Hedis Review Nurse jobs

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Cost Containment Specialist, RN or LPN

PMA Companies - De Witt, NY - +2 locations
used in the bill review process. Review bills in CBR... Utilization Review or de-authorization of treatment to the claims staff Perform clinical review of medical...
11 days ago - save job - block - email - more...

CSHCS Review Nurse

Meridian Health Plan - Michigan
The CSHCS Review Nurse is primarily responsible for identification, review and clinical coordination of... Prior experience with HEDIS/NCQA or CSHCS is a plus...
23 days ago - save job - block - email - more...

Systems Analyst II-HEDIS

Virginia Premier Health Plan, Inc. 12 reviews - Richmond, VA 23220 (The Fan area)
nurse laptops, and external peripheral tools Work with the Quality Project Manager to generate the HEDIS... flow charts and review processes for HEDIS and other...
9 days ago - save job - block - email - more...

Utilization Manager - LCSW, LISW, LMFT, LCPC or RN

- Laconia, NH - +7 locations
review timeliness, Outpatient Treatment Report review... of care and adherence to HEDIS standards. Compile and report daily review activity and facility statistics...
Miracle Workers - 12 days ago - save job - block - email - more...

Nurse Case Manager - P4Q

Cigna 636 reviews - Chicago, IL
NCQA, HEDIS, CQI and/or TQM. Ability to abstract ICD codes. Current RN with Associate's degree in nursing. At least 3 years of experience in quality review and...
5 days ago - save job - block - email - more...

Data Abstractor - Auditor

Pathway Medical Staffing - Belleville, IL - +5 locations
perform accurate and comprehensive medical record review and data abstraction. The healthcare professional... a licensed Registered Nurse or Social Worker in the...
4 days ago - save job - block - email - more...

Registered Nurse (RN) - HEDIS Manager - Clinical Quality

Centra Healthcare Solutions - Iselin, NJ 08830
state to work as the HEDIS Manager for the Quality Management Department. The HEDIS Mgr for the Quality... and external HEDIS quality review activities.-Manages...
6 days ago - save job - block - email - more...

Registered Nurse (RN) - Quality Management Nurse Consultant...

Aetna 320 reviews - City of Sunrise, FL 33323
for the review and evaluation of clinical information and documentation as it relates to HEDIS, CAHPS, HOS, and Medicare Stars. Reviews documentation and...
14 hours ago - save job - block - email - more...

Complex Case Manager

Meridian Health Plan - Chicago, IL 60604 (Loop area) - +1 location
discharge planning, disease management and the review of claims, pharmacy and hospital discharge data. Is... efforts to improve HEDIS measures and Provider...
CareerBuilder - 8 days ago - save job - block - email - more...

Medicare Star Ratings Coordinator

Meridian Health Plan - Michigan
Information Set (HEDIS), CAHPS, and HOS are met. Identify opportunities for improvement in HEDIS, CAHPS... of Medicare guidance review and interpretation...
9 hours ago - save job - block - email - more...
Quality Improvement Outreach Coordinator, RN QI
Managed Care Staffers - Westmont, IL
The QI Nurse participates in the review of all... & HEDIS data. SPECIAL SKILLS AND ABILITIES REQUIRED: Current licensure as a registered nurse in the state...
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Sponsored by Managed Care Staffers - 20 days ago
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