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MJ Morgan Group - 7 reviews - Lutherville-Timonium, MD
$80,000 a year
Currently seeking an Registered Nurse to fill a HEDIS Nurse position working within a managed care organization just outside of Baltimore....
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Utilization Manager IP/OP
Cenpatico National - Omaha, NE
Master's degree in Behavioral Health or Registered Nurse required. Ensure compliance with all performance measures in regards to appeals, denials, higher level...
Sponsored by Centene Corporation

Quality Nurse Manager

GlobalHealth - Tulsa, OK 74136
The Quality Nurse is responsible for the review of clinical cases that may be related to quality of care issues identified by appeals and grievance process,...

Quality Accreditation Coordinator

WESTERN HEALTH ADVANTAGE - 5 reviews - Sacramento, CA
Participate in medical record documentation and HEDIS hybrid medical record review projects. Valid California Registered Nurse license required....
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Provider Based RN Case Manager - Sussex, NJ

UnitedHealth Group - 3,957 reviews - Newton, NJ
RN, Registered Nurse, Case Manager, Nursing, HEDIS, EMR, Managed Care, Medicare, Sussex, NJ, New Jersey. Experience with HEDIS and EMR (electronic medical...

Perioperative Quality Specialist

Virginia Hospital Center - 123 reviews - Arlington, VA
Registered Nurse Licensed in the Commonwealth of Virginia. Works with VHC Quality Division and Perioperative Clinical Educator to maintain JCAHO, AORN, NQCA,...


Epic Management - 15 reviews - United States
On quality review or utilization review background. Studies & HEDIS. The QI Nurse is responsible for maintaining the....
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Health Risk & Quality Consultant -- RN

Aetna - 1,628 reviews - Atlanta, GA 30339
Nursing/Registered Nurse (RN) is required. Functional - Clinical / Medical/Clinical claim review & coding/4-6 Years....

Clinical Quality Management Nurse

Johns Hopkins Health Care - 336 reviews - Glen Burnie, MD
The Clinical Quality Management Nurse (CQMN) has good knowledge of quality improvement (QI) standards such as accreditation, regulatory, HEDIS ®, Value Based...

QM Nurse Consultant

Aetna - 1,628 reviews - Dallas, TX
Nurse Consultant role responsible for medical record reviews for HEDIS and Potential Quality of Care incidents....

Cnslt, Clinical Quality - GA Region - FT(40hrs)

Kaiser Permanente - 3,637 reviews - Atlanta, GA
Responsible for continuous quality reviews of the program to ensure HEDIS, STARs and other Adult Medicine/ Pediatric departmental quality measures are met....

Compliance Liaison

CareSource - 69 reviews - Dayton, OH 45402 (Downtown area)
Support accreditation initiatives, including URAC, NCQA and HEDIS. Performs quality monitoring/case review in coordination with Quality Improvement staff....
EBI Medical Informatics Analyst - I
ABCBS - 18 reviews - Little Rock, AR
HEDIS and Quality of Care Measurement. For example, a Registered Health Information Administrator (RHIA), registered nurse (RN), etc....
Sponsored by Arkansas Blue Cross and Blue Shield
QUALITY REVIEW SPECIALIST-Administration RMG-Presence Medica...
Presence Health - 89 reviews - Des Plaines, IL
QUALITY REVIEW SPECIALIST. Completes ambulatory medical record reviews against internal and external performance measures and accreditation standards to ensure...
Hedis Specialist
AmeriHealth Caritas - 104 reviews - Philadelphia, PA
HEDIS experience Knowledge of the NCQA and HEDIS submission process. Minimum 4-5 years working with HEDIS data including:....
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