Hedis Review Nurse $120,000 jobs

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Medical Director - Claims
Nexus Healthcare 2 reviews - Seattle, WA
Reviews cases with concurrent review nurses. Reviews quality referred issues, focused reviews and recommends corrective actions....
Sponsored by TheLadders.com - 13 days ago
Director Medical Management Medicare
AmeriHealth Caritas 61 reviews - Philadelphia, PA
2 years’ experience in case management and utilization review preferred. Includes focusing staff efforts to contribute to STAR and Hedis measures....
Sponsored by AmeriHealth Caritas - 30+ days ago
RN, Registered Nurse - Vice President, Quality Improvement
Infinity MedStaff - Sacramento, CA
Responsible for all activities related to National Committee for Quality Assurance (NCQA) Accreditation and/or Healthcare Effectiveness Data and Information Set...
Sponsored by NurseJobsNationwide.com - 3 hours ago

Vice President of Care Management

Meridian Health Plan 41 reviews - Detroit, MI
Current license as a Registered Nurse is required. Review analyses of activities, costs, operations to determine progress toward stated goals and objectives....

Director Medical Management Medicare

AmeriHealth Caritas 61 reviews - Philadelphia, PA
2 years’ experience in case management and utilization review preferred. Includes focusing staff efforts to contribute to STAR and Hedis measures....

RN, Registered Nurse - Vice President, Quality Improvement

Infinity MedStaff - Sacramento, CA
Responsible for all activities related to National Committee for Quality Assurance (NCQA) Accreditation and/or Healthcare Effectiveness Data and Information Set...

Director of Clinical Quality and High Reliability

Providence Health & Services 158 reviews - Everett, WA
Ensure nurses, medical assistants and/or other clinical support personnel are appropriately oriented, trained, and demonstrate competency within their scope of...

Medical Director - Northern CaliforniaSY

Anthem, Inc. 585 reviews - Sacramento, CA - +1 location
Participates in policy review, reviews trends and makes recommendations; Provides support to nurses and clinical leaders in pre-authorization, concurrent and...

East Central Regional Medical Director

Humana 924 reviews - Dublin, OH
Oversee Quality Improvement Department with QI Director as direct report and monitor QI Nurses on HEDIS/STARS metrics improvement with PCP offices and IPAs....

Associate Director of Quality Management

Medical Staffing Network Care Management - New York, NY
Registered Nurse License in the State of New York. Please be advised that we are only considering nurses with the following:....

Medical Director - Unicare/Medicaid - WVSY

Anthem, Inc. 585 reviews - Charleston, WV
Participates in policy review, reviews trends and makes recommendations; Provides support to nurses and clinical leaders in pre-authorization, concurrent and...

Medical Director - Illinois

Meridian Health Plan 41 reviews - Chicago, IL
Offer clinical guidance to the Utilization Management nurses and other staff. Review “clean” files and prepare exception report prior to Credentialing Committee...

Medicaid Health Plan President

MDStaffers.com - Charleston, WV
Oversight and participation in medical management, including hospital census review, medical staffing, seasonality issues, constant and detailed communications...

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Company with Hedis Review Nurse $120,000 jobs
AmeriHealth Caritas is the nation's leader in health care solutions for the underserved and chronically ill for over 30 years.