Hedis Review Nurse $100,000 jobs

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Director of Quality Improvement and Program Management
BMC HealthNet Plan and Well Sense - Boston, MA
Reviews and edits documentation (e.g. Including HEDIS, P4P, CAHPS, and CMS is required. Provides leadership for all activities relating to the development and...
Sponsored by Boston Medical Center HealthNet Plan - 30+ days ago
Psychiatric Medical Director
Molina Healthcare 113 reviews - Midvale, UT
Reviews cases with concurrent review nurses. Reviews quality referred issues, focused reviews and recommends corrective actions....
Sponsored by Molina Healthcare - 22 days ago

Mgr, Health Care QM

Aetna 402 reviews - Beachwood, OH - +1 location
Nursing/Registered Nurse is required. HEDIS and STARs experience is required. Supplemental HEDIS data IT background experience preferred....
6 days ago - save job - email - more...

Medical Director - BH

Molina Healthcare 113 reviews - Bothell, WA
Reviews cases with concurrent review nurses. Reviews quality referred issues, focused reviews and recommends corrective actions....
9 days ago - save job - email - more...

Medical Dir

Molina Healthcare 113 reviews - West Allis, WI - +3 locations
Reviews cases with concurrent review nurses. Reviews quality referred issues, focused reviews and recommends corrective actions....
24 days ago - save job - email - more...

RN Provider Educator

WellMed Medical Mgmt, Inc - San Antonio, TX
Chart review, registered nurse, CPC, san antonio, tx, educator, provider education, sign-on bonus. Performs annual HEDIS chart reviews as determined by Clinical...
WellMed Medical Group - 9 days ago - save job - email - more...

RN, Clinical Claims Review

HealthCare Partners 68 reviews - Torrance, CA
Responsible for review, research and complete retrospective clinical claims review for Commercial, Senior and Medi-Cal products....
6 days ago - save job - email - more...

Director Medicare Stars Quality Program

Aetna 402 reviews - City of Sunrise, FL
Click here to review the benefits associated with this position. Responsible for managing Medicare Stars activities including overseeing a team of nurses....
18 days ago - save job - email - more...

Medical Director - Unicare/Medicaid - WV -SY

Anthem, Inc. 493 reviews - Charleston, WV
Participates in policy review, reviews trends and makes recommendations; Provides support to nurses and clinical leaders in pre-authorization, concurrent and...
24 days ago - save job - email - more...

PRESIDENT MEDICAID HEALTH PLAN

SSI Technical - Waukesha, WI
Oversight and participation in medical management, including hospital census review, medical staffing, seasonality issues, constant and detailed communications...
30+ days ago - save job - email - more...

Medical Dir (MIA)

Molina Healthcare 113 reviews - Miami, FL
Reviews cases with concurrent review nurses. Reviews quality referred issues, focused reviews and recommends corrective actions....
30+ days ago - save job - email - more...

Psychiatric Medical Director

Molina Healthcare 113 reviews - Midvale, UT
Reviews cases with concurrent review nurses. Reviews quality referred issues, focused reviews and recommends corrective actions....
22 days ago - save job - email - more...
Medical Director
Molina Healthcare 113 reviews - Oak Brook, IL
Reviews cases with concurrent review nurses. Reviews quality referred issues, focused reviews and recommends corrective actions....
Sponsored by Molina Healthcare - 27 days ago
QUALITY REVIEW SPECIALIST
Presence Health 40 reviews - Bolingbrook, IL
Complete ambulatory medical record reviews against internal and external performance measures and accreditation standards to ensure they are complete and meet...
Sponsored by Miracle Workers - 1 day ago

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