Hedis Review Nurse $120,000 jobs

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VP, Enterprise Member Care

CareSource 43 reviews - Dayton, OH
Regulatory, URAC, HEDIS, NCQA and future business related standards. § Current, unrestricted Registered Nurse (RN) licensure in the state of practice is...

Vice President of Care Management

Meridian Health Plan 42 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....

Medical Director - Illinois

Meridian Health Plan 42 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...

Physician (Chief of Medicine/Emergency Department)

Department of Veterans Affairs 1,025 reviews - Dublin, GA
The ED Director/Chief of Medicine will work in a team setting with other physicians, nurse managers, registered nurses and support staff assigned to perform...

Chief Medical Officer

Sinai Health System 9 reviews - Chicago, IL
Familiarity with HEDIS 3 indicators for quality. Chair the Joint Quality and Utilization Review Committees assuring that they are meaningful, efficient, and...

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...

Medical Director - Northern CaliforniaSY

Anthem, Inc. 600 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...

Director Medical Management Medicare

AmeriHealth Caritas 67 reviews - Philadelphia, PA
2 years’ experience in case management and utilization review preferred. Includes focusing staff efforts to contribute to STAR and Hedis measures....

Director of Medical Policy

Surf Search - Irvine, CA
Licensed Nurse Practitioner or Nurse with strong mixture of clinical and healthcare policy development. Creating, developing and implementing workflow and best...

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...
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...
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