- CenterWell (Orlando, FL)
- …preferred, not required, unless otherwise specified + Proven work experience as a HEDIS Nurse or similar role in healthcare quality improvement + Excellent ... across the following areas: + Quality/clinical management and population health + HEDIS and Stars performance + Operational improvements + Data sharing and… more
- CenterWell (New Smyrna Beach, FL)
- …Florida + 5+ years of clinical nursing experience + Proven work experience as a HEDIS Nurse or similar role in healthcare quality improvement + Strong knowledge ... following areas: + Quality/clinical management and population health + HEDIS and Stars performance + Operational improvements + Financial...of HEDIS /Stars/CMS + Excellent presentation and communication skills, both oral… more
- CenterWell (Orange Park, FL)
- …part of our caring community and help us put health first** The Nurse Practitioner applies advanced education and clinical competencies to achieve optimal patient ... outcomes. The Nurse Practitioner works on problems of diverse scope and...license and/or Medicaid and Medicare numbers + Familiarity with HEDIS quality indicators and Medicare guidelines. **Compensation & Benefits**… more
- CenterWell (Boynton Beach, FL)
- …two to five years directly applicable experience + Successful completion of a nurse practitioner program with board certification + Active, unrestricted nurse ... environment. + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators. **Additional Information** + Base salary + bi-annual bonus +… more
- CenterWell (Coral Springs, FL)
- **Become a part of our caring community and help us put health first** The Nurse Practitioner (NP) works in our team-based care environment. We are a value based ... team consists of doctors, advanced practice professionals, Pharm D, Care Coach Nurse , MA, Behavioral health specialist, Quality based Coder, Referral Coordinator and… more
- Community Health Systems (Naples, FL)
- Join us as a **Registered Nurse (RN) - Utilization Review position** at Physicians Regional Collier Unit: Utilization Review Shift: Mon-Fri (this is an onsite ... available for Full and Part-Time roles **Job Summary** The Utilization Review Nurse - RN reviews hospital admissions, extended stays, and supporting documentation to… more
- CVS Health (Tallahassee, FL)
- …related role. + 2+ years of process improvement experience related to HEDIS measures. + In-depth knowledge of healthcare regulations, clinical operations, quality ... VPN. **Preferred Qualifications:** + Licensed Allied Health Professional or Licensed Registered Nurse + Coding or Sales background + Certified Six Sigma Green Belt… more
- ChenMed (Tampa, FL)
- …and execution of business strategies that increase revenue and quality ratings ( HEDIS /STARS/Clinical Gaps) and support our core model. + Develops protocols and ... healthcare related field preferred + Active and good standing Licensed Practical Nurse (LPN) in current state of employment **OR** a nationally accredited Certified… more
- University of Miami (Miami, FL)
- …supervises advance d practice providers (APPs) ( ie, Advanced Registered Nurse Practitioners, Physician Assistants etc.). Key responsibilities of this position ... + Completion of Medicare annual wellness exam documentation preferred + Knowledge of HEDIS Quality Care Gaps - review and closure preferred + Knowledge of… more
- Molina Healthcare (Tampa, FL)
- …Chief Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review, and manages the denial ... policy/procedure development, provider contracting experience. + Experience with NCQA, HEDIS , Medicaid, Medicare and Pharmacy benefit management, Group/IPA practice,… more