Hedis Review Nurse $80,000 jobs

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Registered Nurse (RN) - Clinical Quality
Centra Healthcare Solutions - Iselin, NJ
record review, focus studies and surveys.-Performs monthly, quarterly, annual and ad hoc medial record reviews such as HEDIS and CPG compliance;-Conducts...
Sponsored by Centra Healthcare Solutions - 2 days ago
Utilization Manager (Sign-On Bonus)
Centene Corporation 136 reviews - Bedford, NH
review timeliness, Outpatient Treatment Report review... of care and adherence to HEDIS standards. Compile and report daily review activity and facility...
Sponsored by Centene Corporation - 24 days ago

Clinical HEDIS Practice Advisor, RN (Registered Nurse) Santa...

WellCare 74 reviews - Santa Clara, CA - +1 location
HEDIS Practice Advisor, RN (Registered Nurse) Santa... HEDIS medical record review and/or Quality Improvement with experience in clinical data/chart reviews and...
15 days ago - save job - email - more...

Quality Improvement Nurse (QA/RN)

Healthcare Support Staffing 24 reviews - Chicago, IL 60606 (Loop area)
of HEDIS - 2+ years clinical experience - Knowledge of federal and state regulations - Experience with Medicaid and Medicare - Medical record review experience...
CareerBuilder - 1 day ago - save job - email - more...

Quality Improvement Project Manager, New York, NY

WellCare 74 reviews - Manhattan, NY - +1 location
care complaint/adverse event review and assessment of medical record review results and recommend actions... through medical record review. Fields annual member...
3 days ago - save job - email - more...

National Director of Quality

AIDS Healthcare Foundation 40 reviews - Los Angeles, CA
Health plan specific HEDIS, HOS, CAHPS, NCQA SNP... at a minimum DUR, Medicare DDI review, Formulary review, ADR review, and denial/appeal process. Complaint...
10 days ago - save job - email - more...

Sr Dir, Healthcare Quality/Accreditation

Aetna 320 reviews - Phoenix, AZ
knowledge of NCQA and HEDIS management. Years of... Quality Assurance is desired Nursing/Registered Nurse (RN) is desired FUNCTIONAL EXPERIENCES Functional...
9 days ago - save job - email - more...

Sr Dir, Healthcare Quality/Interventions

Aetna 320 reviews - Phoenix, AZ
Sr. Director will use HEDIS analytical expertise and... Quality and Management is desired Nursing/Registered Nurse is required FUNCTIONAL EXPERIENCES Functional...
9 days ago - save job - email - more...

Medical Dir

Molina Healthcare 96 reviews - Albuquerque, NM - +3 locations
Reviews quality referred issues, focused reviews and... support of nurse reviewers and manages the denial process. • Reviews cases with concurrent review nurses...
9 days ago - save job - email - more...

Quality Management Nurse (NJ MCD)

Aetna 320 reviews - Princeton, NJ 08540
participants (e.g., HEDIS/Accreditation) May seek... eligibility may vary by position. Click here to review the benefits associated with this position. Aetna...
25 days ago - save job - email - more...

Medical Management Preauthorization Nurse

Pathway Medical Staffing - Bronx, NY
Please be advised that we are only considering nurses with the following: managed care experience in... care management and HEDIS healthcare professionals...
10 days ago - save job - email - more...

RN QI Specialist III - Interventions

Molina Healthcare 96 reviews - Troy, MI
QI and HEDIS interventions. Essential Functions The position’s essential functions are as follows: • Coordinates the preparation of annual HEDIS medical...
30+ days ago - save job - email - more...
Full Time – Family Nurse Practitioner – Clinic Manager – Cle...
Take Care Health Systems 76 reviews - Mentor, OH
AANP or ANCC as a Family Nurse Practitioner. · Valid... experience preferred (Charge Nurse in Hospital setting, Charge Nurse in Outpatient setting, ER/Urgent Care...
Sponsored by Take Care Health - 23 days ago
Full Time – Family Nurse Practitioner – Clinic Manager – Col...
Take Care Health Systems 76 reviews - Reynoldsburg, OH
AANP or ANCC as a Family Nurse Practitioner. · Valid... experience preferred (Charge Nurse in Hospital setting, Charge Nurse in Outpatient setting, ER/Urgent Care...
Sponsored by Take Care Health - 3 days ago
President Medicaid Health Plan - WI (90270)
WellPoint 417 reviews - Waukesha, WI
hospital census review, medical staffing, seasonality issues, constant and detailed communications with the medical director and nurse leader and monthly...
Sponsored by WellPoint - 4 days ago
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Company with Hedis Review Nurse $80,000 jobs
Centra Healthcare Solutions, Inc. was established with the mission to provide first class staffing services and concierge customer service.
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