Hedis Review Nurse jobs

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RN Nurse Case Manager- Williamson County, TN

Cigna 657 reviews - Nashville, TN
Review and participate in audits of medical records. Coordinate real-time performance measure management across multiple practices that provide care for members...
34 minutes ago - save job - email - more...

Cost Containment Specialist, RN or LPN

PMA Companies - De Witt, NY - +1 location
In this position, use a proactive approach in providing extensive medical bill coding and medical documentation review in all jurisdictions....
CareerBuilder - 7 hours ago - save job - email - more...

Clinical HEDIS Practice Advisor, Bilingual (English \ Spanis...

WellCare 77 reviews - Miami Lakes, FL
Clinical HEDIS Practice Advisor, Bilingual (English \ Spanish) RN (Registered Nurse) Miami, FL. Care Health Plans, Inc....
8 hours ago - save job - email - more...

Baltimore Utilization Review Nurse -- Managed Care

CareNational Healthcare Services, LLC - Baltimore, MD
Utilization Review Nurse (RN) - Managed Care. The Utilization Review Nurse is responsible for utilization management and utilization review for prospective,... $70,000 - $80,000 a year
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9 hours ago - save job - email - more...

President Medicaid Health Plan - WV

KORE Healthcare Recruitment - Charleston, WV - +1 location
Lead strategic planning and development of the health plan business plan, quarterly reviews and course corrections....
11 hours ago - save job - email - more...

Quality Manager- Government Programs (Cigna Medical Group)

Cigna 657 reviews - Phoenix, AZ
Oversees the CMS Quality Program audit process, HEDIS reporting and ensures that SNP Structure and Process Performance Measures are being met....
12 hours ago - save job - email - more...

Home Chronic Care Physician - Alegis Care - Mobile AL

Cigna 657 reviews - Mobile, AL
The Physician is responsible for quality medical care for all assigned patients, meeting or exceeding generally accepted standards of medical care, along with...
12 hours ago - save job - email - more...

RN Clinical Quality Audit Analyst Senior

WPA Staffing Solutions, LLC - New York, NY 10001 (Chelsea area)
RN Clinical Quality Audit Analyst Sr Fortune 35 Health Benefits Company Healthcare / Health Services - Managed Care Medical / Health - Nurse Leadership....
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TalentDesk.com - 14 hours ago - save job - email - more...

Registered Nurse (RN) - Quality Management Nurse Consultant

Aetna 334 reviews - Omaha, NE 68118
The Quality Management Nurse Consultant is responsible for the review and evaluation of clinical information and documentation....
14 hours ago - save job - email - more...

Licensed Utilization Management (UM) Nurse Associate - LPN /...

Aetna 334 reviews - Dallas, TX 75247 (Northwest Dallas area)
-Familiarity with NCQA, JCAHO, URAC, HEDIS standards/measures. The level of education desired for candidates in this position is a Associate's degree or...
14 hours ago - save job - email - more...
RN Quality Coder - Coding Experience Required - Phoenix, AZ
UnitedHealth Group 1,430 reviews - Phoenix, AZ
reviews medical records to extract HEDIS and STAR documentation for documentation and submission to a health plan. The RN is also accountable for the review of...
Sponsored by UnitedHealth Group - 10 days ago
Clinical Nurse Manager
General Physician, PC - Elma, NY
NCQA, DRP and incentive programs • Understanding of HEDIS measures • Providing suggestions and input to... test reports, etc. • Review current pricing of...
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Sponsored by General Physician, PC - 5 days ago
Clinical Practice Consultant - Albuquerque, New Mexico
UnitedHealth Group 1,430 reviews - Albuquerque, NM
HEDIS medical record chase to support optimum HEDIS... CPC, Clinical, RN, Registered Nurse, Nurse, LPN, Licensed Practical Nurse, medical records, HEDIS, NCQA...
Sponsored by UnitedHealth Group - 30 days ago

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