experience in clinical data/chart reviews and...

Quality Improvement Director

St. John’s Well Child & Family Center - Los Angeles, CA
Reviews patient file/record, including allergies, problems, medications and immunization status. Considerable knowledge of the nurse practitioner guidelines,...

QI Compliance Specialist II RN -

Molina Healthcare 126 reviews - Long Beach, CA
HEDIS reporting or collection. Gather and review medical records from providers and facilities to complete activities related to quality of care issues, HEDIS...

Managed Care Director of Pharmacy

AIDS Healthcare Foundation 47 reviews - Los Angeles, CA
Collaborates with Chronic Care Model nurse care management staff in designing and executing the Medi. Annual formulary review and regulatory and/or contractual...

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