Hedis Review Nurse jobs in California

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Travel Case Manager RN/Case Manager Registered Nurse
Medical Staffing Network 343 reviews - San Jose, CA
Current state registered nurse license. Hospital case management utilization review experience. Travel Case Manager RN/Case Manager Registered Nurse....
Sponsored by Medical Staffing Network
Clinical Quality Nurse
Sutter Health 242 reviews - Modesto, CA
Knowledge in the principles of NCQA (Pay for Performance) and HEDIS quality measures. Assists with other functions of the Quality Department including but not...
Sponsored by Sutter Health
Vice President - Clinical Services - Work Remotely
Gorman Health Group - United States
Must have at least 10 years of clinical experience as a licensed vocational orregistered nurse in addition to the requirements below....
Easily apply
Sponsored by Gorman Health Group

Quality Improvement Nurse

Alignment Healthcare - Orange, CA
Quality Improvement Nurse. Knowledge of Medicare Managed Care Plans, NCQA and HEDIS. Assists various departments with annual quality related projects (internal...

HEDIS Abstractor -External Audits and Quality Control

L.A. Care Health Plan 18 reviews - Los Angeles, CA
The HEDIS Abstractor, External Audits and Quality Control conducts validation and production checks on medical records abstracted for the HEDIS Project and...

Clinical HEDIS Practice Advisor - Registered Nurse (RN)

WellCare 130 reviews - Cypress, CA
Required 2 years of experience in directly related HEDIS medical record review and/or Quality Improvement with experience in clinical data/chart reviews and...

Orange Inpatient Concurrent Review Nurse (RN or LVN) – Manag...

CareNational Healthcare Services, LLC - Orange, CA
$65,000 - $75,000 a year
Perform Utilization Review pre-authorization, concurrent and retrospective review as needed for inpatient or outpatient services and predetermination reviews....
Easily apply

San Francisco Utilization Review Nurse (RN) - Managed Care

CareNational Healthcare Services, LLC - San Francisco, CA
$90,000 - $100,000 a year
The Utilization Review Nurse is responsible for utilization management and utilization review for prospective, concurrent, or retrospective review....
Easily apply

Temporary - Quality Improvement Nurse - Facility Site Review

Central California Alliance for Health 6 reviews - Scotts Valley, CA
Facility Site Review Certification preferred. Ensuring patient safety through Facility Site Review (FSR) and Medical Record Review (MRR) and Physical...

Utilization Review Nurse - 90,000k

ALL's WELL 12 reviews - Oakland, CA 94601 (Harrington area)
Apply for this great position as a Utilization Review Nurse today! We are in search for nurses with utilization review, discharge planning and Interqual/HEDIS...

Supervisor QI Compliance - HP

Molina Healthcare 159 reviews - Long Beach, CA
HEDIS reporting or collection. Registered Nurse with active State License. Provider credentialing, PQOC and Grievance and Appeals review....

Medical Record Field Reviewer

Altegra Health 91 reviews - Bakersfield, CA  +1 location
Medical Record Reviews (Accreditation). Accurately and efficiently conduct medical record review services. Scan relevant components of the medical record to...

Senior Manager, HOA Quality Performance Management

L.A. Care Health Plan 18 reviews - Los Angeles, CA
The Senior Manager, Quality Performance Management is responsible for managing the HEDIS and CAHPS data and operations staff which includes overseeing the HEDIS...
Senior Manager, HOA Quality Performance Management
L.A. Care Health Plan 18 reviews - Los Angeles, CA
The Senior Manager, Quality Performance Management is responsible for managing the HEDIS and CAHPS data and operations staff which includes overseeing the HEDIS...
Sponsored by L.A. Care Health Plan
Quality Assessment Manager
Chinese Community Health Plan - San Francisco, CA
Q Registered Nurse with current CA California license. Monitors member access to provider network through HEDIS practitioner turnover measures;...
Easily apply
Sponsored by Chinese Community Health Plan

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Company with Hedis Review Nurse jobs
Gorman Health Group, LLC is a leading consulting and software solutions firm specializing in government health programs.