Hedis Review Nurse jobs

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Clinical HEDIS Practice Advisor, RN (Registered Nurse) Long...

WellCare 66 reviews - Long Beach, CA - +3 locations
Intermediate Ability to implement process improvements. Required Other Clinical license as an RN, pharmacist, LCSW, MD, DO, APRN, ANP, CPHARM, etc....
39 minutes ago - save job - block - email - more...

Cost Containment Specialist, RN or LPN

PMA Companies - De Witt, NY
Identify trends and recommend corrective measures. Perform retrospective review of medical billing and documentation for the purposes of recommending a state...
CareerBuilder - 9 hours ago - save job - block - email - more...

Utilization Manager

Centene Corporation 113 reviews - Brighton, MA - +10 locations
License/Certificates:. Unrestricted license as a LCSW, LMFT, PhD, PsyD or RN. provide member assistance and participate in special utilization projects....
10 hours ago - save job - block - email - more...

Utilization Manager (Sign-On Bonus)

Centene Corporation 113 reviews - McAllen, TX
License/Certificates:. Unrestricted license as a LCSW, LMFT, PhD, PsyD or RN. provide member assistance and participate in special utilization projects....
10 hours ago - save job - block - email - more...

Provider Support Specialist: Nurse / RN or MSW (Region 10 -...

Magellan Health Services 78 reviews - Fort Lauderdale, FL 33301 (Colee Hammock area) - +7 locations
15lbs. Implements programs to build and nurture positive provider relationships and improve the quality of care for Magellan Complete Care enrollees....
Monster - 15 hours ago - save job - block - email - more...

RN Quality Analyst/Clinical Educator for WellMed in San Anto...

UnitedHealth Group 1,170 reviews - San Antonio, TX
Ensures compliance with ICD-9 CM guidelines and CMS Risk Adjustment Data Validation requirements. Analyzes data along with Clinical Process Quality Manager to...
1 day ago - save job - block - email - more...

QI NURSE REVIEWER

Optima Health 6 reviews - Virginia Beach, VA
If RN candidate is not BSN prepared must be willing to sign an education agreement upon hire to complete BSN within 60 months of hire date, otherwise will not...
1 day ago - save job - block - email - more...

Practice Coordinator (Nurse Case Manager) Baltimore County

Cigna 555 reviews - Baltimore, MD
We encourage you to complete all questions on the candidate profile if you wish to be considered for this opportunity....
2 days ago - save job - block - email - more...

Director, Case Management High Risk

CareSource 20 reviews - Columbus, OH - +2 locations
Knowledge of regulatory requirements for both Medicaid and Medicare. Review Case Management effectiveness and conduct outcome evaluation on all programs....
CareerBuilder - 2 days ago - save job - block - email - more...

Director of Care Coordination

Aspirus Wausau Hospital 17 reviews - Wausau, WI 54401
utilization management/case management and inpatient and outpatient Social Work. Knowledge of patient care standards and management practices in a healthcare...
CareerBuilder - 2 days ago - save job - block - email - more...
Medical Record Field Reviewer
Outcomes Health Information Solutions 29 reviews - Reno, NV
2. HEDIS 3. Medical Record Reviews (Accreditation) 4... record review services 2. Scan relevant components of the medical record to support reviews performed 3...
Easily apply
Sponsored by Outcomes Health Information Solutions - 25 days ago
Registered Nurse - Naval Medical Center
Rao Medical Group - Portsmouth, VA
Participate in the peer review and training of staff... the scope of Registered Nurse practice as requested. Collaborate in the review and revision of clinic...
Easily apply
Sponsored by Rao Medical Group - 20 days ago
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